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PHTH 511: Anatomy > Final Lecture Questions (Pelvic cavity, thoracic wall, respiratory, heart, etc.) > Flashcards

Final Lecture Questions (Pelvic cavity, thoracic wall, respiratory, heart, etc.) Flashcards

1
Q

What is the function of the pelvic cavity?

A

-Contains and supports the urinary bladder, rectum, anal canal, and reproductive tracts
-Contains most of the reproductive tracts in women and part of the reproductive tracts in men

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2
Q

What are the contents of the pelvic cavity in women?

A

-Fallopian/uterine tube
-Ovary
-Uterus
-Bladder
-Vagina
-Urethra
-Ureter
-Internal iliac artery/veins
-Rectum
-Anal canal
-Anal aperture

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3
Q

What are the contents of pelvic cavity in men?

A

-Ductus deferens
-Seminal vesicle
-Prostate
-Ejaculatory duct
-Rectum
-Anal canal
-Anal aperture
-Bladder
-Urethra

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4
Q

How many parts are there in the male urethra?

A

4 parts

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5
Q

What triangles are there in the pelvis?

A

-Anal triangle of perineum
-Urogenital triangle of perineum

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6
Q

What is the sacrum? What does it articulate with?

A

-Formed by the fusion of the five sacral vertebrae
-The base of the sacrum articulates with L5
-The apex articulates with the coccyx

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7
Q

What part of the sacrum projects into the pelvic inlet?

A

Promontory

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8
Q

What does the lumboscaral joint consist of?

A

-Formed by L5 and the sacrum
-2 facet joints (zygapophysial joints)
-An intervertebral disc that joins the body of L5-S1
-Stabilized by iliolumbar ligament, lumbosacral ligament, and anterior longitudinal ligament

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9
Q

What movements do the lumbosacral ligaments stabilize?

A

They stabilize all movements of L5-S1

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10
Q

What is the sacroiliac joint? What does it consist of?

A

-Synovial joints between the L-shapes articular facets on the lateral surfaces of the sacrum & facets on the iliac parts of the pelvic bones
-Anterior sacro-iliac ligament
-Interosseous sacro-iliac ligament
-Posterior sacro-iliac ligament

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11
Q

Which is the largest and strongest of the sacro-iliac ligaments?

A

Interosseous sacro-iliac ligament

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12
Q

What happens to the sacro-iliac joint as we age?

A

It becomes a fibrous joint, and can completely ossify

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13
Q

What does the pubic symphysis joint consist of ?

A

-Lies anteriorly between the adjacent surfaces of the pelvic bones
-Joint surfaces are covered by cartilage
-Can sometimes become fibrous or ossified

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14
Q

What ligaments stabilize the pubic symphysis joint?

A

-Superior pubic ligament
-Inferior pubic ligament
-These ligaments stabilize the pubic symphysis during childbirth

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15
Q

What are the muscles that make up the lateral pelvic wall?

A

-Obturator internus
-Piriformis

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16
Q

What nerve roots form the sacral & coccygeal plexuses? Where is it located?

A

-Situated on the posterolateral wall of the pelvic cavity
-Posterior to internal iliac vessels
-Formed by the ventral rami of S1-Co with a significant contribution from L4 & L5

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17
Q

What areas/muscles does the sacral & coccygeal plexus innervate?

A

-Muscles of the lower limb
-Muscles of the pelvis and perineum
-Cutaneous branches supply skin over the medial side of the foot, posterior aspect of lower limb, and most of the perineum

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18
Q

What forms the sacral plexus? Where is it located? Where does it pass through?

A

-Formed by anterior rami of S1-S4 and the lumbosacral trunk (L4 & L5)
-Located anteriorly to the piriformus muscle which is part of the posterolateral pelvic wall
-Passes out of the anterior sacral foramina & course laterally & inferiorly on the pelvic wall

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19
Q

Which major lower extremity nerves are formed by branches of the sacral plexus?

A

-Sciatic nerve
-Gluteal nerves
-Pudendal nerve (innervates perineum)
-Nerve to quadratus femoris
-Posterior femoral cutaneous nerves
-Nerve to piriformis
-Nerves to levator ani, coccygeus, and external anal sphincter

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20
Q

Where do most nerves from the sacral plexus exit the pelvic cavity?

A

Most exit by passing through the greater sciatic foramen, inferior to the piriformis muscle

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21
Q

What does the coccygeal plexus innervate?

A

Sensory to the perineum

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22
Q

What are the boundaries of the thoracic wall?

A

-The superior thoracic aperture bordered by vertebrae T1, rib 1, and the manubrium of the sternum
-The inferior thoracic aperture bordered by vertebrae T12, rib 12, the end of rib 11, costal margin, and the xiphoid process of the sternum

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23
Q

What is the skeletal framework of the thoracic wall?

A

-Thoracic vertebrae
-Intervertebral discs
-Ribs
-Sternum

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24
Q

What are the classifications of the ribs?

A

-True ribs
-False ribs
-Typical
-Atypical
-Floating ribs

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25
Q

Which ribs are the true ribs?

A

1-7

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26
Q

Which ribs are the false ribs?

A

8-12

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27
Q

Which ribs are floating ribs?

A

11 & 12

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28
Q

Which ribs are the typical ribs?

A

3-9

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29
Q

Which ribs are atypical?

A

1 & 2, 10-12

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30
Q

What are distinct features of rib 1?

A

-Has a scalene tubercle for attachment of the anterior scalene
-Has a groove for the subclavian artery
-Has a groove for the subclavian vein
-Only articulates with T1

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31
Q

What are distinct features of rib 2?

A

Has a tubercle for attachment of serratus anterior

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32
Q

What are distinct feature of rib 10?

A

The head has a single facet for articulation with T10 (instead of 2 facets)

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33
Q

What does the sternum consist of?

A

-Manubrium
-Body
-Xiphoid process

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34
Q

What are distinct features of ribs 11 & 12?

A

-Only articulate with the bodies of their corresponding vertebrae & have no tubercles
-Both are short w/ little curve
-Point anteriorly
-No articulation w/ sternum

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34
Q

Which of the sternocostal joints is not a synovial joint? Why is it a fibrocatilaginous joint?

A

-Sternocostal joint 1
-It is a fibrocartilaginous joint so that it does not move upward and compress major vessels and nerves/brachial plexus that passes over the top of it

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34
Q

What portions of the sternum have demifacets? What ribs are they for?

A

-There is one demifacet that crosses the manubriosternal joint that is for rib 2
-There is another demifacet where the body and xiphoid process articulate which is for rib 7

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35
Q

What movements occur at the interchondral joints?

A

The interchondral joints allow for gliding movements to allow false ribs to move

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36
Q

What movement does the manubriosternal joint/sternal angle allow for?

A

Allows for anterior displacement during inhaling

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37
Q

What intercostal space are the aortic vale and pulmonary valves located in?

A

The second intercostal space (under rib 2)

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38
Q

What is the level of the sternal angle in relation to the vertebral column?

A

At the level of T4-T5 intervertebral disc

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39
Q

What does the sternal angle/angle of Louis mark the level of? What does it overlie?

A

-It marks the level of the transverse thoracic plane which divides the mediastinum into the superior and inferior mediastinum
-It overlies the aortic arch on the left and the superior vena cava on the right

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40
Q

What structure extends downwards from just superior to the angle of Louis to the xiphisternal joint?

A

The pericardium

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41
Q

Where does the trachea bifurcate?

A

-Roughly at the level of the angle of Louis
-The tracheal carina is deep to the sternal angle

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42
Q

Where does the pulmonary trunk bifurcate?

A

Roughly at the level of the angle of Louis (sternal angle between manubrium and body)

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43
Q

What does the intercostal space consist of?

A

-Intercostal vessels
-Intercostal nerves
-3 layers of intercostal muscles

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44
Q

Where does the intercostal nerves and associated vessels lie?

A

They lie in the costal groove along the inferior margin of the superior rib & pass between the inner two muscle layers

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45
Q

What is the order of the nerves and vessels in the intercostal space?

A

-The vein is the most superior
-Then the artery is inferior to the vein
-The nerve is the most inferior

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46
Q

What structure in the intercostal space is not protected by bone?

A

Intercostal nerves

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47
Q

Which of the intercostal muscles contracts with the diaphragm and favors inspiration? What direction are the fibers?

A

-External intercostal muscle
-Fibers are in the same direction as external oblique (think of putting something in your pocket)

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48
Q

Which of the intercostal muscles favors expiration? What is another function of these muscles? What direction are the fibers?

A

-Internal intercostal muscle (middle muscle)
-Innermost intercostal muscle
-They are stiff to provide a wall between the thoracic wall and pleura
-Fibers are in the same direction as internal oblique

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49
Q

What arteries supply the thoracic wall?

A

-Posterior intercostal artery
-Internal thoracic artery
-Anterior intercostal artery
-Musculophrenic artery

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50
Q

What artery is also known as the mammary artery?

A

Internal thoracic artery

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51
Q

Where is the musculophrenic artery located?

A

It runs obliquely downward behind the cartilages of the false ribs

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52
Q

Where is the internal thoracic artery located? What branches off of it?

A

-Lateral to sternum on both sides
-Anterior intercostal arteries branch off of it

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53
Q

What veins supply the thoracic wall?

A

-Azygous vein
-Right and left superior intercostal veins
-Right and left subcostal veins
-Accessory hemiazygous vein
-Hemiazygous vein
-Anterior intercostal vein
-Posterior intercostal vein
-Internal thoracic vein

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54
Q

Where is the azygous vein located? What does it branch off from?

A

-It is located on the right side of the thoracic wall just anterior to the vertebral bodies
-It branches directly off the superior vena cava

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55
Q

Where is the accessory hemiazygous vein located? What does it branch off from?

A

-It is located on the superior left side of the thoracic wall just anterior to the vertebral bodies
-It branches off the superior intercostal vein superiorly, and the azygous vein inferiorly

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56
Q

Where is the hemiazygous vein located? What does it branch off from?

A

-It is located on the inferior left side of the thoracic wall just anterior to the vertebral bodies
-It branches off the azygous vein

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57
Q

Where is the internal thoracic vein located?

A

Lateral to the sternum on both sides

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58
Q

Where do the superior intercostal veins branch off from?

A

Both right and left branch off the brachiocephalic veins

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59
Q

What are the intercostal nerves? What do they innervate? What muscles are they located between?

A

-Anterior rami of spinal nerves T1-T11
-They segmentally innervate the intercostal muscles
-Located between the internal and innermost intercostal muscles
-They are just called spinal nerves before it reaches the intercostal space

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60
Q

What is the main goal behind rib movement? What movements of the ribs create inspiration and which create expiration?

A

-To change the pressure in the thoracic cavity
-Elevation of ribs favors inspiration
-Depression of ribs favors expiration

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61
Q

What are the divisions of the respiratory system?

A

-Mouth
-Nasal cavities
-Pharynx
-Larynx
-Trachea & bronchial tree
-Lungs & pleural membranes
-Alveoli

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62
Q

What are the two classification systems for the respiratory system?

A

-Upper & lower respiratory system
-Conductive & respiratory zones

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63
Q

What structures make up the upper respiratory zone?

A

-Mouth
-Nasal cavities
-Pharynx
-Larynx

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64
Q

What structures make up the lower respiratory system?

A

-Trachea & bronchial tree
-Lungs & pleural membranes
-Alveoli

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65
Q

What structures make up the conductive zone?

A

-Nose
-Larynx
-Trachea
-Bronchi
-Bronchioles
-Terminal bronchioles

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66
Q

What structures make up the respiratory zone?

A

Alveoli

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67
Q

What are the major structures in the larynx?

A

-Epiglottic cartilage
-Thyroid cartilage: superior horn
-Arytenoid cartilage
-Cricoid cartilage

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68
Q

What is the function of the epiglottis?

A

-Can open & close larynx
-Closes during swallowing/eating so that food goes to esophagus and not into the airways

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69
Q

What is the function of the arytenoid process?

A

-Muscular process for muscle attachment
-Helps to move vocal cords to produce phonation (talking)

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70
Q

What is the function of the cricoid cartilage?

A

It ensures that the airways are open

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71
Q

What nerve innervates the muscles of the larynx? What nerve is this a ramification from? What happens if this nerve is damaged?

A

-Recurrent laryngeal nerve
-Ramification of vagus nerve
-Patients will have a hard time swallowing and may aspirate their food

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72
Q

Where is the partietal pleura attached to?

A

It is attached to the thoracic wall & innermost intercostal muscle

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73
Q

What is the pleura? What does it create?

A

-Membranes of the lung
-There is a parietal and visceral pleura
-Creates the pleural sac, where serous fluid circulates between the two layers

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74
Q

What is the visceral pleura attached to?

A

It is attached to the surface of the lung

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75
Q

What is the pulmonary ligament formed by?

A

It is formed by where the pleura join together at the root of the lung

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76
Q

Where is the apex of the lungs located?

A

Located above rib 1 and extends into the root of the neck

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77
Q

Where does the bottom of the lungs extend into?

A

Extends to a level just above the costal margin

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78
Q

What is the innervation of the parietal pleura?

A

-Intercostal nerves
-Diaphragmatic and mediastinal parts are innervated by the phrenic nerve

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79
Q

What is the suprapleural membrane?

A

It is a ligament that attaches to the transverse processes of C7 and the medial border of rib 1

80
Q

What muscle is attached to the suprapleural membrane? What happens if this muscle is too lax?

A

-The scalenes attach to this ligament
-If the scalenes are too lax/loose, the apex of the lungs will be depressed

81
Q

What vessel delivers oxygenated blood from the lungs to the heart?

A

Pulmonary veins

82
Q

What vessel delivers deoxygenated blood to the lungs?

A

Pulmonary arteries

83
Q

What type of blood is sent back to the heart from the lungs via the pulmonary veins? Where does it enter the heart?

A

-Oxygenated blood
-Goes into the left atrium

84
Q

What surface do all structures enter and exit the lungs?

A

Mediastinal surface

85
Q

What are the main landmarks on the lungs?

A

-Anterior border
-Posterior border
-Mediastinal surface
-Inferior border
-Base/diaphragmatic surface
-Costal surface

86
Q

What structure surrounds the primary bronchii and pulmonary vessels? What do all of those structures together make up?

A

-Hilum
-Root is made up of the hilum and all the structures within the hilum

87
Q

What structures pass through the hilum?

A

-Pulmonary artery
-2 pulmonary veins
-A main bronchus
-Bronchial vessels
-Nerves
-Lymphatics

88
Q

What vessels supply blood to the lungs?

A

Bronchial vessels

89
Q

Where does the vagus nerve pass in relation to the lungs?

A

It passes immediately posterior to the roots of the lungs in the mediastinum

90
Q

Where does the phrenic nerve pass in relation to the lungs?

A

It passes immediately anterior to the root of the lungs in the mediastinum

91
Q

What lobes are there in the right lung?

A

-Superior lobe
-Middle lobe
-Inferior lobe

92
Q

What fissures separate each lobe in the right lung?

A

-Horizontal fissure separates the superior and middle lobes
-Oblique fissure separates the inferior lobe from the superior & middle lobes

93
Q

What is the mediastinum?

A

The space between the lungs

94
Q

Where do the lungs attach to each other?

A

The two lungs only attach to one another at the root

95
Q

What structures pass on the middle surface of the right lung?

A

-Superior and inferior vena cava
-Esophagus
-Heart
-Azygous vein

96
Q

What lobes are there in the left lung?

A

-Superior lobe
-Inferior lobe
-Lingula

97
Q

What fissure separates the lobes of the left lung?

A

Oblique fissure separates the superior and inferior lobes

98
Q

What is the lingula?

A

-The lingula is a tongue looking structure on the left lung that is similar to the middle lobe on the right lung
-It is independent of the other lobes
-Attached to the superior lobe

99
Q

What structures pass on the middle surface of the left lung?

A

-Aortic arch
-Descending/thoracic aorta
-Esophagus
-Heart

100
Q

Where does the trachea start and end in relation to the vertebral column?

A

The trachea extends from C6 to T4/5 where it bifurcates into the right and left main bronchus

101
Q

How is the trachea held open?

A

-It is held open by C-shapes transverse cartilage rings emdedded in its wall
-The open portion of the rings face posteriorly

102
Q

What is the lowest tracheal ring? What is it called?

A

-A hook-shaped structure that projects backward in the midline between the origins of the two main bronchii
-Called the carina

103
Q

What does the main bronchii split into in order from largest to smallest?

A

-Main bronchus
-Lobar bronchii
-Segmental bronchii
-Bronchioles
-Terminal bronchioles

104
Q

Which of the main bronchii are wider and more vertical through the hilum?

A

The right main bronchus

105
Q

What are the bronchioles? How big are they? What is the main element of them?

A

-The smallest branches from the bronchial tree
-Less than 1mm in diameter
-Cartilage plates disappear in bronchioles
-Muscle is the main element of the wall

106
Q

How does gas exchange occur in the alveoli?

A

-A pulmonary arteriole surrounds the alveolar sacs
-Carbon dioxide exits the blood into the alveoli
-Oxygen enters the blood from the alveoli

107
Q

How many independent segments are there in each lung?

A

There are 10 independent areas in each lung

108
Q

What are the bronchial vessels known as?

A

The “nutrition” of the lungs

109
Q

What are the main bronchial arteries?

A

-Right bronchial artery
-Superior left bronchial artery
-Inferior left bronchial artery

110
Q

Where does the right bronchial artery branch off from?

A

The third posterior intercostal artery

111
Q

Where does the superior left bronchial artery branch off from?

A

The aorta

112
Q

Where does the inferior left bronchial artery branch off from?

A

The descending aorta

113
Q

What two pulmonary veins enter the lungs?

A

Superior & inferior

114
Q

Where do the pulmonary arteries originate from?

A

Pulmonary trunk

115
Q

What is the difference between the right and left pulmonary arteries?

A

-The right is longer and passes horizontally across the mediastinum
-The left is shorter and lies anteriorly to the descending aorta and posterior to the superior pulmonary vein

116
Q

What are the lungs innervated by?

A

-Right and left vagus nerve
-Right and left phrenic nerve
-Anterior and posterior pulmonary plexus
-Sympathetic trunk

117
Q

What is the main functions of the cardiovascular system?

A

-Transportation
-Blood=transport vehicle
-Carries oxygen, nutrients, waste, and hormones
-Movement provided by pumping of heart

118
Q

What is the pulmonary circuit?

A

Circulation between the heart and lungs

119
Q

What is the systemic circuit?

A

Circulation between the heart and all the body tissues

120
Q

What are general characteristics of blood?

A

-Blood flows 4.5-5.5 times slower than water
-38 degrees C/ 100.4 F
-pH 7.35-7.45
-0.85-0.90% salt concentration
-About 8% of total body weight
-Females have 4-5L
-Males have 5-6L

121
Q

What are the functions of the blood?

A

-Transports oxygen, carbon dioxide, nutrients, wastes, hormones, enzymes
-Regulates pH
-Prevents body fluid loss through the clotting mechanism
-Protects against toxins and foreign microbes

122
Q

What is the general structure of arteries and veins?

A

-Tunica intima (innermost)
-Tunica media (middle)
-Tunica externa (outermost)
-Layers are enclosed in endothelium

123
Q

What is the difference between the walls in arteries and veins?

A

The smooth muscle layers (tunica intima, media, and externa) are all much thicker in arteries than in veins

124
Q

What are the characteristics of arteries? What is its function?

A

-Elastic tissue for recoil
-Muscular for distribution: regulates flow and blood to different parts of the body
-Walls contain smooth muscle fibers

125
Q

What are arterioles? What is their function?

A

-Tiny branches off arteries that connect to venules through capillaries
-Major site of blood flow resistance
-Serve as reduction valves
-Narrow lumens
-Thick muscular walls
-Regulate the degree of pressure within the system

126
Q

What are capillaries? What is their function?

A

-Where aterioles and venules connect
-One cell wall thick
-Tight junction
-Internal respiration takes place (gas exchange with tissue)
-Tissue nutrition

127
Q

What are the characteristics of venules and veins?

A

-Venules connect with arterioles via capillaries
-Both easily distend
-Some smooth muscle for venoconstriction
-Veins in exremities have one way valves
-Low blood pressure
-Slow flow
-70% of total blood volume is in veins
-Larger lumens and thinner walls than arteries
-No elasticity
-Less smooth muscle than arteries
-More collagen than arteries

128
Q

What is the orientation of the heart?

A

-Located in the middle mediastinum
-Great veins and arteries at the base
-Pointed tip is apex

129
Q

What is the pericardium? What is its function?

A

-Double walled sac around the heart
-Composed of a superficial fibrous pericardium and two serous layers called parietal pericardium and visceral pericardium
-The layers are separated by fluid called the pericardial fluid
-Protects and anchors the heart
-Prevents overfilling of the heart with blood
-Allows for the heart to work in a relatively friction-free environment

130
Q

What are the two layers of the wall of the heart?

A

-Epicardium (same thing as visceral pericardium)
-Myocardium

131
Q

What is the epicardium? What layers does it have?

A

-Serous membrane that adheres to the outer surface of the heart
-Superficial layer: mesothelium
-Covers ordinary connective tissue
-Deeper layer- large blood vessels, more fat
-Continuous with endomysium of underlying cardiac muscle

132
Q

What is the myocardium?

A

-Cardiac muscle
-Muscular and thickest part of the wall
-Lies deep to the epicardium
-Composed of cardiac muscle

133
Q

What is the endocardium? What is its function?

A

-Connective tissue
-Squamous cells
-Folds to form valves
-Lines the atrial and ventricular cavities and all structures that project into the heart
-Very thin
-Has three layers

134
Q

What is the skeleton of the heart?

A

Fibrous rings that separate the atria from ventricles

135
Q

What are the major structures that are in the heart or come off the heart?

A

-Left common carotid
-Brachiocephalic trunk
-Superior & inferior vena cava
-Pulmonary trunk & arteries
-Right and left atria
-Right and left ventricles
-Left subclavian artery
-Pectinate muscles
-Tricuspid/right AV valve
-Chordae tendinae
-Trabeculae carneae
-Aorta
-Right and left pulmonary veins
-Mitral/bicsupid/left AV valve
-Aortic semilunar valve
-Pulmonary semilunar valve
-Papillary muscles
-Interventtricular septum
-Epicardium
-Myocardium
-Endocardium

136
Q

What are the 4 chambers of the heart?

A

-Right and left atria
-Right and left ventricles

137
Q

Where does the right atria receive blood from?

A

It receives deoxygenated blood from the superior and inferior vena cava

138
Q

Where does the left atria receive blood from?

A

It receives oxygenated blood from the pulmonary veins

139
Q

Where does the left ventricle receive blood from? Where does it pump blood to?

A

It receives oxygenated blood from the left atrium and pumps it to the aorta to the systemic circulation

140
Q

Where does the right ventricle receive blood from? Where does it pump blood to?

A

It receives deoxygenated blood from the right atrium and pumps it into the pulmonary artery to the pulmonary circulation

141
Q

What is the function of the heart valves?

A

They ensure unidirectional blood flow through the heart

142
Q

What are the characteristics of the tricuspid valve?

A

-Right AV orifice
-Anterior, septal, and posterior cusps
-Close during ventricular contraction

143
Q

What are the characteristics and location of the pulmonary valve?

A

-Located in the right ventricle that leads to the pulmonary artery
-3 semilunar cusps

144
Q

What are the characteristics of the mitral valve?

A

-Left AV orifice
-Anterior and posterior cusps
-Closes during ventricular contraction

145
Q

What are the characteristics and location of the aortic valve?

A

-Located in the left ventricle that leads to the aorta
-3 semilunar cusps
-Right, left, and posterior aortic sinuses

146
Q

Where is the coronary sulcus located?

A

Between the right atrium and right ventricle

147
Q

What are the coronary arteries?

A

-Arteries that supply blood to the heart
-Right coronary artery
-Sinu-atrial nodal branch of right coronary artery
-Left coronary artery
-Circumflex branch of left coronary artery
-Left marginal branch of circumflex branch
-Anterior interventricular branch of left coronary artery
-Diagonal branch of anterior interventricular branch
-Right marginal branch of right coronary artery
-Posterior interventricular branch of right coronary artery

148
Q

Where does the left coronary artery branch off of? Where does the right branch off of?

A

-Left branches from the left aortic sinus
-Right branches from the right aortic sinus

149
Q

What is coronary artery disease? How severe is it?

A

-Occlusion of a major coronary artery which leads to an inadequate oxygenation of an area of myocardium
-The severity depends on the size & location of the artery involved & whether or not the blockage is complete

150
Q

What are the main cardiac veins?

A

-Coronary sinus
-Great cardiac vein
-Middle cardiac vein
-Anterior veins of right ventricles
-Posterior cardiac vein
-Right marginal vein

151
Q

What does the cardiac conduction system do? What are the components of it?

A

-The musculature of the heart is capable of contracting spontaneously, so the conduction system initiates and coordinates contractions
-Sinu-atrial (SA) node
-Atrioventricular (AV) node
-Atrioventricular bundle (Bundle of His)
-Subendocardial plexus of conduction cells called Purkinje fibers
-Bachmann’s bundle

152
Q

Where is the SA node located?

A

Right atrium

153
Q

Where is the AV node located?

A

In between the right atrium and right ventricle

154
Q

Where is the right bundle branch located?

A

The right side of the interventricular septum

155
Q

Where is the left bundle branch located?

A

The left side of the interventricular septum

156
Q

Where is Bachmann’s bundle located?

A

It is located in both the right and left atria

157
Q

What part of the nervous system is responsible for innervating the heart? What does it regulate?

A

-The autonomic nervous system
-Regulates heart rate, force of each contraction, and cardiac output

158
Q

What does the cardiac plexus consist of?

A

-Branches from both the parasympathetic and sympathetic systems
-Consists of a superficial part and a deep part

159
Q

Where is the superficial part of the cardiac plexus located?

A

Inferior to and between the aortic arch and pulmonary trunk

160
Q

Where is the deep part of the cardiac plexus located?

A

Between the aortic arch and tracheal bifurcation

161
Q

What nerves does the superficial part of the cardiac plexus consist of?

A

-Cardiac nerves from sympathetic trunk
-Left vagus nerve
-Vagal cardiac branches

162
Q

What nerves does the deep part of the cardiac plexus consist of?

A

-Right and left recurrent laryngeal nerve
-Right and left vagus nerve
-Vagal cardiac branches

163
Q

How does parasympathetic input to the heart effect it?

A

-Decreases heart rate
-Reduces force of contraction
-Constricts the coronary arteries

164
Q

How does sympathetic input to the heart effect it?

A

-Increases heart rate
-Increases the force of contraction

165
Q

What are the visceral afferents of the heart? What is their function?

A

-Afferent fibers that pass through the cardiac plexus and return to the CNS
-Associated with the vagal cardiac nerves and sense alterations in blood pressure and chemistry
-Afferents associated with the sympathetic system conduct pain sensation from the heart, which is detected at the cellular level from tissue damaging events (cardiac ischemia)

166
Q

How does the American Heart Association define heart failure?

A

“A heart that cannot keep up with its workload. The body may not get the oxygen it needs”

167
Q

What can heart failure do to the myocardium?

A

It can weaken the myocardium which leads to less blood being pumped out of the heart

168
Q

What is a normal ejection fraction?

A

50-70%

169
Q

What is a borderline ejection fraction?

A

41-49%

170
Q

What is a reduced ejection fraction?

A

Less than or equal to 40%

171
Q

What are some facts about chronic heart failure in the US?

A

-Over 6 million people in the US have heart failure
-Expected to reach 9 million people by 2030
-High mortality
-Estimated cost is $30.7 billion each year

172
Q

What does the urinary system consist of?

A

-Kidneys
-Ureters
-Urinary bladder
-Urethra

173
Q

What are the functions of the urinary system?

A

-Removes metabolic waste and retains nutrients
-Regulates blood volume and blood pressure
-Regulates concentration of potassium, sodium, chloride, etc
-Helps to stabilize blood pH

174
Q

Where are the kidneys located?

A

-There are 2 kidneys located on either side of the spine
-Between T12 and L3
-Left kidney is slightly superior

175
Q

How are the kidneys stabilized?

A

By connective tissue

176
Q

What color are the kidneys? How big are they?

A

-Reddish brown
-About 10 cm long
-5.5 cm wide
-3 cm thick
-Mass of 150 g

177
Q

What structures are on top of the kidneys?

A

Suprarenal glands

178
Q

What are the landmarks of the kidneys?

A

-Lateral margin
-Anterior surface
-Superior pole
-Medial margin
-Renal hilum
-Renal artery (on top of vein)
-Renal vein
-Renal pelvis
-Ureter
-Inferior pole
-Renal sinus
-Anterior and posterior lips
-Posterior surface

179
Q

What are structures that are related to the anterior surface of the right kidney?

A

-Right suprarenal gland
-Liver
-Descending part of duodenum
-Right colic flexure
-Small intestine

180
Q

What are structures that are related to the anterior surface of the left kidney?

A

-Left suprarenal gland
-Stomach
-Spleen
-Pancreas
-Left colic flexure
-Descending colon
-Jejunum

181
Q

What structures are related to the posterior surface of the kidneys?

A

-Ribs 11-12
-Diaphragm
-Psoas major muscle
-Quadratus lumborum muscle
-Transverse abdominis muscle

182
Q

What are the external layers of the kidneys?

A

-Renal fascia (outermost)
-Adipose capsule-perirenal fat (middle)
-Renal capsule- fibrous (innermost)

183
Q

What are the structures on the inside of the kidney?

A

-Pyramids in renal medulla
-Renal column
-Renal cortex
-Renal papilla
-Renal sinus
-Major calyx
-Minor calyx
-Renal pelvis
-Renal artery
-Renal vein

184
Q

What is the hilum of the kidney? Where is it located?

A

-A deep vertical slit through which renal vessels, lymphatics, and nerves enter and exit the kidney
-On the medial margin of each kidney
-Continuous with the renal sinus

185
Q

What is the renal cortex?

A

A continuous band of pale tissue that completely surrounds the renal medulla

186
Q

What are the renal columns?

A

Divide the renal medulla into discontinuous aggregations of triangular shaped tissue called pyramids

187
Q

What artery supplies the kidneys?

A

-A single large artery that branches off the abdominal aorta supplies each kidney
-Called the renal artery

188
Q

What is the blood flow through the nephrons?

A

-Segmental artery
-Arcuate artery
-Interlobular artery

189
Q

What are ureters?

A

Muscular tubes that transport urine from the kidneys to the bladder

190
Q

Where are the three points of constriction of the ureters? What can happen at these three points?

A

-1st is at ureteropelvic junction
-2nd is where the ureters cross the common iliac vessels/pelvic inlet
-3rd is where the ureters enter the wall of the bladder
-Kidney stones can become lodged at these three constrictions

191
Q

What is the bladder? Where is it located?

A

-Three sided pyramid shaped structure
-Holds the urine before excretion
-It has an apex, a base, a superior surface, and two inferolateral surfaces
-The most anterior element of the pelvic viscera
-It can expand into the abdominal cavity when full

192
Q

Where is the neck of the bladder located?

A

-Surrounds the origin of the urethra at the point where the two inferolateral surfaces and the base intersect
-The neck is the most inferior part and the most “fixed” part

193
Q

How is the neck of the bladder anchored into position?

A

It is anchored by a pair of tough fibromuscular bands, which connect the neck and pelvic part of the urethra to the posteroinferior aspect of each pubic bone

194
Q

What are the fibromuscular bands that hold the neck of the bladder to the pelvic bones called in females? What about in males?

A

-Pubovesical ligament
-Puboprostatic ligament

195
Q

What structures help to support the bladder?

A

-Pubovesical/puboprostatic ligament
-Perineal membrane and associated muscles
-Levator ani muscles
-Pubic bones

196
Q

Where does the urethra begin? Where does it end?

A

It begins at the neck of the bladder & ends with an external opening in the perineum

197
Q

How long is the urethra in females? Where does it pass through?

A

-It is about 4cm long
-It passes through the deep perineal pouch and perineal membrane before opening in the vestibule that lies between the labia minora
-The opening is anterior to the vaginal opening

198
Q

What are the Skene’s glands? Where do they drain?

A

-Two small paraurethral mucous glands that are associated with the lower end of the urethra in females
-Each drains via a duct that opens onto the lateral margin of the external urethral orifice

199
Q

What are the different parts of the urethra in males?

A

-Preprostatic part
-Prostatic part
-Membranous part
-Spongy part

200
Q

How long is the urethra in men? Where does it pass through?

A

-20 cm long
-Begins at the base of the bladder
-Passes inferiorly through the prostate, through the deep perineal pouch, perineal membrane
-It then enters the root of the penis and the body of the penis

PHTH 511: Anatomy (9 decks)

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