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Gross Anatomy > Gray's Notes - Thorax > Flashcards

Gray's Notes - Thorax Flashcards

1
Q

What does the aorticopulmonary septum do?

A

divides the truncus arteriosus and the bulbus cordis into the aorta and pulmonary trunk

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2
Q

what does the bulbus cordis form?

A

ventricle

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3
Q

what does the trucus arteriosus form?

A

aorta and pulmonary trunk

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4
Q

what happens below the laryngeal atresia?

A

airways dilate, lungs enlarge and become echogenic, diaphragm flattens (inverts), fetal as cities/hydrops develop

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5
Q

what is tracheal atresia commonly found with?

A

tracheoesophageal fistula

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6
Q

what is polyhydraminos? what is it associated with?

A

excess of amninotic fluid

associated with esophageal atresia or tracheoesophageal fistula

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7
Q

what is lung hypoplasia and where is it commonly found?

A

reduced lung volume

infants with congenital diaphragmatic hernia

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8
Q

what is oligohydraminos? What is commonly associated with?

A

decrease in amniotic fluid

associated with stunted lung development and pulmonary hypoplasia

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9
Q

if you have a child with transposition of the great arteries, what structure would be good to remain patent until surgery? Why?

A

patent ductus arteriosus
would act as a shunt between the aorta and pulmonary trunk allowing oxygenated and deoxygenated blood to mix and therefore allowing SOME oxygenated blood to reach tissues

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10
Q

what does superior malalignment of the sub pulmonary infandibulum cause?

A

stenosis of the pulmonary trunk - this leads to the tetralogy of Fallot

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11
Q

what is a defect in the formation of the transposition of great arteries?

A

aorticopulmonary septum defect

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12
Q

what type of defect is associated with membranous type VSD?

A

endocardial cushion defect

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13
Q

what two things are associated with Di George’s syndrome (22q11)?

A

Tetralogy of Fallot and truncus arteriosus

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14
Q

what is associated with maternal diabetes?

A

transposition of the great arteries

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15
Q

what are present in individuals with Down Syndrome (trisomy x)?

A

VSD, ASD

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16
Q

what is associated with Turner Syndrome?

A

coarctation of the aorta

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17
Q

what is associated with Marfan syndrome?

A

aortic atresia

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18
Q

what would cause the diaphragm to protrude into the thoracic cavity forming a pouch that the abdominal viscera can protude?

A

absence of musculature in one half of the diaphragm

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19
Q

what are pleuropericardial folds responsible for?

A

separating the pericardial cavity from the pleural cavity

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20
Q

what does abnormal septation of the sinus venosus lead to?

A

can lead to inappropriate pumlonary connections

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21
Q

what does the first aortic arch develop into?

A

maxillary a.

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22
Q

what does the second aortic arch develop into?

A

stapedeal a. and hyoid

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23
Q

what does the third aortic arch develop into?

A

common carotid

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24
Q

what does the fourth aortic arch develop into?

A

aortic arch on L and subclavian on R

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25
Q

what does the Left sixth aortic arch develop into? (there is no right!)

A

ventral - pulmonary a.

dorsal - ductus arteriosus

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26
Q

what does common truncus arterioles result from?

A

separation of the pulmonary trunk and aorta

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27
Q

what does common trucus arteriosus present with?

A

severe cyanosis and right to left shunt

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28
Q

when closing a VSD what should I be careful of?

A

don’t suture over the right bundle branch because it carries impulses from the AV node to the apex of the heart through right bundle of His

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29
Q

an incomplete division of the foregut into respiratory and digestive poritions or incomplete division of the tracheoesophageal septum results in what?

A

esophageal atresia

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30
Q

where is the incision made for a tracheostomy?

A

level of the C6 near cricoid cartilage

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31
Q

what structure is most likely to be damaged in a tracheostomy?

A

left brachiocephalic vein

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32
Q

when you hear S1 what is it?

A

closing AV valves (lub)

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33
Q

when you hear S2, what is it?

A

closing semilunar valves (dub)

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34
Q

what does a murmur at S2 mean?

A

artioventricular valve defect

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35
Q

what would cause murmur at S1?

A

trnasposition of great arteries and aortic stenosis

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36
Q

what does a left to right shunt mean?

A

oxygenated blood is mixing with deoxygenated blood and being circulated to body

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37
Q

what is the location of the preganglionic neural cell bodies involved in increase heart rate (sympathetics)?

A

lateral horn of T1 to T4

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38
Q

which nerves carry pain fibers from the heart to the CNS?

A

cardiopulmonary splancnic (or thoracic visceral) nerves

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39
Q

what nerves carry parasympathetic fibers to the heart?

A

vagus n.

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40
Q

what nerve carries preganglionic sympathetic fibers to the abdomen and carry afferent (sensory) for pain from the abdomen?

A

greater and lesser splancnic nerves

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41
Q

what are 2 somatic nerves that are not involved in innervating the heart or lungs?

A

phrenic n. and intercostal n.

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42
Q

what nerve is responsible for innervation of the skin on the medial surface of the upper arm?

A

intercostobrachial n.

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43
Q

which nerve transmits pain fibers radiating from pericardial friction rub (pericarditis)?

A

phrenic n.

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44
Q

why does the phrenic n. have referred pain in shoulder?

A

its supplied by C3, C4, C5 and those also supply the skin of the shoulder

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45
Q

what nerve is responsible for radiating pain to the arm during MI?

A

intercostobrachial n.

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46
Q

what do ventral rami contain and do?

A

have both sensory and motor fibers

also sympathetics to body wall except for rissues of the back

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47
Q

what do dorsal roots have and do?

A

somatic and visceral sensory information from the periphery

48
Q

what is the pharynogoesophageal junction?

A

where the pharynx ends and the esophagus begin at the level of the 6th cervical vertebrae

49
Q

where is the apex of the heart located (rib)?

A

5th intercostal space around midclavicular line

50
Q

what does left dominant mean?

A

the LCA provides the posterior interventricular a. as a terminal branch of the coronary circumflex

51
Q

what is near the opening to the IVC?

A

the estuchian valve is an ebryolic remnant of teh valve of the inferior NC and is not a functional valve

52
Q

what is the thespian valve?

A

semicircular fold at the orfice of the coronary sinus

53
Q

what do you want to be careful of when acessing the right atrium?

A

crista terminalis - a muscular ridge that provides the pathway taken by the posterior internodal pathway (of Thorel) between the sinoatrial and atrioventular nodes

54
Q

where do you insert a needle for pericardiocentesis?

A

below the xyphoid process, or in the left 5th intercostal space in the mid clavicular line

55
Q

whats another name for anterior interventrucular artery?

A

left anterior descending artery

56
Q

what would a finger passing through the transverse pericardial sinus pass directly behind?

A

the great arteries - pulomary trunk and aorta - could clamp if needed

57
Q

what does the onlique sinus provide access to?

A

IVC, posterior wall of the left atrium, right atrium and right and left pulmonary v.

58
Q

where do the leads of pacemakers go to reach the right ventricle?

A 
brachiocephalic v. 
superior VC
RA
tricuspid
RV
59
Q

what is mitral valve stenosis?

A

leads to left atrial dilation - compress the esophagus

60
Q

what is the surgical anastomosis that can alleviate symptoms of portal hypertension?

A

splenic v. and left renal v.

61
Q

what artery is repsonsible for fundic bleeding?

A

short gastric or dorsal gastric branches of the splenic artery

62
Q

what type of hernia is most common in females?

A

indirect inguinal hernia

63
Q

do femoral hernias occur more frequently in males or females?

A

females

64
Q

are inguinal hernias more common in males or females?

A

males

65
Q

are direct inguinal hernias common in males or females?

A

both - equal occurence

66
Q

Where is the SA node located specifically in the RA?

A

near the opening of the superior vena cava

67
Q

where is the AV node?

A

junction of the coronary sinus and the RA upon the right bfibrous trigone

68
Q

what does the moderator band carry?

A

the right bundle branch of the conduction system just beneath endocardial layer

69
Q

where should a chest tube be placed at the midclavicular line?

A

6-8

70
Q

where should the chest tube be placed at teh midaxillary line?

A

8-10

71
Q

where should the chest tube be placed paravertebral line?

A

10-12

72
Q

what layer of lung must be anesthetized to reduce pain during apiration or chest tube placement with pleural effusion?

A

parietal pleura - innervated by intercostal nerve = sensitive to pain = somatic innervation

73
Q

what structure is present at the right fourth costal cartilage?

A

horizontal fissure of the right lung

74
Q

what are inversion of nipple, dimpling over overlying skin common with?

A

retraction of suspensatory ligaments of Cooper

75
Q

where are the inferior tracheobronchial nodes (carinal nodes) located?

A

inferior aspect of the carina - site of bifurcation

76
Q

where do the pulmonary nodes lie?

A

on secondary bronchi

77
Q

where are bronchpulmonary nodes (hilar)

A

run along primary bronchi

78
Q

where are superior tracheobronchial nodes

A

junction of bronchi and trachea

79
Q

where are the paratracheal nodes

A

run along trachea

80
Q

what nerve is responsible for the innervation of teh skin above the mons pubis?

A

anterior cutaneous branch of the iliohypogastric n.

81
Q

what are indicative of appendicitis (2)?

A

mc burneys point and positive psoas test

82
Q

what nerves transmit pain (visceral afferent) to the rectum?

A

pelvic splanchnic nerves

83
Q

what supplies the parasympathetic supply to the rectum?

A

pelvic splanchnic n.

84
Q

where does an aortic aneuyrism usually occur?

A

L3 and L4 below the bifurcation of teh aorta

85
Q

where does most lymph drain from the breast first?

A

axillary nodes, more specifically to the anterior pectoral nodes

86
Q

what is one of the cardinal signs of coarctation of the aorta?

A

notching of the ribs due to reversal of direction of blood flow through the anterior intercostal branches of the internal thoracic a.

87
Q

what does the thoracic duct drain?

A

the entire body except the right upper quadrant

88
Q

dilation of the esophagus in lower thorax can compress the thoracic duct, what would this cause?

A

edema of lower limb

89
Q

what would a midline tumor of the thymus gland in the young cause?

A

compression of the left brachiocephalic vein

90
Q

what is another name for cervical pleura?

A

cupula - dome of the pleura

91
Q

what presents as a “wood like” texture in the breast?

A

cancer en cuirasse

92
Q

where does lymph form the lower 1/3 of the esophagus drain?

A

to posterior mediastinual and left gastric lymph nodes

93
Q

where does the middle 1/3 of the esophagus drain?

A

posterioer and superior mediastinal lymph nodes

94
Q

where does the upper 1/3 of the esophagus drain?

A

deep cervical nodes

95
Q

what would be compressed if there was a left deviation of trachea due to tumor in thyroid gland?

A

left brachiocephalic v.

96
Q

what is commonly used to guide the placement of a centrla venous line?

A

carina!

97
Q

with a patent ductus arteriosus what is the flow of blood?

A

blood leaves the left ventricle
intro the aorta
reshunted to left pulmonary artery

98
Q

what are signs of patent ductus arteriosus?

A

murmur during ascultation
enlarged pulmonary a
increased atrial pressure

99
Q

what are the cyanotic congenital heart defects?

A 
transposition of great arteries
common ventricle
truncus arteriosus
tetrology of Fallot
total anomolous pulmonary return
100
Q

what are the common acyanotic congenital heart defects?

A 
ASD
VSD
Patent ductus arteriosus
coarctation of aorta
aorta valve stenosis
pulmonary valve stenosis
101
Q

what is the result of an incomplete division of the foregut into respiratory and digestive portions (or tracheoesophageal septum)?

A

esophageal atresia

102
Q

what nerves carry pain fibers from the heart to the CNS? like with angina?

A

cardiopulmonary (thoracic visceral)

103
Q

what do ventral rami contain?

A

sensory and motor fibers and sympathetics to teh body wall

= somatic plexus!

104
Q

what provides the sensory and sympathetic supply to the areola and nipples?

A

anterior and lateral cutaneous branches

105
Q

at what level does aorta pass through diaphragm?

A

T 12

106
Q

what level does esophagus pass through diaphragm?

A

t 10

107
Q

what level does IVC enter diaphragm?

A

T 8

108
Q

injury to which conduction tissue would cause problems in both ventricles?

A

bundle of His

109
Q

what artery supplies the upper porition of the anterior right ventricle ?

A

artery of the conus

its from the RCA

110
Q

what resembles a thrombus in the right atrium near the opening of the IVC?

A

eustachian valve

111
Q

where do you insert a needle for pericardial centesis?

A

just below xiphoid process

left ICS in the midclavicular line

112
Q

what artery supplies the AV node?

A

branch of RCA

113
Q

regurgitation through any heart valve will eventually decrease what?

A

systemic blood flow

114
Q

what does the moderator band carry?

A

right bundle branch

115
Q

what direction does pump handle movement increase intrathoracic capacity?

A

anteiror - posterior

116
Q

what direction does bucket handle increase intrathoracic capacity?

A

medial lateral - transverse

117
Q

what is the most important factor in increases the intrathoracic capacity in inspiration?

A

descent of the diaphragm - increase vertical dimensions

Gross Anatomy (12 decks)

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