Exam II - General Information Flashcards
What are the 6 cartilages of the Larynx?
Thyroid Cricoid Epiglottic Arytenoid Cuneiform Corniculate
What joint allows rotation of the thyroid cartilage around a horizontal axis?
Cricothyroid Joint
What pierces the thyrohyoid membrane?
Internal Laryngeal Nerve and Superior Laryngeal Vessels
What is the true vibratory part of the vocal cord?
Vocal Ligament/Fold
The superior margin of the quadrangular membrane forms ______, while the inferior margin forms ______.
Aryepiglottic ligament; Vestibular ligament
What initiates the cough reflex?
Vestibular Folds (False Vocal Cords)
What is the narrowest part of the laryngeal cavity?
Rima Glottidis
What is the sound producing part of the larynx?
The Glottis (rima glottidis + vocal folds)
What is the “oil can” of the vocal folds?
Laryngeal Succule
What are the elevators of the larynx?
Thyrohyoid Stylohyoid Mylohyoid Digastric Stylopharyngeus Palatopharyngeus
What are the depressors of the larynx?
Omohyoid
Sternohyoid
Sternothyroid
What is the only muscle of the larynx NOT innervated by the recurrent laryngeal nerve?
Cricothyroid (External Laryngeal Nerve)
What muscle raises the pitch of the voice?
Cricothyroid Muscle
What is the muscle of whispering?
Lateral Cricoarytenoid
What are the muscles of coughing?
Transverse Arytenoid and Oblique Arytenoid
What muscle closes the laryngeal inlet?
Aryepiglottic Muscle
What muscle opens the laryngeal inlet?
Thyroepiglottic Muscle
What muscle lowers the pitch of the voice?
Thyroarytenoid Muscle
What muscle is responsible for fine-tuning the voice?
Vocalis Muscle
Tension of the vocal folds is ______ to raise the pitch, and ______ to lower the pitch.
Increased (Cricothyroid); Decreased (Thyroarytenoid and Vocalis)
The recurrent laryngeal nerve is motor to ______ and sensory to ______.
all intrinsic muscles of larynx except cricothyroid; mucosa of the larynx below the vocal fold
The internal laryngeal nerve is a branch of ______, and is sensory to ______.
Superior laryngeal nerve; mucosa of the larynx above the vocal fold
The external laryngeal nerve is a branch of ______, and is motor to ______ and sensory to ______.
Superior laryngeal nerve; cricothyroid; inferior constrictor muscle
What is the blood supply of the larynx?
Superior laryngeal artery (from superior thyroid) and Inferior laryngeal artery (from inferior thyroid)
______ lymph vessels drain lymph TO a node, while ______ lymph vessels drain lymph FROM a node.
Afferent; Efferent
How is lymph moved?
Skeletal muscle contraction
What are the superficial lymph nodes of the head?
Occipital
Mastoid
Parotid
What are the superficial lymph nodes of the neck?
Submandibular
Submental
Anterior Cervical
Superficial Cervical
Where are the deep cervical lymph nodes found?
Inside the carotid sheath
What lymph nodes drain the tongue?
Jugulodigastric and Jugulo-omohyoid nodes
Where does the right jugular trunk drain into?
The junction between the internal jugular and subclavian veins
Where does the left jugular trunk drain into?
The thoracic duct
What lymph node drains the lower lip, the floor of the mouth, and the tip of the tongue?
Submental Node
What lymph node drains the cheek, the side of the nose, the upper lip, lateral part of the lower lip, gums, and margin of the tongue?
Submandibular Node
What is the term that describes the spread of cancer via the lymphatic system?
Lymphogenous Metastasis
The breast is derived from what embryonic tissue?
Epidermis
The breast is located between which ribs?
2 and 6
What rib level is the nipple usually found?
4th intercostal space
What part of the breast is the most common developmental site for cancer?
Axillary tail
T/F) Each mammary gland has one lob of glandular tissue.
Fale (15-20 lobes each)
What is the blood supply of the breast?
Internal thoracic artery
Thoracoacromial artery
Lateral thoracic artery
Intercostal arteries
75% of breast lymph drains into what lymph nodes?
Axillary Nodes
The body of the sternum articulates with which rib cartilages?
2nd - 7th rib
What makes up the sternal angle? What V.L. is it found?
Manubrium and Body; TV 4 & 5
What are the boundaries of the Superior Thoracic Aperture (Thoracic Inlet)?
Manubrium, 1st Rib, 1st T vertebra
What are the boundaries of the Inferior Thoracic Aperture (Thoracic Outlet)?
Xiphoid Process Costal Margin 12th Rib Distal End of 11th Rib 12th Thoracic Vertebra
What muscles are used for inspiration?
Diaphragm and External Intercostals
What muscles are used for forced expiration?
Internal Intercostals, Innermost Intercostals, Subcostalis, Transverse Thoracis
What are the branches of the Internal Thoracic Artery?
Pericardiacophrenic A., Anterior Intercostal A., Musculophrenic A., Superior Epigastric A.
What supplies the anterior aspect of the thoracic wall?
Internal Thoracic Artery and its branches
What supplies the posterior aspect of the thoracic wall?
Supreme (Superior) Intercostal A., 3rd-11th Posterior Intercostal A., Subcostal A.
What drains the anterior aspect of the thoracic wall?
Internal Thoracic Vein
What is the thickening of the fascia over the apex of the lung called?
Suprapleural membrane
What prevents the innermost intercostal muscle from rubbing against the parietal pleura?
Endothoracic Fascia
What structures are found between the internal and innermost intercostal muscles?
Intercostal Vein, Artery, and Nerve
What are the 4 parts of the parietal pleura?
Costal, Mediastinal, Cervical, and Diaphragmatic
T/F) Biopsies are usually done in the costomediastinal recess?
False; they are done in the costodiaphragmatic recess
What is the procedure called where fluid in the costodiaphragmatic recess is removed? What level is it done at?
Thoracentesis; Intercostal Space 9
What is the blood supply of the parietal pleura?
Intercostal A., Internal Thoracic A., Superior Phrenic A.
What is the blood supply of the visceral pleura?
Bronchial A.
What is the innervation of the parietal pleura?
Intercostal N., Subcostal N., Phrenic N.
What is the innervation of the visceral pleura?
NONE
The sternal angle indicates the level of what structures?
Inf. & Sup. Mediastinum Boundary Articulation of 2nd Rib w/ sternum Aortic Arch Bifurcation of the trachea Upper Border of the pulmonary trunk
What things are found in the Superior Mediastinum?
Superior Vena Cava R/L Brachiocephalic Veins Arch of the Aorta and its branches Thoracic Duct Trachea Esophagus Thymus Vagus Nerve Left Recurrent Laryngeal Nerve Phrenic Nerve
What is found in the Anterior Mediastinum?
Thymus
Lymph nodes
Sternopericardial ligaments
What is found in the Middle Mediastinum?
Heart Pericardium Roots of the Great Vessels Main Bronchi Phrenic Nerve
What is found in the Posterior Mediastinum?
Esophagus Thoracic Aorta Azygos Vein Hemiazygos Vein Thoracic Duct Vagus Nerve Splanchnic Nerve
What is the name of the prominent ridge located within the trachea at its bifurcation?
The Carina
The trachea deviates to the ______ just before bifurcation.
Right
T/F) The Right Main Bronchus splits into the Superior, Middle, and Inferior Lobar Bronchi within the hilum.
False; It gives off the Superior Lobar Bronchus BEFORE entering the hilum
What is the blood supply to the trachea?
Inferior Thyroid A. and Bronchial A.
What is the innervation of the trachea?
Vagus N. (Pain & Parasympathetic) and Sympathetic Trunk
What structures form the root of the lung?
Bronchi Pulmonary Vessels ( Pulmonary Arteries & Veins) Bronchial Vessels Nerves Lymphatics
What is the double-layered pleura membrane called?
Pulmonary Ligament
T/F) Grooves and Impressions in the lungs are not found in living individuals.
True
T/F) Sympathetic activation produces bronchial constriction and vasodilation and increases glandular secretion.
False; bronchial dilation, vasoconstriction, decrease glandular secretion
Where does lymph from the lungs drain?
Pulmonary and Bronchopulmonary Nodes
What separates the thorax from the abdomen?
The Diaphragm
What are the 3 points of origin of the muscular part of the diaphragm?
Xiphoid process, lower 6 costal cartilages, lumbar vertebrae 1-3
What vertebral level is the Caval Opening located? What passes through it?
TV 8; Inferior Vena Cava and Phrenic Nerve
What vertebral level is the Esophageal Hiatus? What passes through it?
TV 10; Esophagus (not firmly attached) and Posterior Vagal Trunk
What vertebral level is the Aortic Hhiatus? What passes through it?
TV 12; Aorta, Thoracic Duct, and Azygos Vein
What is the blood supply to the diaphragm?
Musculophrenic A.
Pericardiacophrenic A.
Superior Phrenic A.
Inferior Phrenic A.
What is the innervation of the diaphragm?
Phrenic Nerve (Motor to whole; sensory to central part) Intercostal Nerve (sensory to peripheral part)
What movement increases the vertical diameter of the thorax?
Piston Movement (contraction of the diaphragm)
What movement increases transverse diameter of the thorax?
Bucket Handle Movement (elevation of the lower ribs)
What movement increases the antero-posterior diameter of the thorax?
Pump Handle Movement (elevation of the upper ribs)
What are the 4 morbid causes of hiccups?
Brain Lesions
Pleuritis
Pericarditis
Peritonitis
What connects the fibrous pericardium to the back of the sternum?
Sternopericardial Ligaments
What is the blood supply to the pericardium?
Pericardiacophrenic A. (most important)
Bronchial A.
Esophageal A.
Coronary A.
List the chambers of the heart in order of greatest wall thickness greatest to least.
Left V. > Right V. > Left A. > Right A.
What produces the “Lub” sound upon auscultation?
Contraction of the Ventricles and closure of bicuspid and tricuspid valves
What produces the “Dub” sound?
Closure of the pulmonary and aortic valves
What is the most frequently and 2nd most frequently diseased valve?
Mitral, then Aortic
What are the auscultation points for each valve?
Pulmonary Valve - left 2nd intercostal space
Aortic Valve - right 2nd intercostal space
Mitral Valve - left 5th intercostal space at midclavicular
line
Tricuspid Valve - left 5th intercostal space at its border
with the sternum
What marks the termination of the pectinate muscles and separates the right atrium proper from the sinus of venae cavae?
Crista Terminalis
What heart structure represents the embryonic sinus venosus?
Sinus of Venae Cavae (Sinus Venarum)
What heart structure is the remnant of the foramen ovale?
Fossa Ovalis
What are the 4 parts of the septal wall?
Interatrial Septum
Atrioventricular Septum
Membranous Interventricular Septum
Muscular Interventricular Septum
What part of the septum do defects occur?
Interatrial Septum
T/F) Pulmonary and Aortic valves contain chordae tendineae and papillary muscle.
False; they contain neither
The pulmonary and aortic valves are sometimes called ______.
Semilunar Valves
What are the 3 parts of the fibrous skeleton of the heart?
Fibrous Rings
L/R Fibrous Trigones
Membranous part of septal wall
What are the branches of the right coronary artery
Sinuatrial Nodal A.
Right Marginal A.
Posterior Interventricular A.
What are the branches of the left coronary artery?
Anterior Interventricular A.
Circumflex A.
Left Marginal A.
Which coronary artery is dominant?
Right in 70%
Left in 30%
What is supplied by the right coronary artery?
Right Atrium Most of Right Ventricle Diaphragmatic surface of left ventricle Posterior 1/3 of interventricular septum Conduction system (most important)
What is supplied by the left coronary artery?
Left Atrium
Most of Left Ventricle
Part of Right Ventricle
Ant. 2/3 of interventricular septum
Where do anastomosies typically occur?
Right coronary & Circumflex A.
Ant. & Post. interventricular A.
What is the largest vein in the heart?
Coronary Sinus
What are the 5 tributaries of the coronary sinus?
Great Cardiac Vein Middle Cardiac Vein Small Cardiac Vein Posterior Vein of the Lft. Ventricle Oblique Vein of the Lft. Atrium
What is the smallest vein in the heart?
Venae Cordis Minimae
Where does sympathetic innervation come from?
Cervical and Thoracic cardiac nerves from T1-4
Outline the conduction system of the heart.
SA node -> AV node -> AV bundle -> R/L bundle branches -> Perkinje Fibers
What is the remnant of the embryonic ductus arteriosus?
Ligamentum Arteriorsum
What part of the esophagus is the longest?
The thoracic part
Where does esophagus begin?
CV 6
Where does the esophagus join the stomach?
TV 10 at the cardioesophageal junction
What is the superior esophageal sphincter also called?
Cricopharyngeus
What is the blood supply to the esophagus?
Inferior Thyroid A. Bronchial A. Esophageal A. Left Gastric A. Inferior Phrenic A.
What is the venous drainage of the esophagus?
Esophageal V.
Left Gastric V.
Where does the thoracic aorta begin?
TV 4
Where does the thoracic aorta turn into the abdominal aorta?
TV 12
What are the parietal branches of the thoracic aorta?
3rd - 11th Intercostal A.
Subcostal A.
Superior Phrenic A.
What are the visceral branches of the thoracic aorta?
Bronchial A.
Pericardial A.
Mediastinal A.
Esophageal A.
What is the junction of intestinal, lumbar, and descending intercostal trunks called?
Cisterna Chyli
The thoracic duct drains the lymph of the entire body except what?
Right upper extremity
Right thoracic cavity
Right side of the head and neck
What is the variation of the phrenic nerve that arises from C5?
Accessory Phrenic Nerve
Where are the cell bodies of gray rami communicantes located?
In the sympathetic trunk
Where are the cell bodies of white rami communicantes located?
Lateral horn of spinal cord from T1-L2
What is the fusion of the inferior cervical and the first thoracic ganglion called?
Cervicothoracic (stellate) ganglion
What are the levels of each splanchnic nerve?
Greater Splanchnic Nerve - T5-T9
Lesser Splanchnic Nerve - T10-T11
Least Splanchnic Nerve - T12
What nerve forms the esophageal plexus?
Vagus Nerve