module 1 Flashcards

1
Q

what is the diaphragm

A

thin musculotendinous septum

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2
Q

septum

A

a wall or partition dividing a body space or cavity each named according to its location

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3
Q

what does the diaphragm separates

A

the thoracic and abdominal cavities

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4
Q

what is the principle muscle of respiration

A

diaphragm

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5
Q

what does the diaphragm do during respiration

A

when it contracts its domes flatten to increase the volume of the thoracic cavity during inspiration

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6
Q

features of the diaphragm

A
  • right dome
  • left dome
  • central tendon
  • right crus
  • left crus
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7
Q

right dome

A

can rise to the level of the upper border of the 5th rib

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8
Q

left dome

A

can rise to the lower border of the 5th rib

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9
Q

central tendon

A

peripheral muscular fibers of the diaphragm attach to the inferior margin of the thoracic cage and the lumbar vertebrae, to converge on the central tendon

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10
Q

location of central tendon

A

inferior to the fibrous pericardium of the heart

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11
Q

right crus

A

muscular extension of the diaphragm that originates from the anterolateral surface of the upper three lumbar vertebrae

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12
Q

left crus

A

muscle extension of the diaphragm that originates from the anterolateral surface of the upper 2 lumbar vertebrae

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13
Q

apertures of the diaphragm

A
  • caval opening
  • esophageal hiatus
  • aortic hiatus
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14
Q

caval opening

A

in the central tendon
- level of the 8th thoracic vertebra (T8)

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15
Q

what is the caval opening an opening for

A

the inferior vena cava (IVC)

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16
Q

where is the IVC situated

A

in the posterior thorax on the right side

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17
Q

esophageal hiatus

A
  • in the right crus at T10
  • opening for the esophagus
  • as the esophagus descends through the thorax it deviates to the left, lying anterior to the thoracic
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18
Q

aortic hiatus

A
  • between the right and left crus
  • anterior to T12
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19
Q

what is the aortic hiatus an opening for ?

A

the abdominal portion of the aorta

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20
Q

where is the aortic hiatus located

A

on the left side of the posterior thorax

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21
Q

what are the intercostal muscle

A
  • external, internal , innermost
  • seriers of muscles runnning between adjacent ribs forming the chest wall
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22
Q

where are the external and internal located

A

inbetween ribs

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23
Q

what do the innermost intercostals form

A

an incomplete layer that can span across 2-3 ribs

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24
Q

external intercostals

A
  • fibers run anterinferiorly from the lower border of the ribe
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25
Q

internal/innermost intercostals

A

fibers run posterosuperioly from the upper border of the rib

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26
Q

what are the functions of the intercostal mucles

A

expand and contract the thoracic cage during inspiration and expiration

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27
Q

muscle strain

A

stretching or tearing of muscle fibers because muscle has been stretched beyond its limits or been forced to contract too strongly

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28
Q

what action could result in intercostal muscle strain

A
  • twisting
  • reaching upwards
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29
Q

intercostal muscle strain symptoms

A

swelling
pain
tightness
in the affected areas such as back, chest, thoracic cage

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30
Q

features of the sternum

A

manubrium
manubriosternal joint
body
xiphisternal joint
xiphoid process

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31
Q

what does the inferior border of the manubrium articulate with?

A

the superior part of the sternal body at the manubriosternal joint

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32
Q

what is joining of the manubrium and manubriosternal joint also known as

A

sternal angle (angle of louis)

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33
Q

where is the sternal angle

A

in line with the 4th and 5th thoracic vertebrae

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34
Q

what is the angle of louis (sternal angle) easily …

A

palpable forming a clinical landmark

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35
Q

where does the xiphoid process attach

A

the sternal body at the xiphisternal joint

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36
Q

where is the xiphisternal joint

A

in line with 9th thoracic vertebrae T9

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37
Q

forms the vertebral formen to protect and house the spinal cord

A
  • vertebral arch
  • body
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38
Q

forms the intervertebral foramen where a spinal nerve exits the vertebral canal

A

pedicle

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39
Q

attachment site for muscles and ligaments of the spine

A
  • spinous process
  • transverse process
  • body
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40
Q

vertebral articulations: intervertebral discs

A
  • between vertebral bodies
  • are cartilaginous joint consisting of 2 parts
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41
Q

what do intervertebral discs consist of

A
  • outer annulus fibrosus
  • central nucleus pulposus
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42
Q

what is the point of intervertebral discs

A

shock absorbers
- minimal movement

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43
Q

annulus fibrosus

A
  • outer ring of the disc
  • made of fibrocartilage
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44
Q

function of annulus fibrosus

A

resist shear forces
- most visible of the disc

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45
Q

fibrocartilage

A

cartilage that contains bundles of collagen fibres

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46
Q

nucleus pulposus

A

gelatinous strucutres that functions to resist compressive force

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47
Q

what forces does annulus fibrosus resist

A

shear force

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48
Q

what force does nucleus pulposus resist

A

compressive force

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49
Q

do the disc come in contact with contents of the intervertebral foramen or vertebral foramen

A

NO. unless there is structural damage to the disc itself

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50
Q

what is the damage to the disc called

A

herniated (slipped) disc

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51
Q

how does a herniated disc result from

A

the bulging of the nucleus pulposus through weak spots of the annulus fibrosus
- if annulus fibrous is completely ruptured the protuding nucleus pulposus can compress the contents of the intervertebral forament (spinal nerve ex)

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52
Q

symptoms of herniated disc

A
  • localized back pain, numbness, weakness due to the compressed nerve
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53
Q

what are the functions of the ribs

A

to protect the throacic cavity
where vital organs and vessels are

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54
Q

what do the ribs contain within

A

heart, lungs, esophagus

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55
Q

what connects the ribs to sternum

A

costal cartilage

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56
Q

rib fracture

A

results in injury to the internal organs such as the lungs causing localized chest and back pain

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57
Q

bruising of ribs

A

results in localized pain and swelling of that area

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58
Q

inflammation of ribs/costal cartilage

A

results in chest wall pain that can affect a region spanning more than one rib

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59
Q

what is the most common fractured ribs

A

is direct blow to the chest, often from a car crash or fall
- coughing to hard (uncommon)

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60
Q

what could a fractured ribs result in

A

injury to local organs, local chest and back pain
- pain with inhalation/exhalation also

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61
Q

thoracic apertures

A
  • thoracic inlet (superior thoracic aperture)
  • thoracic outlet (inferior thoracic apeture
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62
Q

thoracic inlet (superior thoracic aperture)

A

allows passage between thorax and neck
- formed by manubrium rib 1, body of T1

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63
Q

thoracic outlet (inferior thoracic apeture

A
  • passage between thorax and abdomen
  • formed by: xiphoid process, costal margin, rib 11 & 12 and body of T12
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64
Q

thoracic outlet syndrome; occurs

A
  • associated with the INLET
  • occurs when blood vessels or nerves passing through the thoracic inlet are compressed
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65
Q

common causes of the thoracic outlet syndrome

A
  • physical trauma from car accident
  • repetitive injuries from job or sports
  • anatomical defects
  • pregnancy
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66
Q

symptoms of thoracic outlet syndrome

A
  • pain
  • numbness in shoulders and neck bc of compression of blood vessels and nerves
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67
Q

what are interal thoracic arteries

A
  • 2 paired arteries that are located lateral to the sternum
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68
Q

what are the main blood supply of the anterior thoracic wall

A

internal thoracic arteries

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69
Q

intercostal and subcostal arteries formation

A

the thoracic aorta and internal thoracic arteries give rise to pairs of posterior and anterior intercostal arteries

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70
Q

thoracic aorta

A

portion of the aorta that descends through the thoracic cavity

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71
Q

anterior intercostal arteries

A
  • arise from the internal thoracic arteries
  • pass around the thoracic wall in the costal grooves of ribs
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72
Q

what does the passing of anterior intercostal arteries in the groove of ribs form

A

an anastomosis with posterior intercostal arteries

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73
Q

anastomosis

A

a direct connection between two blood vessels

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74
Q

posterior intercostal arteries

A

branches off the thoracic aorta
- travel anteriorly to anastomose with the anterior intercostal arteries

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75
Q

subcostal arteries

A

the 12th pair of arteries in the intercostal space
- they run inferior to the costal margin compared to the intercostal arteries

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76
Q

venous drainage of the thoracic wall generally ____ the arterial supply

A

parallels

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77
Q

venous drainage of the thoracic wall

A
  • anterior intercostal veins
  • posterior intercostal veins
  • subcostal veins
    all drain DEoxygenated blood to the heart
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78
Q

what is the main vessel that drains the lower body

A

inferior vena cava

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79
Q

where does the inferior vena cava travel

A

through the caval opening in the diagram at level T8 level to return blood to heart

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80
Q

hemothorax

A

accumulation of blood in the pleural cavity

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81
Q

where do thoracic spinal nerve passs through

A

the intervertebral foramina

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82
Q

formation of dorsal (posterior) and ventral (anterior) ramus

A

after exciting the intervertebral foramen, each thoracic spinal divides into these

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83
Q

ventral rami

A

called intercostal nerves, that run in the costal grooves of the coressponding ribs

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84
Q

dorsal rami

A

of the 12 thoracic spinal nerves supply the deep muscle of the back segmentally and the overlying skin

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85
Q

branches of the thoracic spinal nerves

A
  • anterior cutaneous branch
  • lateral cutaneous branch
  • spinal nerve
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86
Q

what does a intercostal nerve give off

A

lateral cutaneous branch
terminal anterior cutaneous branch

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87
Q

what do the branches of the intercostal nerves innervate

A

skin of the thoraco-abdominal wall

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88
Q

what else does an intercostal nerve also give off

A

muscular branches to the intercostal and anterolateral abdominal muscles for motor innervation

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89
Q

the upper 6 intercostal nerves

A

innervate different strucutres compared to lower intercostal nerves

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90
Q

intercostal nerves 1-6

A

distributed in their intercostal spaces, innervating the intercostal muscles of the thoracic wall and overlying skin

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91
Q

intercostal nerves 7-12 and subcostal nerves T12

A

continue anteriorly from the intercostal spaces to enter the anterior abdominal wall supplying the abdominal muscles and overlying skin

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92
Q

phrenic nerves formed

A

by the union of the three cervical spinal nerves C3. C4, C5

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93
Q

what to the paried left and right phrenic nerves provide

A

motor innervation to the diaphragm
sensory innervation to the central area (central tendon)

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94
Q

cervical spinal nerves

A

are the spinal nerves from the cervical vertebrae in the cervical segment of the spinal cord
- there are 8 cerival nerves even though there are 7 cervical vertebrae

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95
Q

perimenopausal

A

the period of time before menopause

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95
Q

submuscular breast augmentation

A

breast implantation
- enlarges breasts using synthetic implants
- involves implantation below the pectoralis muscles of the chest

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96
Q

internal structures of the breast

A
  • lobes
  • suspensory ligaments (of cooper)
  • nipple
  • Laciferous ducts
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97
Q

what is the breast speciliazed for

A

production and secreation of lactiferous products

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98
Q

what might blockages of the breast duct system lead to

A

buildup of products at the site of the nipple

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99
Q

lactiferous products

A

milk or a milky lubricating fluid

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100
Q

lobes

A

each breast is divided into 15 to 20 lobes that contain the mammary glands

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101
Q

suspensory ligaments (of cooper)

A

lobes are separated by radial septa called these and help support the breast

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102
Q

mammary duct ectasia

A

condition that can occur when a lactiferous widens causing the duct walls to thicken
- duct can become blocked or clogged with products

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103
Q

symptoms of duct ectasia

A

nipple discharge
breast tenderness
breast lump
can be asymptomatic and more common in perimenopasual ppl

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104
Q

pectoralis major rupture cause

A

heavy weight

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105
Q

symptoms of pect major rupture

A

pain
localized swelling at the breast
weakness
reduced range of movement in the shoulder

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106
Q

what are act as a conduit for the spread of infection and metastases

A

vasuclature system

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107
Q

lateral breast arterial supply

A

supplied by the lateral thoracic arteries, branches of the axillary artery

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108
Q

medial breast arterial supply of breast

A

supplied by branches of the internal thoracic artery (which is lateral to the sternum)

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109
Q

pagets disease of the breast

A
  • rare form of breast cancer
  • begins forming a mass at the nipple and extends to the (areola) around the nipple
  • spread through arterial vessels or lymphatic system
  • changes in nipple (shape, formations of crusting products)
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110
Q

lympathic system

A

network of vessels that transport extracellular fluid (lymph) from the body’s interstitial fluid compartments, filtering it through the lymph nodes and returing it to the venous system

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111
Q

regions of the thorax that are concentrated with lymph nodes

A
  • axillary nodes laterally
  • parasternal nodes medially
  • supraclavicular nodes superiorly
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112
Q

swollen lymph nodes

A

sign that they are working hard and usually indicate an infection due to buildup of immune cells and waste

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113
Q

intraductal papilloma how does it begin

A

begins as a small benign tumor, can form in the lactiferous duct

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114
Q

where is the intraductal papilloma

A
  • felt as a small lump confined to the region proximal to the nipple
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115
Q

what happens if intraductal papilloma blocks duct completely

A

infection can occur and spread rapidly through lymphatic system

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116
Q

what kind of direction is blood flow in the heart

A

unidirectional flow of blood

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117
Q

apex of the heart

A
  • directed forward
  • downward
  • to the left
  • base is its posterior surface
118
Q

pericardium of the heart

A
  • is covers the heart
  • a sac that encloses the heart and the roots of the great vessels entering and leaving it
119
Q

location of the heart + size

A
  • size of a clenched fist
  • lies behind the sternum and central part of the thoracic cage
119
Q

what is pericarditis

A

inflammation of the pericadium and often idiopathic in patients

120
Q

idopathic

A

arises spontaneously or has an unknown cause

121
Q

what can pericarditis cause

A

abnormal buildup of fluid in a body cavity (such as pericardial cavity)

122
Q

sensory and motor innovation of the heart

A

phrenic nerves carry sensory and motor innervation

123
Q

where do phrenic nerves supply sensory innovation

A

fibrous pericardium
serous parietal pericardium

124
Q

how are the phrenic nerves formed

A

cervical spinal nerves C3, C4 and C5

125
Q

layers of the pericardium

A
  • Fibrous layer
  • partietal layer of the serous pericardium
  • serous fluid in paricardial cavity
  • Visceral layer of the serous pericardium
126
Q

what does the serous pericardium layer divide into

A
  • partial layer
  • visceral layer
127
Q

what are one of the first signs of a heart attack

A

pain in the shoulder and arm

128
Q

why would she be experiencing pain in her shoulder/arm

A

phrenic nerves are formed by the C3, C4, and C5 cervical spinal nerves
- sensory information of heart travels up those nerves to the cervical vertebrae

129
Q

what is the pain called when the pain in her arm/shoulder (associated with the heart) is called?

A

referred pain

130
Q

ventricular outflow tract

A

describes the pathway of blood out of either the left ventricle or right ventricle of the heart through great vessels

131
Q

left ventricular outflow tract: superior portion

A
  • consists of a smooth-walled vestibule leading to the aortic orifice
132
Q

left ventricular outflow tract: aortic oridice

A
  • included to aortic valve
133
Q

left ventricular outflow tract: aortic valve

A
  • consists of 3 semilunar cusps, and 3 aortic sinuses
134
Q

right venticular outflow tract

A

the superior wall of the right ventricle is smooth and funnel-shaped, forming the infundibulum or conus arteriosus (RVOT)

135
Q

right ventricular outflow tract: infundibulum

A
  • leads to the pulmonary truck carrying deoxygenated blood to the lungs
136
Q

right ventricular outflow tract: at the pulmonary orifice

A
  • is the pulmonary valve which consists of 3 cusps
137
Q

what is the interventricular septum

A
  • happens during development the formation of it can be incomplete
  • leanving an opening between the left and right venticle
138
Q

what is the opening that can be created between the left and right vent be called

A

ventricular spatial defect

139
Q

hypertrophic cardiomyopathy causes

A

long term excessive endurance exercise could include pathological structural remodeling of the heart and large arteries such as thickening of the heart muscle

140
Q

what is hypertrophic cardiomyopathy

A

thickening of the heart musculature
- frequently asymmetric

141
Q

what does hypertrophic cardiomyopathy invovle

A

interventricular septum as well as the free wall of the left ventricle

142
Q

symptoms of hypertrophic cardiomyopathy

A
  • shortness of breath
  • chest pain during exercise
  • fainting
143
Q

what do 25% of patients with HCM have

A

left ventricular outflow tract obstruction
- abnormal opening and closing of the mitral valve due to high velocity flow of blood directly on the leaflets and contract of the mitral valve on the thickened interventricular septum

144
Q

what is the most common heart valve abnormality

A

mitral valve prolapse

145
Q

parts of the mitral valve

A

leaflets, chordae tendinea, papillary muscles

146
Q

mitral valve prolapse what is it

A

the valve cusps do not close properly because of abnormally long (or short) chordae tendineae or malfunctioning papillary muscles

147
Q

what happens with mitral valve prolapse

A

the valve flops backwards into the atrium (prolapase)

148
Q

what is the overall effect on the blood flow of mitral valve prolapse

A

regurgitation back to the atrium
- uncommon: can affect blood flow through the left vent
- blood flow between the left atria and left ventricle will consequently affect blood flow between the left vent and aorta

149
Q

what do people with mitral valve prolapse experiences

A

heart palpitations

150
Q

what does the interventricular septum divide

A

the left and right vent

151
Q

what is the role of the interventricular septum

A

isolating the oxygenated blood from the deoxygenated blood

152
Q

what does the interventricular septum consist of

A
  • thick muscular part
  • thin upper membranous part
153
Q

what makes the interventricular septum bulges towards the right vent making it crescent shaped

A

the greater pressure in the left vent

154
Q

what is thickened if their is a ventricular septal defect

A

vent walls and interventricular septum

155
Q

why do the vent walls and interventricular septum get thickened

A

because the pressure of the blood in the left vent is higher than that in the right
- this lesion is initially associated with left-to-right (acyanotic) shunting of blood flow

156
Q

acyanotic

A

shunting of blood that occurs in the left-to-right direction in the heart chambers

157
Q

what is the most common site of ventricular septal defects

A

the membranous part of the interventricular septum

158
Q

what are the most congenital cardiac defects in infants?

A

defects in the interventricular septum

159
Q

the skeleton of the heart

A
  • is dense connective tissue that is the site of attachment of the atrial and ventricular muscles and the heart valves
160
Q

what is calcific aortic stenosis

A
  • processive fibro-calcific remodeling and thickening of the aortic valve leaflets that evolve over years to cause severe obstruction to cardia outflow
161
Q

what happens if the leaflets thicken: calcific aortic stenosis

A

the aortic valve narrows, causing a pressure increase in the left vent
- left vent may also become enlarged to compensate for the blockage

162
Q

who are patients who experience fibro-calcific remodeling

A

usually ppl over 65

163
Q

symptoms of calcific aortic stenosis

A
  • shortness of breath
  • chest pain
  • feeling faint and/or dizzy when exercising
164
Q

what is the most prevalent heart valve disorder in developed countries

A

calcific aortic stenosis

165
Q

fibro-calcific remodeling

A

remodeling of the heart includes any structural changes to the heart, including sizing, shape, functionality
refers to calcification of fibrosus tissue in the heart

166
Q

electrocardiogram (ECG)

A

non invasive test that records the electrical signals in your heart

167
Q

acute pericarditis

A

an inflammation of the pericardium resulting in excess fluid within the pericardial cavity

168
Q

Samantha’s case and acute pericarditis

A

recurrent pain in her chest and arm and diaphragmatic spasms can be explained by the pericardium being innervated by the phrenic nerve
- her case is idiopathic

169
Q

how many times does a heart beat per min to keep blood circulating

A

70 time per min

170
Q

what aorta carries ____ blood

A

oxygenated blood

171
Q

aorta away or to the heart

A

away from the heart

172
Q

what are the 3 main branches off the arch of the aorta

A
  • brachiocephalic
  • left subclavian
  • left common carotid arteries
173
Q

brachiocephalic artery

A
  • brachiocephalic truck ascends approx 4 to 5 cm before it bifurcates
174
Q

what does the brachiocephalic artery bifurcate into

A

the right common carotid artery and the right subclavian artery

175
Q

if dye was injected to the left ventricle where would it travel

A

aorta–> brachiocephalic artery–> left common carotid artery–> left subclavian artery

176
Q

what is the process called when they inject dye in (left vent) to see it travel in blood

A

left heart ventricular angiography

177
Q

angiography

A

examination by X-ray of blood or lymph vessels, carried out after introduction of a radiopaque substance

178
Q

what does abnormal results of an angiography possibly mean

A

may be due to life-threatening conditions including “silent killer” an aortic aneurysm

179
Q

aortic aneurysm

A

abnormal widening or ballooning of a part of an artery due to weakness in the wall of the blood vessel

180
Q

when would a aortic aneurysms cause symptoms

A

until the dilation becomes very large
- could cause chest or back pain, difficulty breathing, shortness of breath

181
Q

what do the left and right internal thoracic arteries supply

A

anterior thoracic wall, such as intercostal muscles

182
Q

how do the left and right internal thoracic arteries’ arise

A

from the subclavian arteries

183
Q

what does the right subclavian artery give rise to

A

the right internal thoracic

184
Q

what does the left subclavian give rise too

A

left internal thoracic artery

185
Q

where do the internal thoracic arteries descend

A

vertically through the thoracic inlet, running lateral to the sternum and posterior to the anterior chest wall

186
Q

what muscles are anterior and lateral to the internal thoracic arteries

A
  • innermost, internal, and external intercostal muscle (facilitate respiration)
187
Q

muscles anterior to the intercostal muscle

A

pectoralis major

188
Q

muscle posterior to the internal thoracic arteirs

A

is the transversus thoracic muscle

189
Q

muscles inferior to the internal thoracic muscle

A

the diaphragm

190
Q

the sinuses of the aortic valve

A

left and right, positeior

191
Q

what does the left and right aortic sinuses give rise to

A

left and right coronary arteries

192
Q

does the posterior sinus give rise to anything?

193
Q

what do the left and right coronary arteries supply

A

the heart itself

194
Q

what do the left and right coronary arteries anastomose with each to form

A

a circle in the coronary sulcus (atrioventricular groove)

195
Q

(atrioventricular groove)

A

between the atria and ventricles

196
Q

interventricular sulcus

A

groove between ventricles

197
Q

why are anastomosis advantageous

A

“back up” blood supply

198
Q

example of why the loop and circle is important for heart blood supply

A
  • if plaque bluids up in a coronary artery creating a blockage the blood may reroute using a alternative path in the circle and loop arrangment of the coronary vessels
199
Q

coronary artery disease

A
  • significant occlusion in any portion of the coronary circulation will reduce blood flow to the heart
200
Q

symptoms of coronary artery disease

A
  • chest pain
  • shortness of breath
  • complete block: heart attack
201
Q

plaque

A

deposits of cholesterol, fat, and calcium that child up inside an vessel

202
Q

coronary angiogram

A

procedure that uses X-ray imaging to see your hearts blood vessels such as the aorta and the coronary arteries

203
Q

stenoses

A

abnormal narrowing of a passage in the body

204
Q

angioplasty

A

balloon catheter is inserted into the blocked artery
- inserted balloon is then inflated, dilating the artery, and restoring blood flow

205
Q

ways to treat coronary artery disease

A

angioplasty, bypass surgery

206
Q

where are the left and right lungs located

A

in the pulmonary cavities deeps to the ribs and sternum

207
Q

what structures are around the lungs

A
  • diaphragm
  • ribs
  • sternum
  • breast
  • clavile
  • pericardium
208
Q

what lung is larger

209
Q

right lobe divisions

A

3
by 2 fissures

210
Q

left lobe divisions

A

2
by 1 fissure

211
Q

left lung features

A
  • superior lobe lingula & groove
  • cardiac notch
212
Q

what is on the mediastinal (medial) surface of each lung

A

important group of structures collectively known as the root of the lung, which connects the lungs to the heart and trachea

213
Q

what are pleural recesses

A

potential spaces of the pleural cavity which are not filled with lung tissue during expiration

214
Q

how many pleural recesses are there

215
Q

what are the 2 pleural recesses

A
  • costomediastinal recess
  • costodiaphragmatic recess
216
Q

what happens if the pleural recess are filled with fluid

A

pleural effusion, and the function of expanding the lungs may be impaired

217
Q

symptoms of pleural effusion

A

difficulty breathing
pain extending into the shoulder/neck

218
Q

potential spaces

A

potential regions because sometimes they are not present- when the lung tissue expands and fills the potential space during inspiration
- potential regions of the pleural cavity are much larger than the potential space within the plural of the lungs

219
Q

costomediatinal recesses

A

left and right

220
Q

the left and right costomediastinal recesses location

A

anterior thorax, between the costal and mediastinal parietal pleura

221
Q

which are larger the left or right costomediastinal recesses

A

left and overlies the heart

222
Q

costodiaphramatic recesses location

A

between the costal and diaphragmatic pleura, below the inferior part of the lungs

223
Q

when are the costodiaphramatic recesses filled with lung tissue

A

during deep inspiration

224
Q

what are the costodiaphramatic recesses important for

A

landmarks in the case of pleural effusion

225
Q

costodiaphramatic recesses: pleural effusions

A

may be caused by underlying heart failsure or cirrhosis
- excess fluid can impair breathing by limiting the expansion of the lungs

226
Q

cirrhosis

A

liver condition where it doesn’t function right due to long-term damage

227
Q

2 types of pleura

A

parietal and visceral

228
Q

innervation of pleura

A
  • parietal and visceral each have their own
229
Q

why is innervation important for

A

trace signals of pain

230
Q

when pain signals are received by the intercostal nerves where is the pain felt or referred?

A

to the thoracic and abdominal walls

231
Q

partietal pleura innervation

A
  • by the intercostal nerves and phrenic nerves depending on the region
232
Q

visceral pleura innervation

A
  • supplied by autonomic innervation
  • not sensitive to pain, temp, or touch
  • sensitive to stretch
233
Q

autonomic innervation

A

the ANS regulates the functions of our internal organs (the viscera) we are often unaware of the ANS because it functions involuntary and reflexively

234
Q

what is the hilum (root of lungs)

A
  • are a collection of structures that enter and exit the lungs
235
Q

what does the hilum connect

A

the lungs to the trachea and heart

236
Q

where is the hilum located

A
  • centered in the medial surface of the lung
237
Q

what structures makeup the hilum

A
  • pulmonary arteries
  • pulmonary veins
  • bronchi
238
Q

what is pulmonary arterial hypertension

A

where a patient has high blood pressure in the pulmonary arteries

239
Q

what do pulmonary arteries carry

A

deoxygenated blood from the heart to the lungs

240
Q

is pulmonary hypertension different from systemic high blood pressure

241
Q

structural changes with pulmonary arterial hypertension

A
  • walls become stiff
  • swollen and thick causing scarring
  • clots
  • build up of plaque
242
Q

blood flow with pulmonary arterial hypertension

A
  • impeded or occlude blood flow to the: lungs, increasing pressure within the pulmonary arteries and veins and potentially compressing the adjacent bronchi
243
Q

heart consequences with pulmonary arterial hypertension

A

heart must exert greater force to direct deoxygenated blood through the pulmonary arteries to the lungs
- cardiac muscle can become strained

244
Q

cardiac dysfunction with pulmonary arterial hypertension

A

prolonged exertion of the cardiac muscle can weaken the muscle

245
Q

symptoms of pulmonary arterial hypertension

A
  • tightness in thoracic wall
  • shortness of breath
  • fatigue
  • fainting
246
Q

where do brachiocephalic veins drain in to

A

the superior vena cava

247
Q

what is another main tributary of the superior vena cava

A

azygos vein

248
Q

where does the azygos veins enter

A
  • enters the thorax from the abdomen through the aortic hiatus (T12) of the diaphragm from off the SVC
249
Q

where does the azygos vein ascend

A

to the right of the lower thoracic vertebral bodies

250
Q

where do the posterior intercostal veins drain

A

directly into the azygos vein

251
Q

where does the hemiazygos vein lie

A

to the left of the thoracic vertebrae

252
Q

what does the hemiazygos drain

A

the left posterior intercostal veins

253
Q

where does the accessory hemiazygos lie

A

to the left of the thoracic vertebrae, superior to the hemiazygos vein

254
Q

what does the accessory hemiazygos vein drain

A

the left posterior intercostal veins

255
Q

where does the right posterior intercostal vein drain

A

directly into the azygos vein (THE left does not)

256
Q

what do bronchial veins do

A

remove deoxygenated blood from the lungs

257
Q

how are the left posterior intercostal veins drained

A

goes into the accessory hemiazygoes then to the azygos

258
Q

what is the lymphatic system

A

part of both the circulatory and immune system
- diseases can travel through it and spread

259
Q

what is the thoracic duct, what does it drain?

A

drains lymph from the left side of the head, neck, thorax, left upper limb, and all of the structures below diaphragm

260
Q

what does the right lymphatic duct drain

A

lymph from the right side of the head and neck, thoraz, and right limb

261
Q

why is checking lymph nodes used for

A

presence of inflammatory disease

262
Q

what can be used to determine if there is node enlargement

A

radiographic

263
Q

radiographic

A

images generated using X-rays, ramma rays, or similar ionizing radiation and non-ionizing radiation to view the internal form of internal structures of the body

264
Q

what is sarcoidosis

A
  • inflammatory disease that causes abnormal masses or nodule to form in the pulmonary bronchopulnary (hilar), and paratracheal lymph nodes
265
Q

symptoms of sarcoidosis

A
  • lymph nodes would drain into the right lymphatic duct
  • enlarged lymph nodes and tracheobronchial tree may compress small and large airways causing airway obstruction
  • dry cough
  • fatigue
  • shortness of breath
  • rarly experience pain
  • tightness
266
Q

arterial supply of the lung

A
  • descending thoracic aorta is a continuatin of the aortic arch, at level T4/T5, provides oxygenated blood to the thorax
267
Q

what supply lungs with blood

A

bronchial arteries

268
Q

anxiety with dyspnea

A
  • constriction of bronchial arteries could result in a decreased blood supply to the lung tissue
  • could be due to the fight or flight response
269
Q

symptoms of anxiety with dyspnea

A

shortness of breath
- tightness
- hyperventilation
- fainting
- nausea

270
Q

what is the mediastnum

A

is a central region in the thorax between the right and left lung

271
Q

waht can the mediastinum be divided into

A
  • superior
  • inferior
  • anterior
  • middle
  • posterior
272
Q

the superior mediastinum

A

located posterior to the manubrium and anterior to the first 4 thoracic vertebrae

273
Q

anterior mediastinum

A

extends from the sternum to the anterior border of the pericardium

274
Q

inferior mediastinum

A
  • bordered superiorly by the superior mediastinum and inferiorly by the diaphragm
275
Q

what is the inferior mediastinum further dividied into

A

anterior
middle
posterior
*compartments *

276
Q

middle mediastinum

A

compartment between the anterior and posterior borders of the pericardium

277
Q

organs in the superior medistinum

A
  • thymus
  • trachea
  • esophagus
278
Q

arteries in the superior mediastinum

A
  • aortic arch
  • branches of aorta
279
Q

veins and lymph in superior mediastinum

A
  • SVC
  • branches of SVC
280
Q

nerves in superior mediastinum

A
  • vagus
  • phrenic
281
Q

inferior, anterior mediastinum organs

282
Q

inferior, anterior mediastinum arteries

283
Q

inferior, anterior mediastinum vein & lymph

A

lymph nodes

284
Q

inferior, anterior mediastinum nerves

285
Q

inferior middle mediastinum organs

A
  • heart
  • pericardium
286
Q

inferior middle mediastinum arteries

A
  • ascending aorta
  • pulmonary trunk
287
Q

inferior middle mediastinum veins and lymph

A
  • SVC
  • azygos vein
  • pulmonary veins
288
Q

inferior middle mediastinum nerves

289
Q

inferior posterior mediastinum organs

290
Q

inferior posterior mediastinum arteries

A

thoracic aorta

291
Q

infeiror posterior mediastinum veins and lymph

A
  • azygos vein
  • hemiazygos vein
292
Q

inferior posterior mediastinum nerves

A

vagus nerve