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CV I > Lungs and Heart > Flashcards

Lungs and Heart Flashcards

1
Q

What makes up the upper respiratory tract

A

Nose/nasal cavities/paranasal sinuses
pharynx
larynx

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2
Q

what makes up the lower respiratory tract

A

trachea
bronchi
lungs

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3
Q

where does the tracheobronchial tree begin and then bifurcate?

A

begins CV6

bifurcates at the transverse thoracis plane

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4
Q

What is the named sm m in the trachea

A

trachealis

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5
Q

What is the carina

A

last cartilage ring before bifurcation of trachea

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6
Q

What supplies the trachea vascularly

A

bronchial and inferior thyroid vessels

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7
Q

what innervates the trachea

A

recurrent laryngeal branches of vagus n

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8
Q

metastatic cancer cells in the paratracheal lymph nodes can cause what

A

carina to be distorted (bronchial carcinomas)

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9
Q

Which bronchus is shorter and more vertically oriented

A

right

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10
Q

how many secondary bronchi are there on the R and L lungs

A

R has 3

L has 2

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11
Q

How many tertiary bronchi are there on the R and L lungs

A

R has 10

L has 8-10

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12
Q

What type of cells make of pleura of lung

A

simple squamous epithelial cells+ loose CT

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13
Q

what is the function of pleura around lung

A

smooth surface for lungs to move during respiration

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14
Q

what does the pleura secrete

A

serosal fluid to lubricate

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15
Q

where is the visceral and parietal pleura continuous

A

hilum of lung

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16
Q

What are the surfaces of the parietal pleura

A

costal, diaphragmatic, mediastinal and cervical

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17
Q

what it the pulmonary ligament

A

formed from parietal and visceral pleura jointing and acts to maintain position of lung in thoracic cavity

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18
Q

what are the lines of reflection of parietal pleura

A

vertebral (post)
costal(inferior)
sternal (anteriorly)

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19
Q

How far does the cervical portion of parietal pleura extend, why is this important

A

the root of neck. could be punctured as result of wounds in this region

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20
Q

Why is pain of the pleura produced and where is it referred

A

lots of sensory innervation and referred to C3 C4 C5 dermatomes because of phrenic

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21
Q

Where do the visceral pleura nn travel

A

with autonomic fibers of bronchial vessels

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22
Q

What part of the cavity is important for pericardiocentesis

A

the small notch where pericardium is in direct contact with anterior thoracic wall.
formed because left sternal reflection runs lateral and inferior from 4th to 6th rib

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23
Q

Where is the pleural cavity

A

between the parietal and visceral pleura

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24
Q

What ribs does the visceral pleura extend along the midclavicular line, mid axillary and scapular

A

midclavicular- 6th
midaxillary-8th
scapular- 10th

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25
Q

what ribs does the parietal pleura extend along the midclavicular line, mid axillary and scapular

A

midclavicular -8th
midaxillary- 10th
scapular- 12th

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26
Q

what are pleural recesses

A

areas of pleural cavity that lungs don;t occupy during quiet respiration- two layers of pareital pleura come in contact

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27
Q

what are the two pleural recesses

A

costomediastinal- mediastinal pleura contacts costal pleura anteriorly
costodiaphragmatic- costal pleura contacts diaphragmatic around periphery

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28
Q

Which pleural recess can be damaged during abdominal procedures

A

costodiaphragmatic

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29
Q

What happens in a pneumothorax

A

potential space (air in pleural cavity) becomes real space

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30
Q

what is a hemothorax and hydrothorax

A

hemo- blood in the pleural space

hydro- fluid in the pleural space

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31
Q

What is tension pneumothorax

A

air entering pleural space and unable to exit- one way valve created. so increases intrathoracic pressure
shifts mediastinal contents and compresses venous return to heart

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32
Q

what are signs of a tension pneumothorax

A

muffled heart sounds, hypotension, and distended neck vv

“Becks triad”

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33
Q

Where are the apex’s of the lungs

A

first rib

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34
Q

At what levels of ribs do you find the cardiac notch in L lung

A

rib 4 mid sternal line then lateral to 6th rib at MCL

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35
Q

At scapular lines where do the lungs project to

A

rib 10

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36
Q

At midaxillary lines where do the lungs project to

A

rib 8

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37
Q

What is the cupula of the lung

A

apex

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38
Q

what is the hilum of the lung

A

area where all structures enter and leave lung

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39
Q

what are the lobes and fissures of the right lung

A

oblique and horizaontal fissure

superior middle and inferior lobes

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40
Q

what are the lobes and fissures of the L lung

A

oblique fissure

superior and inferior lobes

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41
Q

What are 2 specific characterizations of the L lung

A

cardiac notch and the lingula

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42
Q

Where are the oblique fissures located in regards to the ribs

A

4th rib crossing anterioinferioly to 6th ribs

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43
Q

What structures are located at the hilum

A 
pulmonary artery
pulmonary vv
primary bronchi
bronchial aa and vv
pulmonary plexus of nn
lymphatic vessels and lymph nodes
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44
Q

What is the smallest functional unit of the lung

A

bronchopulmonary segment

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45
Q

How many tertiary bronchi supply one bronchopulmonary segment

A

1

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46
Q

Where are the pulmonary vv in regards to the bronchopulmonary segments? aa?

A

one artery branch will run within

the plum vv run intersegmental

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47
Q

What is the difference of a pneumonectomy and lobectomy and a segmentectomy?

A

pneumonectomy- removal of 1 lung
lobectomy- removal of one lobe
segmentectomy- removal of one bronchopulmonary segment

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48
Q

How many bronchial aa do we have

A

2 on left 1 on right

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49
Q

Where do the bronchial vv terminate

A

azygos vv

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50
Q

Where are the pulmonary nodes

A

within substance of lung along bronchial tree

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51
Q

Where are the bronchopulmonary nodes

A

hilum of lung

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52
Q

where are the tracheobronchial nodes

A

tracheal bifurcation

53
Q

where do the superficial pulmonary lymph drain

A

bronchopulmonary nodes–>superior and inferior tracheobronchial nodes–> bronchomediastinal trunk

54
Q

What do the deep pulmonary plexus of lymph drain

A

larger bronchioles and bronchi

55
Q

Where does lymph of the left inferior lobe drain

A

right tracheobronchial nodes

56
Q

Do the lungs recive PANS or ANS inn

A

both

57
Q

Describe the sympathetic inn for lungs

A

preganglionic nerve cell bodies in T2-T6 segments thru sympathetic chain

58
Q

Where are the post ganglionic cell bodies located

A

upper thoracic and cervical

59
Q

what do the cell processes of the postganglionic cell bodies of lungs become?

A

cardiopulmonary splanchnic nn

60
Q

What is the efferent role of the sympathetic inn to lungs

A

vasoconstriction, bronchodilation, inhibit gland secretion

61
Q

what is the afferent role of the sympathetic inn to lungs

A

acute pain

62
Q

where are the cell bodies of the preganglionic fibers of parasympathetics to lung

A

brain stem, processes travel with vagus

63
Q

where are the PANS postganglionic nerve cell bodies for lungs

A

in the wall of the airways

64
Q

What is the role of PANS efferents of lungs

A

vasodilation, bronchoconstriction, gland secretion

65
Q

What inn the parietal pleura

A

nn supplying the thoracic wall including intercostal and phrenic nn.

66
Q

Where is phrenic pain seen on the body

A

neck/shoulder

67
Q

Boundaries of middle mediastinum

A 
superior- transverse thoracis plane
inferior- diaphragm
lateral- mediastinal pleura of lungs
anterior- anterior border pericardium
posterior- posterior border of pericardium
68
Q

what are the contents of the middle mediastinum

A

pericardium, herat, pulm trunk, ascending aorta, pulm vv

phrenic n and pericardiophrenic vessesls

69
Q

Where are the surface projections of the heart

A

superior- 2nd L costal cartilage to 3rd right costal cartilage
right- 3rd right costal carilate to 6th R costal cartilage
inferior- 6th R costal cartilage to L 5th intercostal space at MCL
left- left 5th intercostal space MCL to 2nd L costal cartilage

70
Q

Where does the fibrous pericardium attach

A

sternum via sternopericardial ligaments
posteriorly to fascia of esophagus
inferiorly to central tendon of diaphragm via pericardiacophrenic log
superiorly with the adventitia of great vessels

71
Q

What makes up the serous pericardium

A

visceral and parietal layers

72
Q

What is the function of the serous pericardium

A

allows the heart to move during contraction without friction

73
Q

What cell type make up parietal pericardium

A

simple squamous epithelial cells and thin layer of loose CT

74
Q

What cell type make up visceral pericardium

A

simple squamous epithelial cells and thin layer of loose Ct

75
Q

What part of the pericardium forms epicardium

A

visceral pericardium

76
Q

What causes cardiac tamponade

A

if pericardial space is filled with fluid, heart can’t fill to capacity

77
Q

What is pericardiocentesis

A

procedure to remove excess fluid, typically a needle is inserted through bare area of the heart(left of sternum 5th or 6th intercostal space)

78
Q

What are the pericardial sinuses

A

separate atrial and venouse ends of embryonic tubular heart and turn into transverse and oblique pericardial sinuses

79
Q

What are the anterior and posterior borders of transverse pericardial sinus

A

anterior- aorta and pulm trunk

posterior- SVC and pulm vv

80
Q

why is the transverse pericardial sinus important surgically

A

allows surgeons to pass a surgical clamp around the major aa and vv and insert tubes allowing blood to be diverted to a cardiac bypass pump during coronary artery surgery

81
Q

what are the boundaries for the oblique pericardial sinus

A

pulmonary vv and IVC

82
Q

Where do the paericardiacophrenic aa and vv arise from

A

internal thoracic aa and vv

83
Q

What provides sensory inn to fibrous and parietal pericardium

A

phrenic n

84
Q

what inn the visceral pericardium

A

cardiac plexus

85
Q

Where is pericardial pain referred

A

shoulder/neck because phrenic C345

86
Q

Why is pericarditis painful

A

because of pain fibers in the fibrous and parietal pleura

87
Q

Which part of the heart is more posterior

A

left

88
Q

what are the external sulci of the heart

A 
atrioventricular sulcus (coronary)
interventricular sulci (anterior and posterior)
89
Q

What portion of the heart makes up the apex

A

left ventricle

90
Q

Where is the apex located on the surface of thorax

A

posterior to L 5th intercostal space MCL

91
Q

What portion of the heart makes up the base

A

left atrium

92
Q

What are the functions of the heart’s fibrous skeleton

A

support for heart valves, preventing distention of heart and provides for attachment of cardiac m and for valve leaflets
insulates against impuls conduction to prevent aberrant spread of impulses
provide tunnel for passage of A/V bundle of His

93
Q

Where are the fibrous rings of the heart

A

around orifices of 4 heart valves

94
Q

what are the fibrous trigones of the heart

A

connections between fibrous rings
L between aortic and mitral
R between aortic mitral and tricuspid

95
Q

What lines the auricles

A

pectinate mm

96
Q

What is the crista terminalis of the heart

A

dividing line between sinus venarum and embryonic atrium

demarcated externally by sulcus terminalis

97
Q

Where is the SA node relatively located

A

right atrium nead junction of sulcus terminalis and SVC

98
Q

where is the AV node relatively located

A

near opening of coronary sinus of right atrium

99
Q

Where is the septomarginal band in the heart

A

interventricular septum to anteiror papillary in R ventricle

100
Q

where is the conus arteriosus in R ventricle

A

smooth wall part leading to plum artery

101
Q

how many cusps and what are they in the R AV valve

A
  1. anterior posterior and septal
102
Q

what are the 2 parts of the interventricular septum

A

membranous and muscular

103
Q

how many cusps does the pulmonary semilunar valve have and names?

A

3 anterior left and right

104
Q

what are the components of a cusp in semilunar valves

A

nodule and lunule at thickened parts

105
Q

are there more trabecular carnae in R or L ventricles

A

L, finer but more abundant

106
Q

What is the aortic vestibule

A

smooth wall portion L ventricle leading to aorta

107
Q

How many cusps are there in the L AV valvae

A

2 anterior and posterior

108
Q

How many cusps are there in the aortic semilunar valve

A

3 posterior left and right

109
Q

which cusps of the aortic semilunar valve have the openings for the coronary aa

A

left and right

110
Q

Where can you listen for murmurs at the tricuspid and bicuspid valves

A

tircuspid at 4th ICS left of sternum

bicuspid at 5th ICS left MCL

111
Q

What does the R coronary a supplu

A

right atrium, SA and AV nodes
most of right ventricle
some inferior portion l ventricl and posterior 1/3 IV septum

112
Q

What does the L coronary a supply

A

left atrium
most of left ventricle
some anterior part of right ventricl and anterior 2/3 interventricular septum

113
Q

What v runs with anterior interventricular a

A

great cardiac v

114
Q

what v runs with posterior interventricular a

A

middle cardiac v

115
Q

what v runs with the right marginal a

A

small cardiac v

116
Q

what vv enter chambers of heart directly

A

anterior cardiac vv and venae cordis minimae and coronary sinus

117
Q

Where does most lymph drain from heart

A

subepicardial lymphatic plexus

118
Q

Where do lymph following RCA terminate

A

anteiror mediastinal nodes to the left bronchomediastinal trunk

119
Q

Where do lymph following LCA terminate

A

inferior tracheobronchial nodes to the right bronchomediastinal trunk

120
Q

SA sets HR at what speed

A

60-100bpm

121
Q

What inn the heart

A

cardiac plexus, sympathetics and parasympathetics

122
Q

what type of info do the cardiac plexuses carrry

A

postganglionic SANs and preganglionic PANS

123
Q

how does the cardiac plexus distribute

A

via coronary aa

124
Q

where are the superficial and deep cardiac plexuses found

A

superficial- inferior to aortic arch

deep- posterior to arch of aorta, anterior to tracheal bifurcation

125
Q

Where are the sympathetics to heart found

A

preganglionic in T1-T4 segments
Postganglionic in upper thoracic and cervical sympathetic ganglia
the postganglionic fibers form cardiopulmonary splanchnic nn

126
Q

What are the functions of sympathtetics to heart

A

increase HR, vasodilation, also carry visceral afferents(acute pain fibers)

127
Q

where are the nerve cell bodies of the pain fibers of the heart

A

dorsal root ganglia

128
Q

Where are the postganglionic nerve cell bodies for the vagus n

A

within wall of the heart

129
Q

what are the functions of the PANS to heart

A

decrease HR, vasoconstriction, stretch receptors too so maybe some visceral afferents

CV I (7 decks)

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