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CA1 SHSUCOM > Final Exam Thoracic Cavity > Flashcards

Final Exam Thoracic Cavity Flashcards

1
Q

How many true ribs are there? What makes them true?

A

7 true ribs because they directly articulate with the sternum

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2
Q

What is the classification of rib 9? Why?

A

false rib because it indirectly articulates with the sternum

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3
Q

What does rib 4 articulate with?

A

T3 and T4 vertebral bodies and the articular facets of transverse process of T4

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4
Q

What does rib 1 articulate with?

A

T1 vertebral body

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5
Q

What does rib 11 articulate with?

A

only the body of T12 (do not have tubercle)

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6
Q

Why is rib 1 unique?

A

has grooves for subclavian a. and v.

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7
Q

What is the intercostal space between ribs 4 and 5 called?

A

4th intercostal space

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8
Q

What is the space below the 12th rib called?

A

subcostal space

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9
Q

How many intercostal spaces are there?

A

11

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10
Q

What are the borders of the superior thoracic aperature?

A

T1, rib 1, and manubrium

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11
Q

What structures run through the superior thoracic aperature?

A

esophagus, trachea, neurovasculature that supply head and upper limbs

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12
Q

What are the borders of the inferior thoracic aperature?

A

T12, ribs 11 & 12, costal cartilages of ribs 7-10, and xiphisternal joint

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13
Q

What does the diaphragm attach to?

A

xyphoid process, ribs, and lumbar vertebrae

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14
Q

What innervates the diaphragm?

A

phrenic nerve

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15
Q

What passes through the diaphragm at T8?

A

inferior vena cava

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16
Q

What passes through the diaphragm at T10?

A

esophagus

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17
Q

What passes through the diaphragm at T12?

A

aorta

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18
Q

What direction is the diaphragm pulled with inspiration?

A

down

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19
Q

During expiration, the intrathoracic pressure _____.

A

increases

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20
Q

A fracture of middle ribs can lead to..

A

pneumothorax, lung or spleen injuries

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21
Q

What causes flail chest?

A

multiple rib fractures

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22
Q

What muscles assist with inspiration?

A

external intercostals

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23
Q

What muscles assist with expiration?

A

internal intercostals

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24
Q

What are the muscles that overlie the costal cartilage of ribs 2- by the sternum?

A

transversus thoracis

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25
Q

Where do the first 2 posterior intercostal arteries branch from?

A

supreme intercostal artery

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26
Q

Where do the posterior intercostal arteries branch from (other than the first 2)?

A

directly branch from the thoracic aorta

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27
Q

What is the 12th posterior intercostal artery called?

A

subcostal artery

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28
Q

Where do the upper 6 anterior intercostal arteries branch from?

A

internal thoracic arteries

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29
Q

Where do the anterior intercostal arteries 7-9 branch from?

A

musculophrenic arteries

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30
Q

Where do the last 2 intercostal spaces get their blood supply from?

A

posterior intercostal arteries

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31
Q

The internal thoracic arteries divide into…

A

superior epigastric and musculophrenic arteries before 7th rib

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32
Q

Where do the posterior intercostal veins drain into?

A

azygos

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33
Q

Where do the anterior intercostal veins drain into?

A

internal thoracic veins

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34
Q

How many posterior intercostal veins are there? Why?

A

11 with 1 subcostal vein due to there only being 12 ribs

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35
Q

What innervates the muscles of the intercostal spaces?

A

Ventral rami of T1-T11

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36
Q

What is the T12 intercostal nerve called?

A

subcostal nerve

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37
Q

What branches off of the intercostal nerves?

A

lateral and anterior cutaneous branches

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38
Q

Where are the “VAN”s of each intercostal space located?

A

in the costal groove of each rib sandwiched between the innermost and internal intercostal muscles

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39
Q

If a blockage occurs and blood cannot flow through the posterior intercostal artery of an intercostal space, how will the muscles receive oxygenated blood?

A

via the anterior intercostal arteries because they form anastomoses with the posterior intercostal arteries

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40
Q

What are the 3 compartments of the thoracic cavity?

A

2 lateral pleural cavities and 1 central mediastinal cavity

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41
Q

What pleura covers the lungs?

A

visceral pleura

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42
Q

What are the 4 parietal pleura of the pleural cavities?

A

cervical, costal, diaphragmatic, and mediastinal

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43
Q

What is found between the parietal and visceral pleura?

A

serous fluid

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44
Q

What keeps lungs from collapsing with each breath?

A

surface tension from pleural fluid

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45
Q

A penetrating wound through the thoracic cavity could cause ____ pressure and the lung to collapse.

A

negative

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46
Q

Where are the visceral and parietal pleura continuous?

A

hilum of the lung

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47
Q

What innervates the cervical and costal pleura?

A

intercostal nerves

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48
Q

What innervates the diaphragmatic pleura?

A

phrenic and intercostal nerves

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49
Q

What innervates the mediastinal pleura?

A

phrenic nerve

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50
Q

What are the 2 recesses found in the pleural cavities?

A

costomediastinal recess and costodiaphragmatic recess

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51
Q

Where does fluid collect in the pleural cavity when a person is upright?

A

costodiaphragmatic recess

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52
Q

What is a hemothorax?

A

blood in the pleural cavity

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53
Q

What is pleural effusion?

A

fluid in the pleural space

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54
Q

Where is the best place to perform a thoracentesis? Why?

A

in the 7-9th intercostal space because it avoids the lung and diaphragm

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55
Q

If performing a thoracentesis in the 9th intercostal space, what pleural layers will the needle pass through?

A

only the costal parietal pleura

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56
Q

Where does the trachea begin?

A

~C6 inferior to cricoid cartilage

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57
Q

The trachea is ____ to the esophagus.

A

anterior

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58
Q

Where does the trachea bifurcate?

A

sternal angle

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59
Q

The right primary bronchus passes under the ____.

A

arch of the azygos vein

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60
Q

The left primary bronchus passes inferior to the ___ and anterior to the _____.

A

aortic arch

descending aorta

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61
Q

Which bronchus is wider, shorter, and more vertical?

A

right primary bronchus

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62
Q

What is the section of cartilage called at the bifurcation of the trachea?

A

carina

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63
Q

How many secondary (lobar) bronchi are found in the on the right?

A

3

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64
Q

How many secondary (lobar) bronchi are found on the left?

A

2

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65
Q

How many tertiary (segmental) bronchi are found on the right?

A

10

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66
Q

How many tertiary (segmental) bronchi are found on the left?

A

8-10

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67
Q

What are the largest subdivisions of lung lobe called?

A

bronchopulmonary segments

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68
Q

Bronchopulmonary segments are separated by

A

tissue septa

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69
Q

Each bronchopulmonary segment is supplied by

A

a segmental bronchus, a tertiary branch of the pulmonary artery, and intersegmental parts of the pulmonary vein

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70
Q

What is the descending order of airflow?

A

trachea –> primary bronchus –> secondary (lobar) bronchus –> tertiary (segmental) bronchus –> bronchioles –> alveolar sacs –> alveoli

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71
Q

What is a segmentectomy?

A

the removal of lung segments

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72
Q

What is a lobectomy?

A

the removal of a lung lobe

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73
Q

What is a pneumonectomy?

A

removal of an entire lung

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74
Q

How many lobes in the right lung?

A

3

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75
Q

What lung and lobe is the lingula found?

A

left superior lobe

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76
Q

Where is the horizontal fissure of the right lung found?

A

parallels the 4th rib

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77
Q

What is the root of the lung?

A

collection of structures that connect the lung to the mediastinum

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78
Q

What is the hilum?

A

the doorway that all of the root structures pass through to enter the lung

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79
Q

The pulmonary artery carries

A

deoxygenated blood

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80
Q

The pulmonary vein carries

A

oxygenated blood

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81
Q

What supplies the lung tissues with blood?

A

bronchial arteries and veins

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82
Q

Where does the left bronchial vein drain into?

A

accessory hemi-azygos vein or left superior intercostal vein

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83
Q

Where does the right bronchial vein drain into?

A

azygos vein

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84
Q

Where does the left bronchial artery branch from?

A

thoracic aorta

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85
Q

Where does the right bronchial artery branch from?

A

thoracic aorta OR posterior intercostal artery (3rd) OR common trunk

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86
Q

What are the boundaries of the mediastinum?

A

superior thoracic aperture
sternum
diaphragm
vertebrae

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87
Q

What level is the sternal angle found?

A

T4/5

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88
Q

Where is the bifurcation of the trachea located?

A

sternal angle

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89
Q

What important structures are located in the superior mediastinum?

A 
aortic arch
superior vena cava
thoracic duct
thymus
trachea
esophagus
vagus nerve
phrenic nerve
90
Q

After puberty, the thymus is replaced by

A

fat

91
Q

The esophagus extend from the ____ to the ____.

A

pharynx to stomach

92
Q

Where is the thoracic duct found?

A

posterior to esophagus in the superior mediastinum

93
Q

Where does the thoracic duct empty into?

A

the venous system at the junction of the the left internal jugular and subclavian veins

94
Q

What major vessels feed into superior vena cava?

A

brachiocephalic vein

95
Q

What vessels branch off of the aortic arch?

A

brachiocephalic trunk
left common carotid
left subclavian

96
Q

Which brachiocephalic vein in longer?

A

left

97
Q

The superior vena cava returns all of the blood from the structures superior to the diaphragm EXCEPT

A

heart and lungs

98
Q

Where does the superior vena cava form?

A

inferior border of the 1st right costal cartilage

99
Q

What side of the mediastinum is the superior VC found?

A

right side

100
Q

What part of the mediastinum is the ascending aorta?

A

middle mediastinum

101
Q

Where does the aortic arch become the descending aorta?

A

below the sternal angle

102
Q

What branches off of the right brachiocephalic trunk?

A

right common carotid

right subclavian

103
Q

What does the vagus nerve supply?

A

parasympathetic innervation to thoracic and abdominal viscera

104
Q

The vagus nerves branch into the

A

left and right recurrent laryngeal nerve

105
Q

What is the smallest subdivision of the mediastinum?

A

anterior mediastinum

106
Q

What division of the mediastinum is the heart in?

A

middle mediastinum

107
Q

What are the 3 layers of the pericardium?

A

fibrous, parietal serous, and visceral serous

108
Q

What anchors the fibrous pericardium to the central tendon?

A

pericardiacophrenic ligament

109
Q

What innervates the fibrous pericardium?

A

phrenic nerve for SENSORY

vagus nerve and sympathetic trunks for MOTOR

110
Q

What supplies the fibrous pericardium with blood?

A

pericardiacophrenic a and v

111
Q

The visceral serous pericardium is also called

A

epicardium

112
Q

What is pericardial effusion?

A

fluid within the pericardial cavity

113
Q

What is cardiac tamponade?

A

rapid accumulation of fluid/blood in the pericardial cavity that compresses the heart reducing its output

114
Q

Where would the needle for a pericardiocentesis be inserted?

A

left 5th intercostal space or infrasternal angle

115
Q

What are the pericardial sinuses?

A

where the great vessels pierce the fibrous pericardium and serous pericardium is continuous

116
Q

What are the 2 pericardial sinuses?

A

transverse and oblique pericardial sinuses

117
Q

The right side of the heart is responsible for ____ circulation.

A

pulmonary

118
Q

The left side of the heart is responsible for _____ circulation.

A

systemic

119
Q

The right atrium receives ____ blood from _____.

A

deoxygenated blood from inferior and superior VC

120
Q

The smooth walled portion in the right atrium is called the

A

sinus venarum

121
Q

What chamber of the heart is the fossa ovalis found?

A

Right atrium

122
Q

What is the fossa ovalis a remnant of?

A

foramen ovale

123
Q

The right AV valve is also called the

A

tricuspid valve

124
Q

The smooth walled portion of the right ventricle is called the

A

conus arterious

125
Q

When blood leaves the right ventricle, where does it immediately go?

A

pulmonary trunk

126
Q

What heart chamber receives oxygenated blood from the pulmonary veins?

A

left atrium

127
Q

The rough walled portion of the left ventricle is called the

A

trabeculae carneae

128
Q

Where is the common site of ventricular septal defects?

A

the upper membranous portion of the interventricular septum

129
Q

What is a narrowing of heart valves called?

A

stenosis

130
Q

When a valve fails to fully close causing backflow

A

valvular insufficiency

131
Q

The cusps of the AV valves are attached to ____ by ____.

A

papillary muscles by chordae tendinae

132
Q

What is responsible for closing the AV valves?

A

ventricular contraction pushing blood against them

133
Q

What prevents valves from everting into atria?

A

papillary muscles and chordae tendinae

134
Q

What is the most common type of valvular disease?

A

mitral valve prolapse ( a type of insufficiency)

135
Q

What creates the lub sound?

A

closure of AV valves

136
Q

When are the AV valves closed?

A

ventricular contraction

137
Q

When is heart in systole?

A

ventricular contraction & AV valve closure

138
Q

When is heart in diastole?

A

atrial contraction & semilunar valve closure

139
Q

What creates the dub sound?

A

closure of semilunar valves

140
Q

Where is the best place to listen to the aorta?

A

right 2nd intercostal space/ 3rd costal cartilage

141
Q

Where is the best place to listen to the pulmonic valves?

A

left upper sternal border/ 2nd intercostal space

142
Q

Where is the best place to listen for the tricuspid valve?

A

4th left intercostal space

143
Q

Where is the best place to listen for the bicuspid valvle?

A

5th left intercostal space

144
Q

Where is the SA node found?

A

superior right atria

145
Q

Where is the AV node found?

A

inferior right atria

146
Q

The right coronary artery is found in the

A

coronary sulcus

147
Q

What coronary branch supplies the left atrium?

A

circumflex branch

148
Q

What does the coronary sinus drain into?

A

right atrium

149
Q

What 2 vessels merge to mark the start of the coronary sinus?

A

great cardiac vein and oblique vein of left atrium

150
Q

What is myocardial ischemia?

A

insufficient blood flow to the heart muscles

151
Q

What is a coronary angioplasty?

A

a balloon catheter inserted into a blocked coronary artery to restore blood flow

152
Q

Where do most coronary blockages occur?

A

anterior IV branch (LAD)

153
Q

What is a CABG?

A

coronary artery bypass graft (using healthy vessel from somewhere else)

154
Q

The intraembryonic coelom divides into what 3 cavities?

A

pericardial, pleural, and peritoneal

155
Q

What gives rise to the parietal layer of the peritoneum?

A

somatic mesoderm

156
Q

What gives rise to the visceral layer of the peritoneum?

A

splanchnic mesoderm

157
Q

Where is the only place the ventral mesentery remains?

A

caudal foregut (below diaphragm)

158
Q

What is the partition between the pericardial and pleural membranes in an embryo called?

A

pleuropericardial membranes

159
Q

The septum transversum turns into the

A

central tendon

160
Q

What anchors the diaphragm in an embryo?

A

crura

161
Q

What is important in embryology about C3-5 nerves?

A

they innervate the diaphragm

162
Q

What is a congenital hiatal hernia?

A

herniation of part of the fetal stomach through an excessively large esophageal hiatus

163
Q

What passes through the esophageal hiatus?

A

esophagus and vagus nerve

164
Q

Why do CDHs lead to respiratory failure if not treated in utero?

A

lack of space for lungs to develop

165
Q

What is esophageal atresia?

A

where esophagus ends in a blind pouch

166
Q

What week does the lung bud bifurcate?

A

late 4th week

167
Q

At what week of gestation is the conducting portion complete?

A

week 16

168
Q

What week does surfactant begin being produced?

A

week 28

169
Q

What type of cells produce surfactant?

A

type II pneumocytes

170
Q

What are the 4 stages of lung maturation in order?

A

pseudoglandular stage

canalicular stage

terminal sac stage

alveolar stage

171
Q

What are the 3 layers of the heart wall?

A

endocardium, myocardium, and epicardium

172
Q

Cardiac muscle cells are

A

involuntary, mononucleated, striated and elongated/branched

173
Q

What is considered the pace maker of the heart?

A

the SA node

174
Q

What type of cells make up the endocardium?

A

simple squamous

175
Q

The cardiac skeleton is made of

A

dense irregular CT

176
Q

What type of cells make up the epicardium?

A

simple squamous/cuboidal mesothelium

177
Q

What delivers the purkinje fibers from the interventricular septum to the papillary muscles of the RIGHT ventricle?

A

moderator band

178
Q

What are the purkinje fibers full of?

A

glycogen

179
Q

What are the 3 layers of a vessel from external to internal?

A

tunica adventitia –> tunica media –> tunic intima

180
Q

What vascular layer is much thicker in an artery than a vein?

A

tunica media

181
Q

What do arterial tunica media have more of?

A

elastic fibers

182
Q

What vascular layer is thicker in veins?

A

tunica adventitia

183
Q

What are the 2 layers of a capillary?

A

basement membrane and endothelium

184
Q

What are the elastic arteries?

A

aorta, pulmonary trunk

185
Q

What is distinct in elastic arteries?

A

internal elastic lamina

186
Q

What are vasa vasorum?

A

small vessels that provide blood to larger vessels with thick walls

187
Q

What are arterioles lacking?

A

elastic lamina

188
Q

What is the most common type of capillary?

A

continuous capillaries

189
Q

What type of capillaries have a discontinuous basement membrane?

A

sinusoidal capillaries

190
Q

What is a portal system?

A

one capillary bed drains into a vein which branches into another capillary system

191
Q

What allows for a bypass of capillary beds?

A

arteriovenous shunts

192
Q

What are vein valves composed of?

A

folds of intima

193
Q

What are the ventilation components of the respiratory system?

A

diaphragm
rib cage
intercostal muscles
abdominal muscles

194
Q

What are the conduction components of the respiratory system?

A 
nasal cavity
sinuses
larynx
trachea
bronchi
bronchioles
terminal bronchioles
195
Q

What are the respiratory components of the respiratory system?

A

respiratory bronchioles
alveolar ducts
alveolar sacs

196
Q

What are the common components of the conduction airways?

A

mucosa
smooth muscle
submucosa
adventitia

197
Q

Between what 2 layers is smooth muscle found in the bronchi and bronchioles?

A

mucosa and submucosa

198
Q

What type of epithelium is in the respiratory tract?

A

pseudostratified ciliated columnar epithelium (PCCE)

199
Q

What respiratory cells produce mucus?

A

goblet cells

200
Q

What cell type has the function of chemo receptors in the respiratory tract?

A

brush cells

201
Q

What are the neuroendocrine cells of the respiratory epithelium?

A

kulchitsky cells

202
Q

What are the stem cells that replenish the cells of the respiratory tract?

A

basal cells

203
Q

Smoking cause a transition of respiratory epithelium from _____ to _____.

A

PCCE to NKSSE

204
Q

What are the 4 layers that surround the lumen of the trachea?

A

mucosa
submucosa
cartilage
adventitia

205
Q

What is the order of the bronchial tree from largest to smallest?

A 
primary bronchi 
secondary (lobar) bronchi
tertiary (segmental) bronchi
bronchioles
terminal bronchioles
respiratory bronchioles
alveolar ducts
alveolar sacs
alveoli
206
Q

What are the differences in the bronchi vs the trachea

A
  1. bronchi have spiral bands of smooth muscle in the submucosa
  2. smaller diameter
  3. bronchi are surrounded by lung tissue
207
Q

Primary bronchi have ____ cartilage

A

C-ring

208
Q

Secondary bronchi have ____ cartilage

A

plates of

209
Q

The bronchioles have what kind of epithelium?

A

larger bronchioles have PCCE

smaller and terminal bronchioles have ciliated cuboidal or ciliated columnar

210
Q

What are goblet cells replaced with in terminal bronchioles?

A

club or clara cells

211
Q

What is the function of club/clara cells?

A
  1. secrete surfactant
  2. detoxification via enzymes
  3. antimicrobial peptides and cytokines
212
Q

Terminal bronchioles have an incomplete

A

circular layer of smooth muscle

213
Q

Parasympathetic motor branches are responsible for ______ of bronchioles

A

constriction

214
Q

Sympathetic branches are responsible for bronchiole _______

A

dilation

215
Q

What is the transition point between the conducting and respiratory portions of the respiratory system?

A

respiratory bronchioles

216
Q

What type of epithelium is found in the alveoli?

A

simple squamous

217
Q

What type of cells are the majority of alveolar cells?

A

type II pneumocytes

218
Q

What type of cells make up the majority of the surface of alveoli?

A

type I pneumocytes

219
Q

What is the shape of type I pneumocytes?

A

flat

220
Q

What is the shape of type II pneumocytes?

A

cuboidal

221
Q

During ARDS, what happens to the alveoli?

A
  1. alveolar edema
  2. epithelial necrosis
  3. formation of hyaline membranes

CA1 SHSUCOM (2 decks)

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