Intro to Cardioresp Workbook Flashcards
Describe the anatomy of cartilage in the neck
Thyroid cartilage lies over the larynx and above the thyroid gland in two halves that come together to form th laryngeal prominence (Adams apple) Below this (C6 level) is cricoid cartilage and below again is tracheal cartilage covering the trachea In gap between cricoid and thyroid is cricothyroid ligament where cricothyrotomy occurs due to airway obstruction
How many pairs of ribs do we have?
12
Where is the jugular notch?
Visible dip between the neck and the clavicle
Where is the sternal angle?
Visible ridge (Angle of Louis) - T4/T5 vertebral level Laterally is where the costal cartilage of the second rib attaches to the sternum
What lies at the level of the 4th rib?
horizontal fissure of the right lung - nipple lies at the level of the 4th intercostal space in men
What is the significance of the sternal angle?
This is where the trachea bifurcates and the aortic arch becomes the thoracic aorta
Describe where the heart lies in the chest
Heart lies In the thoracic cavity behind the sternum and in between the two lungs - 2/3 of the heart lies over the midline to the left hand side and extends to the midclavicular line crossing the 5th intercostal space
Where do you hear the aortic valve sound?
2nd intercostal space at the right sternal margin
Where would you hear the pulmonary valve sound?
2nd intercostal space at the left sternal margin
Where would you hear the tricuspid valve sound?
Right sternal margin in the 5th intercostal space
Where would you hear mitral valve sound?
over the heart apex in line with the middle clavicle in the 5th intercostal space
How many lobes does the right and left lung have?
Right lung has three lobes (horizontal and oblique fissure) and the left lung has 2 lobes (Oblique fissure)
Where does the oblique fissure lie?
Start at the 4th rib at the back and travel deep to the 5th rib and end at the 6th costal cartilage
Where do the lungs lie in relation to the ribs?
Inferior extent of the lungs is at the 6th rib anteriorly, 8th rib laterally and 10th rib posteriorly - lung extends above the clavicle into the base of the neck
Why is bronchoconstriction useful?
When asleep it reduces the volume of air that needs to be breathed into the lungs and reduces the effort needed to breathe
What is the arterial blood supply of the lungs?
Bronchial artery from the thoracic aorta supplying OXYGENATED BLOOD
2x Pulmonary arteries from the right ventricle providing DEOXYGENATED BLOOD
Describe the venous drainage of the lungs
Bronchial veins draining DEOXYGENATED BLOOD to the azygous vein
Pulmonary veins x4 draining OXYGENATED BLOOD
Describe the pleurae of the lungs
Inner surface of the chest wall is covered in parietal pleura which comes into contact with the visceral pleurae which covers the lungs - between the two layers is the parietal cavity which contains serous fluid which sticks the lung to the inside of the chest wall
Describe the mechanism of inspiration
Lung pressure must be lower than atmospheric pressure for air to be drawn in
Ribs are angled forwards and downwards and moved upwards and laterally (Pump and bucket handle) to increase the thoracic volume
Diaphragm contracts and moves downwards creating a negative pressure in the thorax resulting in air being drawn into the lungs –> Abdominal breathing
How does the mechanism of breathing change during exercise and pregnancy when increased gas exchange is required?
Contraction of the external intercostal muscles pulls the ribs closer together increasing the lateral and anterior-posterior diameters of the chest –> Thoracic breathing
Describe the mechanism of expiration
Normally a passive process (Diaphragm and external intercostals relax) with no muscular contraction of the intercostal muscles or the diaphragm except in active or forced expiration where internal intercostals and abdominals contract
When do the coronary arteries fill with oxygenated blood?
Fill during diastole when the ventricular wall is relaxed so a reduction in diastolic filling time will reduce the perfusion of cardiac tissue
Where does the coronary sinus drain into?
Right atrium
Define heart failure and list the three different type
HF is a syndrome of signs and symptoms where the heart is unable to pump sufficient blood - can be caused by structural or functional abnormalities
- Left ventricular failure
- Right ventricular failure
- Biventricular failure (Congestive cardiac failure)
What are the causes of heart failure
- Failure of heart valves
- Narrowed valve that restricts blood (increases strain on cardiac muscle
- Leaky valve allowing flow back into chamber - Increased demands on heart to circulate blood
- Anaemia - body needs to circulate more blood due to low Hb
- pregnancy - increased volume of blood and demands on the body
- High blood pressure - has to pump against higher resistance - Failure due to damage itself
- Coronary artery disease - insufficient blood reaching heart muscle - heart attack
- Cardiomyopathy - muscle is diseased
Effects of Heart Failure
Blood returning to the ventricle is not pumped out effectively so blood back log forms
In left ventricle this develops in the lungs = breathlessness
In the right ventricle blood back log develops in bodily tissues leading to leg oedema and prominent veins in the neck
