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Anatomy Block 3 > Lungs and Heart > Flashcards

Lungs and Heart Flashcards

1
Q

where are the visceral and parietal pleura continuous

A

At the root of the lung

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2
Q

What enters at the root of the lung

A

Bronchi, arteries, veins, lymph vessels

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3
Q

What are the 4 parts of the parietal pluera

A

Costal
Diaphragmatic
mediastinal
pleural cupula

PARTS OF THE MEDIASTINAL OFTEN FUSE WITH PERICARDIAL SAC

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4
Q

What is normally in the plerual cavity

A

lubricating pleural fluid from mesothelial lining (facilitates movement of oposing membranes)

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5
Q

What are pleural reflections

A

when parietal pleura folsds or chages directions from one wall of the cavity to another

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6
Q

What and where is the pulmonary ligament

A

aproximation of the anterior and posterior mediastinal plerua, extends inferiorly from root of each lung

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7
Q

What are plerual recesses

A

Where lungs do not mormally extend to the limits of the plerual cavity so the regions contact eachother

Lungs move in and out of these durning respiration

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8
Q

Where is the recess between the cotstal and diaphragmatic pleura and what is its significance

A

costodiaphragmatic recess

it is the infereior extreme of th pleural sac and abnormal accumulations of fluid can be found here

abtained during thoracentesis without contacting lung

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9
Q

What is the junction of the mediastinal and costal pleurae and what is its significance

A

Costomediastinal recess

Lingula of of left lung enters upon respiration, with no apparent clinical significance

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10
Q

What innervates the parietal plerura and is it sensitive to pain?

A

the phrenic nerve (diaphragmatic portion) and intercostal nerves it is sensitive to pain

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11
Q

Where can pain from the parietal plerua be reffered

A

Intercostal spaces adjcacent to pleural region

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12
Q

What innervates the visceral pleura and is it pain sensitive

A

Innervated by sympathetic and parasympathetic innervation from pulmonary plexus

pain insensitive

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13
Q

Do pleural sacs connect with eachother or the mediastinum

A

Do not connet with eachother but do connect to mediastinum at the root via the pulmonary ligament

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14
Q

What are the 4 parts of the lungs

A

apex (superior round end)
Base (concave and by diapram)
Root (passagway for structures from mediastinum
Hilum (where root attaches)

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15
Q

What is the size difference between the lungs and why

A

Right one is larger and heavier but shorter and wider (lacks cardiac notch so bigger) because the hemidiaphram is in a more superior position

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16
Q

What are the lobes and fissures of the right lung

A

Superior middle inferior lobes

Horizontal
oblique

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17
Q

What do the fissures of the right lung seperate

A

Horizontal: superior from middle
oblique: middle from inferior

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18
Q

What are the lobes and fissures of the left lung

A

Superior and inferior lobes

oblique

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19
Q

What lobe in the left lung deviates from the midline and what is this called

A

Superior lobe

Cardiac notch

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20
Q

What is lingula

A

Small projection below the cardiac notch (dips into the costomediastinal recess on inspiration)

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21
Q

Why mus breath sounds be listened to throuth the posterior thoracic wall

A

because the oblique fissure plane puts infior lobe posterior on both sides

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22
Q

Which section of the mediastinum is the trachea end and when does it bifurcate

A

In superior mediastinum, bifurcates at the sternal angle

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23
Q

What is the carina, why is it important

A

The fusion of the two medial walls of the bronchi at deviation

important radiologic landmark

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24
Q

What is the difference in bronchus size and why is it important

A

Right bronchus is wider shorter and straighter meaning foreign objects are more likely to be traped in it than the left

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25
Q

What is the progression of trachea branching

A

Trachea –> Bronchi –> Lobar (secondary) Bronchi –> Segmental (Tert) Bronchi

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26
Q

What is the name for the tissue supplied by a segmental bronchi

A

Bronchopulmonary segment

Each also has its own branch of pulmonary artery and vein

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27
Q

How many bronchopulmonary segments are in the right lung

A

10

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28
Q

How many bronchopulmonary segments are in the left lung

A

8

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29
Q

What lobes are drained by the left and right superior pulmonary veins

A

Right: superior and middle
Left: Superior

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30
Q

What lobes are drained by the left and right inferior pulmonary veins

A

Inferior lobes

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31
Q

WHat supplies the blood to the bronchiole connective tissue and where do they arise

A

Bronchial arteries

From either thoracic aorta or its intercostal branches

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32
Q

What arte the lymphatic plexuses serving the lungs and where are they located/ where do they drain

A

Superficial plexus : beneath visceral plerua drains into bronchopulmonary lymph nodes (at hillum)

Deep plexus: in submucosa of bronchi and trachea drains into pulmonary lymph nodes and THEN bronchopulmonary lymph nodes

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33
Q

What do bronchial veins drain and where do they drain to

A

drain large subdivisions of bronchial tree
right vein enters azygos
Left vein enters hemiazygous system

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34
Q

What are the names for the lung and heart coverings

A

Lung pleura

Heart serous pericardium

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35
Q

What does the pericardial sac enclose and where in the mediatinum is it located

A

Heart and roots of great vessels

Middle Mediastinum

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36
Q

What sits on the outside of the parietal layer of the serous pericardium

A

Fibrous pericardium

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37
Q

Where does the fibrous pericardium attach

A

inferiorly to central tendon of diaphram

superiorly to adventitial coverings of great vessels

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38
Q

What is found just deep to the visceral serous pericardium

A

Fat and coronary vessels

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39
Q

what forms pericardial sinuses and what two are there

A

formed by pericardial reflections in development

transverse and oblique

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40
Q

What gives the main arterial supply to the pericardium and where are they branched from

A

pericardiacophrenic and musculophrenic arteries
(and some other associated arteries)

branches of internal thoracic

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41
Q

Where is venous drainage of the pericarium

A

into triubutaries of the azygos system and the internal thoracic veins

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42
Q

What innervates the pericardium and which parts have pain

A

phrenic nerves and the cardiac plexus

parietal has pain visceral no pain

43
Q

What makes up the cardiac plexus

A

vagal and sympathetic nerves

44
Q

What are the 4 borders of the heart

A

right: right atrium
Left: mainly left ventricle, some left auricle
inferior: mainly right ventricle some left ventricle
Superior: enter and exit of great vessels

45
Q

what is the direction of the apex of the heart

A

Infrolatteraly left

46
Q

What indicates the divisions of the hearts chambers externally

A

sulci

47
Q

What is contained within sulci on the heart

A

major vessels supplying the heart

48
Q

What division does the coronary sulcus indicate

A

Division between atria and ventricles

49
Q

What division does the intraventicular sulcus indicate

A

Divides ventricles

Has an anterior and posterior portion

50
Q

What 4 things does the right atrium recieve blood from

A

Inferior vena cava
superior vena cava
coronary sinus
anterior cardiac veins

51
Q

Where is the right atrium located relative to the intercostals

A

at the level of the fourth and fifth intercostal spaces

52
Q

What is the smooth area of the right atrium called and what is located there

A

sinus venarum

contains opeinings of vena cava and coronary sinus

53
Q

What is located on the anterior inner surface of the right atrium

A

muscular ridges called pectinate muscles

54
Q

What is the crista terminalis and where does it lie

A

a ridge in the right atrium which seperates the rough and smooth areas (sinus venarum and pectinates) it spans the distance between the vena cava entrances

55
Q

What is the sulcus termnialis

A

a groove on the external surface of the heart whcihc corresponds to the cristae terminalis

56
Q

What is the posteromedial wall of the right atrium also, and why is it significant

A

the interatrial septum

the site for congenital atrial sept defects allowing passage of blood between atria

57
Q

What/where s the fossa ovalis and why is is it significant

A

Located on the interatrial septum

previusly the site of the foramen ovale

58
Q

What valve seperates the right atrium and right ventricle

A

Tricuspid in the atrioventricular orifice

59
Q

What is the right Auricle and what does it represent

A

muscular pouch off right atrium projecting left

represents part of embryonic atrium

60
Q

What is the conus arteriosus

A

cone shaped taper in superior region of the right ventricle which leads to the pulmonary trunk

61
Q

What is unqiue about the conus arteriousus portion of the right ventricle

A

It is the only smooth portion (non trabeculae carneae)

62
Q

What makes up the rough muscular area of the ventricle

A

Trabeculae carneae

63
Q

What are the papillary muscles and how many are there

A

large muscleuar bundles projecteting into the ventricular cavity connect to free edge and ventricular surface of valve cusps (by cordae tendinae)

There are 2 projections (and an occasional small 3rd called septal)

64
Q

What are the cords connecting papillary muscles to vlalves

A

Chordae tendinae

65
Q

Where is the septomarginal trabecula and what is it

A

Moderator band

spans from interventricular septum to base of anterior papillary and carries right branch of the atrioventricular bundle from conducting system

66
Q

What is the valve seperating the right ventricle and its major vessels/ what are its major vessels

A

Pulmonary valve or semilunar (pulmonary trunk)

67
Q

How many cusps are on the pulmonary valve and when does it closed

A

3 (anterior, left and right)
closes when ventricle relaxes and pulmonry trunk elasticity forces blood back toward the ventircle into siuses at base of each cusp

68
Q

What forms forms most of the base of the heart

A

left atrium

69
Q

What forms superior left heart border

A

Left auricle

70
Q

What enters the left atrium and where

A

four pulmonary veins (two from each lung)

on posterior wall of left atrium

71
Q

What is the only non smooth inner portion of the left atrium

A

its left auricle

72
Q

what valve seperates the left atrium from left ventrical

A

mitral or bicuspid valve

73
Q

what forms the apex of the heart

A

The left ventricle

74
Q

What is the smooth region of the left ventricle

A

Aortic vestibule

(rest is cvered with trabeculae carneae

75
Q

Which ventricle is thicker

A

Left ventricle

76
Q

What 2 parts is the interventricular sepum composed of and why is it significant emryologically

A

Superior membranous and inferior muscular

Site of congenital septal defects allowing passage of blood between ventricles

77
Q

How many papillary muscles are in the left ventricle and what do they connect to

A

2 (anterior and posterior)

Mitral or bicuspid valve

78
Q

What valve seperates the left atrium and ventricle

A

aortic vlave (three semilunar cusps left right posterior)

79
Q

what are aortic sinuses

A

small deviations above the aortic valve

80
Q

Where do the left and right coronary arteries arise from

A

left and right aortic sinuses

81
Q

Where will you hear the tricuspid valve best

A

5th or 6th intercostal space near left sternal border

82
Q

Where will you hear mitral valve best

A

Near apex of the hear in 5th intercostal space midclavicular line

83
Q

Where whill you hear aortic and pulmonary valve sounds best

A

2nd pulmonary space on left and right borders of sternum

84
Q

Why do you listen for valve sounds away from the vlave

A

sounds are carried with blood as it flows away

85
Q

What arteries supply the heart

A

Left ad right coronary (travel in coronary sulcus)

86
Q

What brances does the right coronary give off and what does it supply

A

Right atrium ventricle, interatrial septum and sa and av nodes

SA Nodal:
Marginal
AV Nodal
Terminal Posterior interventricular arteries

87
Q

Which of the coronary arteries is larger

A

Left coronary artery

88
Q

Where does the left coronary artery travel

A

Passes between pulmonary trunk and left auricle before braching

89
Q

What are the Initial branches of the Left coronary

A

Branches to aiterior interventricular (left anterior descending) and circumflex artery

90
Q

What is the course of the LAD

A

goes inferiorly in nterior interventricular groove to apex of heart to anastomais with posterior interventricualr

91
Q

where does the Marginal branch of the coronary arteries arise

A

off of the circumflex

92
Q

What is the course of the circumflex artery

A

Pases posteriorly in coronary sulcus to anastomose with posterior intervetnricular

93
Q

what is the course of the marginal branch

A

follows left border of heart (left ventricle)

94
Q

What is the main vein of the heart

A

cORONARY SINUS

95
Q

What ein traels with the anterior interventricular artery

A

Great cardiac vein

96
Q

What vein travels witht the posterior interventricular artery

A

Middle cardiac vein

97
Q

What vein travels with the right marginal artery

A

small cardiac vein

98
Q

What cardiac veins arise from right ventricle and emtpty directly into right atrium

A

anterior cardiac veins

99
Q

What initiates the regular electric impulses of the heart

A

automatic depolarization in the SA node

100
Q

What is the pass of depolarization

A

sa node- through atria to av node- to left and right atrioventricular bundles (bundle of his) (causes contraction of papilary muscles and then ventricles

atria contract together prior to ventricles

101
Q

Why are neck injuries dangerous for lungs

A

project up behind strnocliedomastoid

102
Q

What is a pneumothorax and why is it an issue

A

air into pleural cavity,

neutralizes the normally negative intrapleural pressure to atmospheric pressure

103
Q

what is pericardiocentesis and where should it be done

A

drainage of fluid from the pericardial sac to releive pressure on heart

done in the left 5th or 6th intercostal space close to sternum

104
Q

why is fluid in pericardial sac dangerous

A

may restrict venus return

Anatomy Block 3 (16 decks)

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