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Gross Anatomy II > Exam II > Flashcards

Exam II Flashcards

1
Q

The larynx is primarily made of what type of cartilage?

A

Hyaline

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2
Q

What are the functions of the larynx?

A
  • Prevents the passage of food into the airway during swallowing
  • Regulates the flow of air into the lungs
  • Functions in vocalization
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3
Q

What levels of the spinal column is the larynx located?

A

Between C3 and C6

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4
Q

This is a single cartilage of the larynx which presents the superior thyroid notch, inferior thyroid notch, anterior medial elevation, superior horn, inferior horn , laminae, and oblique line.

A

Thyroid cartilage

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5
Q

This feature of the thyroid cartilage of the larynx is also called the laryngeal prominence.

A

Anterior median elevation

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6
Q

This feature of the thyroid cartilage of the larynx attaches to the greater horn of the hyoid bone.

A

Superior horn

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7
Q

This feature of the thyroid cartilage of the larynx articulates with the cricoid cartilage.

A

Inferior horn

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8
Q

This feature of the thyroid cartilage of the larynx is located on the external surface of the lamina and provides attachment for the inferior constrictor, sternothryoid, and thyrohyoid muscles.

A

Oblique line

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9
Q

This is a single cartilage of the larynx, which is shaped like a signet ring. It consists of a narrow anterior arch and a broad, posterior lamina. It is the most inferior of the laryngeal cartilages.

A

Cricoid cartilage (C6 level)

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10
Q

This is a single spoon-shaped cartilage of the larynx, which lies behind the root of the tongue and body of the hyoid bone.

A

Epiglottic cartilage

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11
Q

The lower end of the epiglottic cartilage is attached to the back of the laryngeal prominence of the thyroid cartilage by what structure?

A

Thyroepiglottic ligament

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12
Q

These are paired cartilages of the larynx that are pyramidal in shape. Their bases articulate with the cricoid cartilage and each one presents a vocal and muscular process.

A

Arytenoid cartilages

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13
Q

The vocal process of the arytenoid cartilages give attachment to what structure? Muscular process?

A

Vocal ligament; intrinsic muscles of the larynx

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14
Q

These are paired cartilages of the larynx which lie on the apices of the arytenoid cartilages, and are closed within the aryepiglottic folds.

A

Corniculate cartilages

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15
Q

These are paired cartilages of the larynx which lied in the aryepiglottic folds anterior to the corniculate cartilages.

A

Cuneiform cartilages

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16
Q

What two cartilages of the larynx have the potential to ossify and be mistaken as a fracture on an X-ray?

A

Corniculate and cuneiform cartilages

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17
Q

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

A

Cricothyroid joint

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18
Q

This is a synovial joint of the larynx between the upper border of the cricoid cartilage and the base of thd arytenoid cartilage. It permits gliding and rotation of the arytenoid cartilage on the cricoid cartilage.

A

Cricoarytenoid joint

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19
Q

This is a ligament of the larynx that extends from the thyroid cartilage to the hyoid bone. It is pierced on each side by the internal laryngeal nerve and the superior laryngeal vessels.

A

Thryohyoid membrane

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20
Q

This is a ligament of the larynx that extends from the arch of the cricoid cartilage to the thyroid cartilage.

A

Median cricothyroid ligament

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21
Q

This is a ligament of the larynx that extends from teh thyroid cartilage in front to the vocal process of the arytenoid cartilage behind.

A

Vocal ligament

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22
Q

This is a ligament/fibroelastic membrane of the larynx which extends upward from the cricoid cartilage to the vocal ligament. The vocal ligament forms the free edge of this membrane.

A

Conus elasticus (cricovocal membrane, lateral cricothyroid ligament)

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23
Q

This is a ligament of the larynx which connects the epiglottic cartilage to the arytenoid cartilage on each side.

A

Quadrangular membrane

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24
Q

This margin of the quadrangular membrane of the larynx form the aryepiglottic ligament within the aryepiglottic fold.`

A

Superior margin

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25
Q

This margin of the quadrangular membrane forms the vestibular ligament within the vestibular ligament.

A

Inferior margin

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26
Q

What are the two pairs of folds within the larynx?

A
  • Vestibular folds (false vocal cords, protective in function and initiates the cough reflex)
  • Vocal cords (true vocal cords)
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27
Q

This is the space between the vestibular folds.

A

Rima vestibuli

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28
Q

This is the space between the vocal folds. It is the narrowest part of the laryngeal cavity.

A

Rima glottidis

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29
Q

This includes the rima glottidis and vocal folds.

A

Glottis

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30
Q

The larynx is divided into three cavities by the vestibular and vocal folds, what are they?

A

Laryngeal vestibule: extends from the laryngeal inlet to the vestibular folds
Laryngeal ventricles: lie between the vestibular folds and vocal folds
Infraglottic cavity: extends from the vocal folds to the inferior border of the cricoid cartilage

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31
Q

This is a small diverticulum within the laryngeal ventricle. It contains glands which lubricate the vocal folds. It has been called the “oil can” of the vocal folds.

A

Laryngeal saccule

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32
Q

What are the elevators of the larynx?

A

Thyrohyoid, stylohyoid, mylohyoid, digastric, stylopharyngeus, palatopharyngeus

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33
Q

What are the depressors of the larynx?

A

Omohyoid, sternohyoid, and sternothryoid

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34
Q

The elevators and depressors of the larynx can be considered what type of muscles?

A

Extrinsic muscles of the larynx

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35
Q

What are the intrinsic muscles of the larynx (important for speech)?

A

Cricothyroid, posterior cricoarytenoid, lateral cricoarytenoid, transverse arytenoid, oblique arytenoid, aryepiglottic, thyroepiglottic, thyroarytenoid, and vocalis

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36
Q

What is the origin of the cricothyroid muscle?

A

Cricoid cartilage

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37
Q

What is the insertion of the cricothryoid muscle?

A

Inferior horn and lower lamina of the thyroid cartilage

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38
Q

What is the innervation of the cricothyroid muscle?

A

External laryngeal nerve

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39
Q

What is the function of the cricothyroid muscle?

A

Tilts the thyroid cartilage downward or cricoid cartilage upward thereby tensing the vocal cords and raising the pitch of the voice.

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40
Q

What is the origin of the posterior cricoarytenoid muscle?

A

Posterior surface of the lamina of the cricoid cartilage

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41
Q

What is the insertion of the posterior cricoarytenoid muscle?

A

Muscular process of arytenoid cartilage

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42
Q

What is the innervation of the posterior cricoarytenoid muscle?

A

Muscular process of arytenoid cartilage

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43
Q

What is the function of the posterior cricoarytenoid cartilage?

A

Abducts the vocal folds

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44
Q

What is the neutral position of the vocal folds? Why?

A

They are partially abducted to reduce the risk of suffocation

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45
Q

What is the origin of the lateral cricoarytenoid muscle?

A

Arch of the cricoid cartilage

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46
Q

What is the insertion of the lateral cricoarytenoid muscle?

A

Muscular process of arytenoid cartilage

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47
Q

What is the innervation of the lateral cricoarytenoid muscle?

A

Recurrent laryngeal nerve

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48
Q

What is the function of the lateral cricoarytenoid muscle?

A

Adducts the vocal cords and functions in whispering

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49
Q

What is the origin of the transverse arytenoid muscle?

A

Posterior surface of the arytenoid cartilage

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50
Q

What is the insertion of the transverse arytenoid muscle?

A

Posterior surface of the opposite arytenoid cartilage

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51
Q

What is the innervation of the transverse arytenoid muscle?

A

Recurrent laryngeal nerve

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52
Q

What is the function of the transverse arytenoid muscle?

A

Adducts the vocal folds and functions in coughing to clear the airway

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53
Q

What is the origin of the oblique arytenoid muscle?

A

Muscular process of arytenoid cartilage

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54
Q

What is the insertion of the oblique arytenoid muscle?

A

Apex of the opposite arytenoid cartilage

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55
Q

What is the innervation of the oblique arytenoid muscle?

A

Recurrent laryngeal nerve

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56
Q

What is the function of the oblique arytenoid muscle?

A

Adducts the vocal folds

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57
Q

What is the origin of the aryepiglottic muscle?

A

Apex of the arytenoid cartilage

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58
Q

What is the insertion of the aryepiglottic muscle?

A

Side of the epiglottic cartilage

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59
Q

What is the innervation of the aryepiglottic muscle?

A

Recurrent laryngeal nerve

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60
Q

What is the function of the aryepiglottic muscle?

A

Closes the laryngeal inlet

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61
Q

The aryepiglottic muscle is a continuation of the ____ and lies within the aryepiglottic fold.

A

Oblique arytenoid

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62
Q

What is the origin of the thyroepiglottic muscle?

A

Inner surface of the thyroid lamina

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63
Q

What is the insertion of the thyroepiglottic muscle?

A

Lateral margin of the epiglottis

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64
Q

What is the innervation of the thyroepiglottic muscle?

A

Recurrent laryngeal nerve

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65
Q

What is the function of the thyroepiglottic muscle?

A

Opens the laryngeal inlet

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66
Q

What is the origin of the thyroarytenoid muscle?

A

Inner surface of the thyroid lamina

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67
Q

What is the insertion of the thyroarytenoid muscle?

A

Arytenoid cartilage

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68
Q

What is the innervation of the thyroarytenoid muscle?

A

Recurrent laryngeal nerve

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69
Q

What is the function of the thyroarytenoid muscle?

A

Shortens and relaxes the vocal folds by drawing the arytenoid cartilages forward.

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70
Q

What is the origin of the vocalis muscle?

A

Inner surface of the thyroid lamina

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71
Q

What is the insertion of the vocalis muscle?

A

Vocal process of arytenoid cartilage

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72
Q

What is the innervation of the vocalis muscle?

A

Recurrent laryngeal nerve

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73
Q

What is the function of the vocalis muscle?

A

Adjusts the tension of the vocal cords during phonation. Fine tuning control of the vocal cords

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74
Q

The size and shape of the rima glottidis is altered during phonation and respiration by movements of what?

A

Artenoid cartilages

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75
Q

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

A

Wide; narrow and wedge shaped

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76
Q

Voice dimorphism is determined by what three factors?

A
  • Length of the vocal cords
  • Size of resonating chambers
  • Thickness of the vocal cords (have androgen receptors)
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77
Q

This nerve is motor to all of the intrinsic muscles of the larynx except the cricothyroid. It is sensory to the mucosa of the larynx below the vocal fold.

A

Recurrent laryngeal nerve

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78
Q

This is a branch of the superior laryngeal nerve. It is sensory to the mucosa of the larynx above the vocal folds. Along with the superior laryngeal artery it pierces the thyrohyoid membrane to enter the larynx.

A

Internal laryngeal nerve

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79
Q

This is the other branch of the superior laryngeal nerve. It is motor to the cricothyroid and inferior constrictor muscles.

A

External laryngeal nerve

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80
Q

What two arteries primarily supply the larynx?

A
  • Superior laryngeal artery from the superior thyroid artery

- Inferior laryngeal artery from the inferior thyroid artery

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81
Q

What are the three main functions of the lymphatic system?

A
  • It picks up protein molecules from tissue fluid which are too large to pass through capillaries and transports them to the bloodstream
  • It returns excess tissue fluid to the bloodstream
  • It produces lymphocytes
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82
Q

These are swellings found along the lymphatic system. They produce lymphocytes and acct as filters for the lymph, preventing foreign bodies from entering the bloodstream.

A

Lymph nodes

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83
Q

These vessels drain lymph to a node.

A

Afferent lymph vessels

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84
Q

These vessels drain lymph from a node.

A

Efferent lymph vessels

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85
Q

What are the superficial lymph nodes of the head?

A

Occipital: apex of the posterior triangle
Mastoid: over the mastoid process
Parotid: in front of the ear on the surface of the parotid gland

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86
Q

What are the superficial lymph nodes of the neck?

A

Submandicular: submandibular triangle
Submental: submental triangle
Anterior cervical
Superficial cervical: chain of nodes on the external surface of the SCM and follows the course of the external jugular vein.

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87
Q

How is lymph moved throughout the body?

A

Skeletal muscle contractions

  • Exercise clears toxins from tissue
  • Health benefits of massage
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88
Q

Where are the deep cervical nodes located?

A

Within the carotid sheath and they follow the course of the internal jugular vein

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89
Q

What are the two largest deep cervical nodes?

A
  • Jugulodigastric node

- Jugulo-omohyoid node

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90
Q

This deep cervical node drains the tongue and the palatine tonsils. It is found near the posterior belly of the digastric muscle.

A

Jugulodigastric node

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91
Q

This deep cervical node also drains the tongue and is found near the intermediate tendon of the omohyoid.

A

Jugulo-omohyoid node

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92
Q

All lymphatics of the head and neck drain either directly or indirectly into what?

A

The deep cervical nodes

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93
Q

This lymphatic vessel drains into the junction between the internal jugular and subclavian veins.

A

Right jugular trunk

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94
Q

This is the larges lymphatic vessel in the body and drains into the junction between the internal jugular and subclavian veins.

A

Left jugular trunk

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95
Q

Afferents of these lymph nodes drain the central portions of the lower lip, the floor of teh mout, adn the tip of the tongue.

A

Submental nodes

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96
Q

Afferents of these lymph nodes drain the cheek, the side of the nose, the upper lip, the lateral part of the lower lip, the gums, and the margin of the tongue.

A

Submandibular nodes

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97
Q

This term refers to the spread of cancer via the lymphatic system.

A

Lymphogenous metastasis

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98
Q

This is an enlarge supraclavicular node, usually on the left side and is often the first indication of a visceral tumor of teh thorax or abdomen.

A

Signal (Sentinel) node

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99
Q

This is a primary tumor of the lymph nodes. It has Hodgkin’s and Non-Hodgkins variants.

A

Lymphoma

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100
Q

If a lymph node is tender or painful upon palpating, what does this indicate? If its hard and painless?

A

It indicates infection; it indicates cyst development or cancer

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101
Q

The breast is an epidermally derived structure which consists of what parts?

A

Mammary glands, fat, fibrous tissue

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102
Q

This is a vertical line dividing the armpit into anterior and posterior halves.

A

Midaxillary line

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103
Q

This is a ring of pigmented skin which surrounds the nipple.

A

Areola

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104
Q

This is the portion of the breast which extends back into the armpit. This is a frequent site for cancer.

A

Axillary process (tail)

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105
Q

These are strong fibrous septa which support the breast and which run through the breast from the skin to the deep layer of superficial fascia.

A

Suspensory ligaments

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106
Q

This is a modified sweat gland located in the superficial fascia of the breast. Each gland has 15 to 20 lobes of glandular tissue which open onto the tip of the nipple through a lactiferous duct.

A

Mammary gland

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107
Q

This is an expansion of the lactiferous duct, which serves as a reservoir for milk during lactation.

A

Lactiferous sinus

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108
Q

What is the blood supply to the breast?

A
  • Internal thoracic artery
  • Thoracoacromial artery
  • Lateral thoracic artery
  • Intercostal arteries
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109
Q

What is the lymphatic drainage of the breast?

A
  • Axillary nodes (75% drain from these nodes)
  • Parasternal nodes
  • Nodes of the opposite breast
  • Nodes of the anterior abdominal wall
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110
Q

What are the clinical signs of breast cancer?

A
  • Dimpling (due to invasion of suspensory ligaments)
  • Inverted nipple (due to invasion of lactiferous ducts)
  • Leathery thickening of the skin (like an orange)
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111
Q

Chiropractic Note: Breast cancer is one cause of _____ in a female.

A

Mid thoracic back pain

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112
Q

This bone of the thoracic wall contains bone marrow and is a major site of red blood cell production.

A

Sternum

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113
Q

This is the widest and thickest part of the sternum. Its upper border forms the jugular notch.

A

Manubrium

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114
Q

This part of the sternum articulates with the second to seventh costal cartilages.

A

Body

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115
Q

This part of the sternum is cartilaginous at birth and slowly ossifies throughout life. It is a site of muscle attachment for the diaphragm and rectus abdominus and is sometimes broken during CPR.

A

Xiphoid process

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116
Q

What are some structural variations that the xiphoid process can exhibit?

A
  • Bifid xiphoid process

- Xiphoid foramen

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117
Q

The articulation of the manubrium with the body of the sternum forms what feature?

A

Sternal angle

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118
Q

The sternal angle is found at the level of the intervertebral disc between what vertebrae?

A

T4 and T5

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119
Q

What condition can result in a larger sternal angle (Barrel chest)?

A

COPD

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120
Q

What is the superior thoracic aperture bounded by?

A

Manubrium, first rib, and first thoracic vertebrae

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121
Q

What is the inferior thoracic aperture is bounded by?

A

Xiphoid process, costal margin, twelfth rib, distal end of the eleventh rib, and twelfth thoracic vertebra

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122
Q

What are the true ribs?

A

Ribs 1-7 which articulate with the sternum directly through their own costal cartilages

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123
Q

What are the false ribs?

A
  • Ribs 8-10 which articulate with the sternum indirectly by attaching to the costal cartilage of the rib above
  • Ribs 11 and 12 which are not connected to the sternum at all. These are often referred to as floating ribs
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124
Q

Morphologically, what are the typical ribs?

A

Ribs 3-9

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125
Q

Morphologically, what are the atypical ribs?

A

Ribs 1, 2, 10, 11, and 12

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126
Q

What are the functions of the thoracic cage?

A
  • Protection of thoracic and upper abdominal organs
  • Muscle attachments
  • Respiration
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127
Q

What is the origin of the external intercostal muscle?

A

Lower border of ribs 1-11

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128
Q

What is the insertion of the external intercostal muscle?

A

Upper border of ribs 2-12

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129
Q

What is the innervation of the external intercostal muscle?

A

Corresponding intercostal nerve

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130
Q

What is the function of the external intercostal muscle?

A

Elevates the ribs in inspiration

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131
Q

What is the origin of the internal intercostal muscle?

A

The upper border of ribs 2-12

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132
Q

What is the insertion of the internal intercostal muscle?

A

The lower border of ribs 1-11

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133
Q

What is the innervation of the internal intercostal muscle?

A

Corresponding intercostal nerve

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134
Q

What is the function of the internal intercostal muscle?

A

Depresses the ribs in forced expiration

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135
Q

What is the origin of the innermost intercostal muscle?

A

The upper border of ribs 2-12

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136
Q

What is the insertion of the innermost intercostal muscle?

A

The lower border of ribs 1-11

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137
Q

What is the innervation of the innermost intercostal muscle?

A

Corresponding intercostal nerve

138
Q

What is the function of the innermost intercostal muscle?

A

Depresses the ribs in forced expiration

139
Q

What is the origin of the subcostalis muscle?

A

Inner surface of the ribs near their angles

140
Q

What is the insertion of the subcostalis muscle?

A

The muscle crosses a rib without inserting and then inserts into the rib above that

141
Q

What is the innervation of the subcostalis muscle?

A

Intercostal nerve

142
Q

What is the function of the subcostalis muscle?

A

Depresses the ribs in forced expiration

143
Q

What is the origin of the transversus thoracis muscle?

A

Posterior surface of the lower sternal body and xiphoid process

144
Q

What is the insertion of the transversus thoracis muscle?

A

Inner surface of costal cartilages 2-6

145
Q

What is the innervation of the transversus thoracis muscle?

A

Intercostal nerve

146
Q

What is the action of the transversus thoracis muscle?

A

Depresses the ribs in forced expiration

147
Q

What is the arterial supply of the anterior aspect of the thoracic wall?

A

Internal Thoracic Artery (from subclavian)

  • pericardicophrenic artery: accompanies the phrenic nerve, supplies the pleura, pericardium, and diaphragm
  • anterior intercostal arteries: supply the upper 6 intercostal spaces, anastomose with the posterior intercostal arteries
  • musculophrenic artery: lateral terminal branch of the internal thoracic artery
  • superior epigastric artery: medial terminal branch of the internal thoracic artery
148
Q

What is the arterial supply of the posterior aspect of the thoracic wall?

A
  • Supreme (superior) intercostal artery (from the costocervical trunk): branches into the first and second posterior intercostal arteries
  • Third through eleventh posterior intercostal arteries (arise directly from the thoracic aorta)
  • Subcostal artery (also from the thoracic aorta): lies below the 12th rib
149
Q

What is the venous drainage of the anterior aspect of the thoracic wall?

A

Internal thoracic vein (into the brachicephalic vein)

150
Q

What is the venous drainage of the posterior aspect of the thoracic wall?

A

The azygos system of veins

151
Q

What is the azygos system of veins on the right side of the body?

A
  • 1st posterior intercostal drains into the brachiocephalic vein
  • 2nd and 3rd posterior intercostal veins join together to form the superior intercostal vein which then drains into the azygos vein
  • 4th through 11th posterior intercostal veins and the subcostal vein drain directly into the azygos vein
152
Q

What is the azygos system of veins on the left side of the body?

A
  • 1st posterior intercostal drains into the brachiocephalic vein
  • 2nd and 3rd posterior intercostal veins join together to form the superior intercostal vein which drains into the left brachiocephalic vein
  • 9th through 11th posterior intercostal veins and the subcostal vein join to form the hemiazygos vein which drains into the azygos vein
153
Q

What are the nerves of the thoracic wall?

A
  • Intercostal nerve: the anterior primary rami of the first 11 thoracic spinal nerves
  • Subcostal nerve: the anterior primary ramus of the 12th thoracic spinal nerve
154
Q

What are the layers of the thoracic wall?

A
  • Skin
  • Superficial fasica
  • Deep fascia
  • Serratus anterior
  • External intercostal muscle
  • Internal intercostal muscle
  • Innermost intercostal muscle
  • Endothoracic fascia
  • Parietal pleura
  • Pleural cavity
  • Visceral pleura
  • Lung
155
Q

What is the function of the endothoracic fascia?

A

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

156
Q

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

A

Suprapleural membrane

157
Q

What are the contents of the typical intercostal space?

A

Intercostal vein, intercostal artery, intercostal nerve

158
Q

What three cavities does the thoracic cavity divide into?

A
  • 2 pleural cavities, each of which surrounds a lung

- 1 mediastinum

159
Q

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

A

Mediastinum

160
Q

This type of pleura lines the inner surface of the thorax.

A

Parietal pleura

161
Q

This type of pleura intimately invests the lung

A

Visceral pleura

162
Q

This is a potential space between the parietal and visceral pleurae.

A

Pleural cavity

163
Q

This substance lubricates the pleurae to minimize friction between the parietal and visceral layers, facilitating movement of the lungs.

A

Pleural fluid

164
Q

What are the four parts of the parietal pleura?

A
  • Costal pleura
  • Mediastinal pleura
  • Diaphragmatic pleura
  • Cervical pleura (portion which overlies the apex of the lung)
165
Q

Where does the parietal pleura receive its blood and nerve supply? Visceral pleura?

A

Parietal pleura from the body wall

Visceral pleura from the organs they cover

166
Q

This is the space formed where the costal and diaphragmatic pleurae meet. It is located at the midaxillary line.

A

Costodiaphragmatic recess

167
Q

This is the space formed where the costal and diaphragmatic pleurae meet. It is located at the midaxillary line.

A

Costomediastinal recess

168
Q

Fluid tends to accumulate in what recess? It can be removed by thoracentesis done at intercostal space 9, during expiration.

A

Costodiaphragmatic recess

169
Q

What is the blood supply of the parietal pleura of the lungs?

A

Supplied by the intercostal areteries, internal thoracic artery, and superior phrenic artery

170
Q

What is the blood supply of the visceral pleura of the lungs?

A

Supplied by the bronchial artery

171
Q

What is the innervation of the parietal pleura of the lungs?

A

Intercostal nerves, subcostal nerve, and phrenic nerve. The parietal pleura is highly sensitive to pain.

172
Q

What is the innervation of the visceral pleura of the lungs?

A

No sensory innervation. It is insensitive to pain.

173
Q

This condition is characterized by pleural cavities filling with air. It can be caused by trauma, disease, or a congenital weak spot. A hole is typically present.

A

Pneumothorax

174
Q

This condition is characterized by pleural cavities filling with air, but instead of a hole being present a flap on the visceral pleura is there resulting in air being unable to leave the pleural cavity.

A

Tension pneumothorax

175
Q

This condition is characterized by pleural cavities filling with blood.

A

Hemothorax

176
Q

All types of pneumothorax eventually result in what?

A

Atelectasis (lung collapse)

177
Q

This is an inflammation of the pleurae which leads to adhesions between parietal and visceral pleura. It produces a sound known as a pleural friction rub, which can be heard on auscultation.

A

Pleuritis

178
Q

Pain is often referred to the shoulder in pleuritis via what nerve? It can also radiate along the distribution of what other nerves?

A

Phrenic nerve (C3, C4, C5); supraclavicular nerves (C3, C4)

179
Q

Topographically the sternal angle is an important landmark because it indicates the level of what?

A
  • Boundary between the superior and inferior mediastinum
  • Articulation of the second rib with the sternum
  • Aortic arch
  • Bifurcation of the trachea into the left and right main bronchi
  • Upper border of the pulmonary trunk
180
Q

An imaginary plane passed from the sternal angle through the intervertebral disk between ____ and ____ divides the mediastinum into the superior and inferior mediastinum.

A

T4 and T5

181
Q

What are the contents of the superior mediastinum?

A
  • Superior vena cava
  • Brachiocephalic veins
  • Arch of the aorta (and its branches)
  • Thoracic duct
  • Trachea
  • Esophagus
  • Thymus
  • Vagus nerve
  • Left recurrent laryngeal nerve
  • Phrenic nerve
182
Q

What are the three subdivisions of the inferior mediastinum?

A
  • Anterior mediastinum
  • Middle mediastinum
  • Posterior mediastinum
183
Q

The anterior mediastinum lies anterior to the pericardial sac and posterior to the sternum. What are its contents?

A
  • Thymus
  • Lymph nodes (parasternal nodes are enlarged in breast and lung cancer)
  • Sternopericardial ligaments
184
Q

The middle mediastinum is bounded by the pericardial sac. What are its contents?

A
  • Heart
  • Pericardium
  • Roots of the great vessels
  • Main bronchi
  • Phrenic nerve
185
Q

The posterior mediastinum lies posterior to the pericardial sac and anterior to T5-T12. What are its contents?

A
  • Esophagus
  • Thoracic aorta
  • Azygos vein
  • Hemiazygos vein
  • Thoracic duct
  • Vagus nerve
  • Splanchnic nerves (from sympathetic trunk)
186
Q

Where does the trachea begin?

A

At the inferior border of the cricoid cartilage (C6)

187
Q

Where does the trachea bifurcate into the left and right main bronchi?

A

The level of the sternal angle (T4 and T5)

188
Q

This is a prominent ridge located within the trachea at its bifurcation, which separates the openings of the right and left main bronchi.

A

Carina

189
Q

The trachea deviates to the right just before its bifurcation at the sternal angle due to what structure?

A

The aortic arch

190
Q

This bronchus is shorter, wider, and more vertical than the other. It passes under the arch of the azygos vein and gives off the superior lobar bronchus before entering the hilum of the lung. It divides into the middle and inferior lobar bronchi within the hilum.

A

Right main bronchus

191
Q

The right main bronchus has three lobar bronchi which then divide into how many segmental bronchi?

A

10

192
Q

This bronchus is longer, narrower, and more horizontal than the other. It passes anterior to the esophagus and divides into superior and inferior lobar bronchi within the hilum of the lung.

A

Left main bronchus

193
Q

The left main bronchus has two lobar bronchi which then divide into how many segmental bronchi?

A

10

194
Q

What is the lowest part in the tracheobronchial tree where the cough reflex is mechanically initiated?

A

Carina

195
Q

Aspiration of foreign objects is more common in which main bronchus?

A

Right main bronchus due to its wide, short, vertical arrangement

196
Q

What is the blood supply and innervation of the trachea?

A

Blood supply: inferior thyroid artery and bronchial arteries

Innervation: Vagus nerve (parasympathetic and pain fibers) and sympathetic trunk

197
Q

The root of the lung is formed by the structures which pass through the hilum. It connects the lungs to what structures?

A

Heart and trachea

198
Q

What specific structures form the root of the lung?

A
  • Bronchi (posterior)
  • Pulmonary vessels (pulmonary arteries (superior) and pulmonary veins (anterior and inferior)
  • Bronchial vessels
  • Nerves
  • Lymphatics
199
Q

The root of the lung is covered with pleura, which is prolonged downward as a double layered membrane called what?

A

Pulmonary ligament

200
Q

Each lung has how many bronchopulmonary segments?

A

10

201
Q

How many lobes does the right lung have? Where are they located in relation to the fissures of the right lung?

A

Three

Superior Lobe: above the horizontal fissure
Middle Lobe: between the horizontal and oblique fissure
Inferior Lobe: below the oblique fissure

202
Q

What are the characteristic features of the right lung?

A
  • Groove for the azygos vein
  • Groove for the esophagus
  • Cardiac impression (shallow)
  • Groove for the superior vena cava
  • Groove for the right brachiocephalic vein
203
Q

How many lobes does the right lung have? Where are they located in relation to the fissures of the left lung?

A

Two

Superior Lobe: above the oblique fissure
Inferior Lobe: below the oblique fissure

204
Q

What are the characteristic features of the left lung?

A
  • Lingula
  • Cardiac notch
  • Cardiac impression (deep)
  • Groove for the aorta
  • Groove for the left subclavian artery
205
Q

Bronchopulmonary segments are the functional units of the lung. What are they composed of?

A
  • Segmental bronchus
  • Branch of the pulmonary artery
  • Segment of lung tissue
  • Surrounding septum
206
Q

What is the arterial and venous supply of the lungs?

A

Arterial: bronchial arteries (from the thoracic aorta)
Venous: bronchial veins (to the azygos and accessory hemiazygos veins)

207
Q

What is the structure and primary tissue of the tracheobronchial tree from biggest to smallest?

A 
Trachea: cartilageous rings
Main bronchi: cartilagenous rings
Lobar bronchi: cartilagenous plates
Segmental bronchi: smooth muscle
Bronchioles: smooth muscle
Alveoli: membrane
208
Q

Where in the tracheobronchial tree does bronchitis typically occur?

A

Segmental bronchi

209
Q

Where in the tracheobronchial tree does bronchiolitis typically occur?

A

Bronchioles

210
Q

Where in the tracheobronchial tree does pneumonia typically occur?

A

Alveoli

211
Q

What is the innervation of the lungs?

A 
Vagus (parasympathetic and sensory) 
Sympathetic trunk (T2 to T5, sympathetic and sensory)
212
Q

This type of nervous activation produces bronchial dilation and vasoconstriction. It decreases glandular secretion.

A

Sympathetic

213
Q

This type of nervous activation produces bronchial constriction and vasodilation. It increases glandular secretion.

A

Parasympathetic

214
Q

This is an obstructive airway disease characterized by coughing, weezing, and difficulty breathing. It is caused by spasms of the smooth muscle which lies in the segmental bronchi and bronchioles and is often accompanied by excessive secretion of mucus.

A

Asthma

215
Q

What are the two types of asthma? What are they triggered by?

A

Extrinsic asthma: triggered by allergies

Intrinsic asthma: triggered by non-allergenic stimuli such as stress, cold, or exercise

216
Q

Where does lymph from the lungs drain?

A

Pulmonary and bronchopulmonary nodes located in the hilum, which then drain into the tracheobronchial nodes

217
Q

This is a primary tumor of the bronchus and is directly related to cigarette smoking and air pollution. It is highly metastatic and often causes enlargement of a sentinel node.

A

Bronchogenic carcinoma

218
Q

Lung cancer may effect what nerves?

A

Phrenic nerve: resulting in paralysis of half the diaphragm

Recurrent laryngeal nerve: at the apex of the lung, resulting in paralysis of half the larynx

219
Q

This is a fibromuscular dome-shaped structure with right and left domes. The right dome is slightly higher than the left dome, because it overlies the liver.

A

Diaphragm

220
Q

What are the two parts of the diaphragm?

A
  • Muscular part (lies around the periphery)

- Central tendon

221
Q

The muscular part of the diaphragm has three points of origin. What are they?

A
  • Sternal: from the xiphoid process
  • Costal: from the lower 6 costal cartilages
  • Lumbar: from lumbar vertebrae 1-3 and the medial adn lateral arcuate ligaments
222
Q

What are the openings of the diaphragm?

A
  • Caval opening (foramen)
  • Esophageal hiatus
  • Aortic hiatus
223
Q

This opening of the diaphragm is located at T8 within the central tendon and transmits the inferior vena cava and the right phrenic nerve.

A

Caval opening (foramen)

224
Q

This opening of the diaphragm is located at T10 and transmits the esophagus and the anterior and posterior vagal trunks.

A

Esophageal hiatus

225
Q

This opening of the diaphragm is located at T12 and transmits the aorta, thoracic duct, and azygos vein.

A

Aortic hiatus

226
Q

What is the blood supply of the diaphragm?

A
  • Musculophrenic artery (from internal thoracic artery)
  • Pericardiacophrenic artery (from internal thoracic artery)
  • Superior phrenic artery (from the aorta)
  • Inferior phrenic artery (from the aorta)
227
Q

What is the innervation of the diaphragm?

A
  • Phrenic nerve (C3, 4, 5): motor to diaphragm as a whole and sensory to central part
  • Intercostal nerves: sensory to peripheral part
228
Q

This condition is due to weakness in the diphragmatic wall around the esophageal hiatus.

A

Hiatal hernia

229
Q

During inspiration, three major movements take place within the thorax which result in an increase in intrathoracic volume and a decrease in intrathoracic pressure. What are they?

A
  • Piston movement
  • Bucket handle movement
  • Pump handle movement
230
Q

In this major movement during inspiration, the diaphragm contracts, pulling the domes inferiorly into the abdomen. this results in an increase in the vertical diameter of the thorax.

A

Piston movement

231
Q

In this major movement during inspiration, elevation of the lower ribs (7th to 10th) about an antero-posterior axis occurs. This results in an increase in the transverse diameter of the thorax.

A

Bucket handle movement

232
Q

In this major movement during inspiration, elevation of the upper ribs (2nd to 6th) about a transverse axis occurs. This results in an increase in the antero-posterior diameter of the thorax.

A

Pump handle movement

233
Q

The elevation of the ribs in both the bucket handle and pump handle movements is due to the contraction of what muscles?

A

External intercostal muscles

234
Q

In normal expiration, the diaphragm and external intercostal muscles relax and air is expelled passively. What muscles are involved in forced expiration?

A

Internal intercostals, innermost intercostals, and the muscles of the anterior abdominal wall.

235
Q

How does intrathoracic volume and pressure change with inspiration? Expiration?

A

Inspiration: volume increases and pressure decreases
Expiration: volume decreases and pressure increases

236
Q

Hiccups are the result of what?

A

Spasmodic contraction of the diaphragm due to irritation of the phrenic nerve

237
Q

What are some morbid underlying causes of hiccups (2-3 days)?

A

Pericarditis, pleuritis, and peritonitis

238
Q

This is the fibroserous sac which encloses the heart and great vessels. It occupies the middle mediastinum, and forms its borders.

A

Pericardium

239
Q

This is the strong, dense outer part of the pericardium. It blends with the central tendon of the diaphragm, and with the walls of the great vessels which pierce it. It is continuous with the pretracheal fascia above and acts as a “cardiac seatbelt”.

A

Fibrous pericardium

240
Q

This is the part of the pericardium lines the inner surface of the fibrous pericardium.

A

Parietal layer of the serous pericardium

241
Q

This is the part of the pericardium that is closely adherent to the outer surface of the heart. This layer is also known as the epicardium.

A

Visceral layer of the serous pericardium

242
Q

This is a potential space between the parietal and visceral layers of the serous pericardium. It contains serous fluid.

A

Pericardial cavity

243
Q

This structure is equivalent to the visceral layer of the serous pericardium.

A

Epicardium

244
Q

This structure is composed mainly of cardiac muscle fibers and arranged in a spiral.

A

Myocardium

245
Q

This structure is the smooth endothelium which lines the inside of the heart.

A

Endocardium

246
Q

This condition is characterized by fluid leaking rapidly into the pericardial cavity (pericardial perfusion), which can lead to the heart being compressed and venous return being impeded.

A

Cardiac tamponade (superior vena cava is particularly vulnerable)

247
Q

This is a subdivision of the pericardial sac which lies posterior to the aorta and pulmonary trunk, and anterior to the superior vena cava and left atrium.

A

Transverse pericardial sinus

248
Q

This is a subdivision of the pericardial sac which lies posterior to the heart. It is surrounded by the left and right pulmonary veins and the inferior vena cava.

A

Oblique pericardial sinus

249
Q

What is the blood supply to the pericardium?

A
  • Pericardiacophrenic artery (most important)
  • Bronchial artery
  • Esophageal artery
  • Coronary arteries (supply visceral layer of serous pericardium only)
250
Q

What is the innervation of the pericardium?

A
  • Phrenic nerve: sensory
  • Sympathetic trunk: vasomotor
  • Vagus
251
Q

This condition is characterized by an inflammation of the pericardium and is always serous.

A

Pericarditis

252
Q

How is a pericardial friction rub distinguished from a pleural friction rub?

A

Ask the patient to hold their breath. If the sound stops it is a pleural friction rub, if it continues it is a pericardial friction rub

253
Q

This condition is characterized by an obstruction of a pulmonary artery by a blood clot. It forms in the systemic venous system then passes through the venae cavae to the right atrium, right ventricle, pulmonary trunk and finally the pulmonary arteries where it can block blood flow to the lungs. It can result in acute respiratory distress and even heart failure.

A

Pulmonary embolism

254
Q

What are three reasons for why we do not listen to heart valves directly over them?

A
  • Presence of bone
  • Orientation of the heart
  • Acoustics of blood flow
255
Q

Valves control the flow of blood through the heart. Each consists of what?

A
  • Valve orifice, surrounded by a
  • Fibrous ring (Anulus), to which is attached
  • Cusps: flaps which close the valve
256
Q

What are the four major valves in the human heart?

A
  • Pulmonary valve: between the right ventricle and pulmonary trunk. It has three cusps
  • Aortic valve: between the left ventricle and aorta. It has three cusps
  • Mitral (bicuspid valve): between the left atrium and left ventricle. It has two cusps
  • Tricuspid valve: between the right atrium and right ventricle. It has three cusps
257
Q

The heart produces a two-stroke beat (“Lub-Dup”). What produces this sound?

A

Lub sound: produced by contraction of the ventricles and closure of the tricuspid and mitral valves

Dup sound: produced by closure of the pulmonary and aortic valves

258
Q

This valve is located behind the medial end of the third left costal cartilage and is most audible over the left second intercostal space.

A

Pulmonary valve

259
Q

This valve is located behind the left half of the sternum medial to the third intercostal space and is most audible over the right second intercostal space.

A

Aortic valve

260
Q

This valve is located behind the left half of the sternum medial to the fourth costal cartilage and is most audible over the left fifth intercostal space at the midclavicular line.

A

Mitral valve

261
Q

This valve is located behind the right half of the sternum medial to the fourth intercostal space and is most audible over the left fifth intercostal space at its border with the sternum.

A

Tricuspid valve

262
Q

What is the orientation of the heart?

A

It lies obliquely in the thorax. From base to apex, it runs forward, downward, and to the left.

263
Q

This boundary of the heart is formed by the left and right atria.

A

Base

264
Q

This boundary of the heart lies in the left fifth intercostal space, formed by the left ventricle.

A

Apex

265
Q

What are the surfaces of the heart?

A
  • Anterior (sternocostal): formed mostly by the right ventricle
  • Diaphragmatic: formed by the right and left ventricles
  • Left pulmonary: formed mostly by the left ventricle
  • Right pulmonary: formed mostly by the right atrium
266
Q

This is an ear-like appendage from the superior aspect of the right atrium.

A

Right auricle

267
Q

These are prominent parallel ridges located in the anterior atrial wall.

A

Pectinate muscles

268
Q

This is a vertical muscular ridge which runs from the opening of the superior vena cava to that of the inferior vena cava. It marks the termination of the pectinate muscles and separates the right atrium proper from the sinus of venae cavae.

A

Crista terminalis, which is marked externally by a vertical groove called the sulcus terminalis

269
Q

This is the smooth-walled area located posterior to the crista terminalis. It represents the embryonic sinus venosus and receives the openings of the superior vena cava, inferior vena cava, coronary sinus, and anterior veins of the right ventricle.

A

Sinus of venae cavae (sinus venarum)

270
Q

This is a depression which is the remnant of the foramen ovale, an opening between the right and left atrium which closes at birth.

A

Fossa ovalis

271
Q

What is the sharp border of the fossa ovalis called?

A

Limbus fossa ovalis

272
Q

This condition is when the foramen ovale persists as a small opening in the superior part of the fossa ovalis. Blood is shunted from the left atrium to the right, causing dilation of the right atrium, right ventricle, and pulmonary trunk.

A

Atrial septal defect

273
Q

These are interconnecting muscular ridges located in the ventricular wall that act as reinforcements.

A

Trabeculae carneae

274
Q

These are cone-shaped muscles which originate from the ventricular wall. Their apices are connected to the chordae tendineae.

A

Papillary muscles

275
Q

These attach the papillary muscles to teh borders of the cusps of the tricuspid and bicuspid valves. They prevent eversion of the valve during ventricular contraction.

A

Chordae tendineae

276
Q

This is the upper portion of the right ventricle which ends in the pulmonary trunk.

A

Conus arteriosus

277
Q

This is a thick, muscular ridge which separates the conus arteriosus from the rest of the right ventricle.

A

Supraventricular crest

278
Q

This is a large trabecula which extends from the interventricular septum to the base of the anterior papillary muscle. It transmits the right bundle branch of the conduction system.

A

Septomarginal trabecula (moderator band)

279
Q

This is the ear-like appendage of the left atrium

A

Left auricle

280
Q

This is the smooth-walled portion of the left ventricle, below the cusps of the aortic valve.

A

Aortic vestibule

281
Q

What are the four parts of the septal wall of the heart?

A
  • Interatrial septum: between the two atria
  • Atrioventricular septum: small portion above septal cusp of tricuspid valve and below the anterior cusp of the mitral valve.
  • Membranous interventricular septum: thin, smooth, and fibrous in structure
  • Muscular interventricular septum: very thick
282
Q

What are two ways that the heart enlarges? Describe each.

A
  • Muscular hypertrophy: elasticity of blood vessels is lost with age, more force is required to push blood through arteries, and the walls grow thicker
  • Dilation of a chamber: septal defects and valve incompetency cause regurgitation of blood into other chambers causing a dilation to accommodate the extra volume.
283
Q

What three features do semilunar cusps have?

A
  • Nodules: small central thickenings on the free edge of each cusp
  • Lunules: the thin, crescentic part of the cusps
  • Pulmonary and aortic sinuses: the spaces between the cusps and the walls of the vessel
284
Q

These form the foundation of each of the heart valves and are component of the fibrous skeleton of the heart.

A

Fibrous rings (Anuli)

285
Q

These connect the fibrous rings of the fibrous skeleton of the heart together, and represent the strongest part of the fibrous skeleton.

A

Left and right fibrous trigones

286
Q

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

A
  • To provide a structural framework for the valves
  • To insulate the electrical impulses of the conduction system within the atrial wall from those within the ventricular wall
287
Q

What is the blood supply of the heart?

A

Right and left coronary arteries

288
Q

What are the branches of the right coronary artery?

A
  • Sinuatrial nodal artery: provides the blood supply to the SA node
  • Right marginal artery: runs along the right lower margin of the heart
  • Posterior interventricular artery: lies within the posterior interventricular sulcus
289
Q

What are the branches of the left coronary artery?

A
  • Anterior interventricular artery: lies within the anterior interventricular sulcus
  • Circumflex artery: passes posteriorly to anastomose with the right coronary artery
  • Left marginal artery: runs along the left margin of the heart and supplies the left ventricle
290
Q

What does the right coronary artery typically supply?

A
  • Right atrium
  • Most of the right ventricle
  • Diaphragmatic surface of the left ventricle
  • Posterior 1/3 of the interventricular septum
  • Conduction system to proximal parts of the right and left bundle branches
291
Q

What does the left coronary artery typically supply?

A
  • Left atrium
  • Most of the left ventricle
  • Part of the right ventricle
  • Anterior 2/3 of the interventricular septum
292
Q

Where do anastomoses occur in the heart?

A
  • Right coronary and circumflex arteries

- Anterior and posterior interventricular arteries

293
Q

What is the venous drainage of the heart?

A
  • Coronary sinus
  • Anterior veins of the right ventricle
  • Venae cordis minimae
294
Q

What are the five tributaries of the coronary sinus?

A
  • Great cardiac vein: accompanies the anterior interventricular artery
  • Middle cardiac vein: accompanies the posterior interventricular artery
  • Small cardiac vein: accompanies the right coronary artery near the right lower margin of the heart
  • Posterior vein of the left ventricle: to the left of the middle cardiac vein
  • Oblique vein of the left atrium
295
Q

This condition is characterized by deposition of lipid plaques on the inner walls of arteries, which results in the narrowing of the lumen.

A

Atherosclerosis

296
Q

This condition is characterized by substernal chest pain upon exertion. It is a symptom of partial occlusion of coronary artery branches and occurs due to insufficient blood flow to the heart tissue.

A

Angina pectoris

297
Q

This occurs when a coronary artery branch becomes completely occluded. The portion of the heart supplied by the artery dies and is converted to fibrous scar tissue.

A

Myocardial infarction

298
Q

What are the most common sites for myocardial infarction?

A
  • Anterior interventricular artery (40-50%)
  • Right coronary artery (30-40%)
  • Circumflex artery (15-20%)
299
Q

What is the lymphatic drainage of the heart?

A

Subepicardial lymphatic plexus to the tracheobronchial node

300
Q

What is the innervation of the heart?

A

Innervation for the heart is via the cardiac plexus, which is divisible into the:

  • Superficial cardiac plexus: located beneath the arch of the aorta, anterior to the pulmonary trunk
  • Deep cardiac plexus: located posterior to the arch of the aorta
301
Q

Where does the heart receive sympathetic innervation?

A

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

302
Q

Where does the heart receive parasympathetic innervation?

A

Vagus nerve

303
Q

This part of the conduction system of the heart is the natural pacemaker. It is located at the upper end of the crista terminalis, near the junction of the right atrium with the superior vena cava.

A

Sinuatrial node

304
Q

This part of the conduction system of the heart is located in the septal wall, above the opening for the coronary sinus in the right atrium.

A

Atrioventricular node

305
Q

This part of the conduction system of the heart is located within the septal wall and divides into the right and left bundle branches.

A

Atrioventricular bundle

306
Q

This part of the conduction system of the heart is joined by branches of the left and right bundle branches.

A

Subendocardial plexus of conduction cells (Purkinje fibers)

307
Q

This is the remnant of the embryonic ductus arteriosus. it connects the arch of the aorta to the left pulmonary artery or pulmonary trunk. It is located at the level of the sternal angle.

A

Ligamentum arteriosum

308
Q

The esophagus consists of an upper, middle, and lower portion. What is each portion composed of?

A
  • Upper 1/3 is composed of striated muscle
  • Middle 1/3 is composed of mixed striated and smooth muscle
  • Lower 1/3 is composed of smooth muscle
309
Q

The esophagus begins at the laryngopharynx at what vertebral level?

A

C6

310
Q

The esophagus enters the abdomen through the esophageal hiatus at what vertebral level?

A

T10

311
Q

This sphincter is formed by the lower part of the inferior constrictor, sometimes referred to as cricopharyngeus.

A

Superior esophageal sphincter

312
Q

This sphincter is formed by encircling fibers of the diaphragm at the esophageal hiatus.

A

Inferior esophageal sphincter

313
Q

What is the blood supply of the esophagus?

A
  • Inferior thyroid artery
  • Bronchial artery
  • Esophageal artery
  • Left gastric artery
  • Inferior phrenic artery
314
Q

What is the venous drainage of the esophagus?

A
  • Esophageal veins (into adjacent systemic veins)

- Left gastric vein (into the portal vein)

315
Q

What is the innervation of the esophagus?

A
  • Vagus nerve (motor fibers for the striated portions and parasympathetics for the smooth muscle portions)
  • Sympathetic fibers from thoracic cord levels
  • Pain fibers carried in the sympathetic trunk
316
Q

What vertebral level does the thoracic aorta begin?

A

T4

317
Q

What are the parietal branches (supplies the body wall) of the thoracic aorta?

A
  • 3rd through 11th intercostal arteries
  • Subcostal arteries
  • Superior phrenic arteries
318
Q

What are the visceral branches (supplies the thoracic viscera) of the thoracic aorta?

A
  • Bronchial arteries (1 right and 2 left)
  • Pericardial arteries
  • Mediastinal arteries
  • Esophageal arteries
319
Q

What are the important anastomoses that occur off the thoracic aorta?

A
  • Between the anterior and posterior intercostal arteries

- Between the superior and inferior epigastric arteries

320
Q

Most of the lymph of the body reaches the venous system through what structure?

A

Thoracic duct

321
Q

The thoracic duct begins in the abdomen as a dilation at the junction of three abdominal trunks called what?

A

Cisterna chyli

322
Q

The thoracic duct crosses over to the left at what vertebral levels?

A

T5 and T6

323
Q

Where does the thoracic duct empty into?

A

The junction of the left internal jugular and subclavian veins

324
Q

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

A
  • Right upper extremity
  • Right thoracic cavity
  • Right side of the head and neck
325
Q

What are the nerves of the thorax?

A
  • Phrenic nerve (C3, 4, 5)
  • Sympathetic trunk
  • Splanchnic nerves
  • Vagus nerve
  • Autonomic Plexuses
326
Q

This is a variation which arises from C5 and which is a branch of the nerve to subclavius. Sectioning of the phrenic nerve will not completely paralyze the corresponding half of the diaphragm when this is present.

A

Accessory phrenic nerve

327
Q

The sympathetic trunk is connected to the thoracic spinal nerves by what two structures?

A
  • Gray rami communicantes

- White rami communicantes

328
Q

This structure contains postganglionic sympathetic fibers and are connected to every spinal nerve. Nerve cell bodies are located in the sympathetic trunk

A

Gray rami communicantes

329
Q

This structure contains preganglionic sympathetic fibers and are limited to spinal cord segments T1 to L2. Nerve cell bodies are located in the lateral horn (intermediolateral cell column) of the spinal cord.

A

White rami communicantes

330
Q

Splanchnic nerves are the major visceral branches of the sympathetic trunk which supply the abdominal viscera. They include what?

A
  • Greater splanchnic nerve (T5-T9)
  • Lesser splanchnic nerve (T10-T11)
  • Least splanchnic nerve (T12)
331
Q

All three splanchnic nerves reach the abdomen by piercing what?

A

The crura of the diaphragm and end in abdominal ganglia

332
Q

The ____ recurrent laryngeal nerve hooks around the right subclavian artery and ascends into the neck between the trachea and esophagus.

A

Right

333
Q

The ____ recurrent laryngeal nerve hooks around the arch of the aorta posterior to the ligamentum arteriosum and ascends into the neck between the trachea and esophagus.

A

Left

334
Q

The phrenic nerve passes ____ to the root of the lung, while the vagus nerve passes____ to the root of the lung.

A

Anterior; posterior

335
Q

This autonomic plexus is related to the arch of the aorta. It controls hart rate and is subdivided into superficial and deep parts.

A

Cardiac plexus

336
Q

This autonomic plexus is related to the root of the lung.

A

Pulmonary plexus

337
Q

This autonomic plexus is formed along the esophagus.

A

Esophageal plexus

338
Q

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

A

Thoracic aortic plexus

339
Q

Each of the autonomic plexuses of the thorax receives sympathetic fibers from _____ and parasympathetic fibers from _____.

A

Sympathetic trunk; vagus nerve

340
Q

What are the functional components of the phrenic nerve?

A
  • Motor (to the diaphragm)
  • Sensory (pain fibers from the diaphragm, pericardium, pleura, and peritoneum)
  • Sympathetic
341
Q

What are the functional components of the vagus nerve?

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

Gross Anatomy II (4 decks)

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