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pt momints ver 2.0 > Org Ana: Large Vessels and Clinical Notes > Flashcards

Org Ana: Large Vessels and Clinical Notes Flashcards

1
Q

what are the structures founded at the superior mediastinum

A

thymus
R and L brachiocephalic veins
L superior intercostal vein
SVC
arch of aorta w 3 large branches
trachea
esophagus
vagus
phrenic
left recurrent laryngeal nerve
thoracic duct
other small nerves, bv and lymphatics

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2
Q

describe the anterior mediastinum

A

only on the left side where the left pleura diverges from the mid-sternal line

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3
Q

what are the boundaries of the anterior mediastinum

A

front - sternum
behind - pericardium
lat - pleura
sup - transverse plane passing sternal angle
inf - diaphragm

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4
Q

what are the structures inside the anterior mediastinum

A

loose areolar tissue
lymphatic vessels which ascend from the convex surface of liver
2 or 3 anterior mediastinal lymph glands
small mediastinal branches of the internal mammary artery
portion of thymus

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5
Q

describe middle mediastinum

A

broadest part of inf mediastinum
located in pericardial cavity

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6
Q

what does the middle mediastinum contain

A

ascending aorta
lower half of the SVC w azygos vein opening into it
bifurcation of the trachea and the 2 bronchi
pulmonary artery and its branches
phrenic nerves
some bronchial lymph gland

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7
Q

what are the contents of the posterior mediastinum

A

thoracic part of ascending aorta
azygos and 2 hemiazygos veins
vagus and splanchnic nerves
sympathetic trunk
thoracic duct
lymph glands
esophagus and associated nerve plexus

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8
Q

describe the aorta

A

main arterial trunk that delivers O2 rich blood from LV to the rest of the body

4 parts: ascending, arch, descending, abdominal

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9
Q

describe the ascending aorta

A

from base of LV; has 3 bulges and the sinuses of the aorta

branches: R and L coronary arteries

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10
Q

what are the branches of the aortic arch

A

brachiocephalic
- right common carotid
internal > brain tissues; circle of willis
external > face, neck, scalp
- right subclavian > UE

left subclavian
left common carotid

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11
Q

where is the descending aorta found

A

found in the posterior mediastinum

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12
Q

what are the branches of the descending aorta

A

bronchial
mediastinal
oesophageal
posterior intercostal
pericardial
superior phrenic
subcostal

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13
Q

what does the pulmonary trunk do

A

convey O2 poor blood from the RV to lungs

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14
Q

what are the branches of the pulmonary trunk

A

R pulmonary artery - behind ascending aorta and SVC to enter right lung

L pulmonary - in front of descending aorta to enter left lung

ligamentum arteriosum - fibrous band connecting the bifurcation of pulmonary trunk to arch aorta

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15
Q

what is the brachiocephalic vein

A

R and L from root of neck recieves blood from subclavian and internal jugular vein

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16
Q

describe the SVC and IVC

A

SVC - combi of 2 brachiocephalic; head, neck and UE

IVC - from LE

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17
Q

describe the pulmonary vein

A

2 from in each; carries O2 rich blood

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18
Q

compare the different azygos veins

A

main - inter something lumbar

inf - lower intercostal, subcostal, lumbar C

sup - upper intercostal

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19
Q

what is the function of the azygos veins

A

drains blood from posterior parts of intercostal space, posterior abdominal wall, pericardium, diaphragm, bronchi and esophagus

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20
Q

describe the lymphatic drainage in the thoracic wall

A

skin of anterior thoracic - anterior axillary > internal thoracic

posterior thoracic - posterior axillary

deep - posterior intercostal

mediastinal structures - bronchomediastinal trunk

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21
Q

describe the thoracic duct

A

it starts from below abdomen as cisterna chyli and ascend through the aortic opening of diaphragm right of the descending aorta

recieves lymph from left jugular, subclavian, bronchomediastinal

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22
Q

what are the structures founded anterior to esophagus

A

trachea
left recurrent laryngeal
left principal bronchus
pericardium

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23
Q

what are the structures founded posterior to esophagus

A

body of thoracic vertebrae
thoracic duct
azygos vein
right posterior intercostal artery
descending thoracic aorta

24
Q

what are strucutres found at R and L of esophagus

A

R - mediastinal pleura and terminal azygos

L - left subclavian, aortic arch, thoracic duct, mediastinal pleura

25
Q

what is the arterial supply of esophagus

A

upper - inferior thyroid
middle - esophageal branch of descending aorta
lower - left gastric

26
Q

what is the venous drainage of the espohagus

A

upper - inferior thyroid
middle - azygos
lower - left gastric vein

27
Q

what is the nerve and lymph supply of the esophagus

A

parasymph and symph fibers via vagus ant symph trunks

lymp:
upper - deep cervical
middle - sup and inf mediastinal
lower - left gastric and celiac

28
Q

describe the thymus

A

in ant mediastinum; reaches sup media in new born

site for development of T-lymphocytes

29
Q

what is bronchitis

A

inflammation of lining of the tracheobronchial tree

acute - infection, virus and less often bacteria

chronic - cigarettes and inhaling dust/chemicals

30
Q

what are the symptoms and treatment of bronchitis

A

inflammation and swelling
inc mucus production = hoarseness, cough and fever

antibiotics, water, mucolytic

31
Q

what is the emphysema

A

loss of elasticity of lungs = unable to recoil adequately causing incomplete expi

type of COPD involving damage to alveoli = dec O2 diffusion

32
Q

what are the causes and treatment of emphysema

A

smoking

inhalers, O2 medications, surgery

33
Q

what is asthma

A

bronchi narrows, coughing, wheezing and shortness of breath

caused by airway hyperresponsiveness - bronchodilators

34
Q

what is bronchogenic carcinoma

A

highly malignant primary lung tumor
- accounts for most cases of lung cancer
- vv poor prognosis
- 2nd most common cancer in men
- 3rd most common in women
- 45-70

35
Q

what are the causes of bronchogenic carcinoma

A

smoking, second hand smoke, occupational agents, poison gas

36
Q

what are the symptoms and treatment of bronchogenic carcinoma

A

persistent cough
blood tinged sputum or hemoptysis
fatigue and weakness
chest pain, shortness of breath
weight loss or bone pain of

pneumonectomy (late) or lobectomy (early)

37
Q

what is tubercolosis

A

chronic bacterial infection from myobacterium tubercolosis

develop after inhale droplets from infected person

38
Q

what are the symptoms of tuberculosis

A

cough w thick and cloudy and bloody mucus for > 2wks

rapid heartbeat
swollen neck - lymph
fever, chills, night sweats
fatigue and muscle weakness
loss of appetite and weight loss
shortness of breath and cheast pain

39
Q

what is postural drainage

A

patient is positioned to let gravity assist in drainage of excessive bronchial secretions sa lobes

40
Q

describe valvular heart disease

A

inflammation in valve that causes valves to stick and fibrous thickening; loss of flexibility and shrinkage

narrowing - stenosis = hypertrophy
regurgitation - incompetence = babalik

RHD - mitral

41
Q

when are heart murmurs heard

A

stenosis - before closure of AV valves

regurgitation - ventric systole

42
Q

what is coronary heart disease

A

block in coronary artery that causes necrosis/myocardial infarc

due to arteriosclerosis

ischemia > angina pectoris - aggravated by exertion and relieved by rest or vasodilators

43
Q

what are the causes and symptoms of cardiac pain

A

O2 deficiency and accumulation of metabolites; myocardial infarc

pain
- mild discomfort
- severe crushing
- referred to skin supplied by upper 4 intercostal

44
Q

what is differential diagnosis from cardiac pain

A

GERD - acid reflux; relieved by sit patient or sleep w a higher pillow, antacid

45
Q

describe conducting system problem

A

arrhythmia caused by arteriosclerosis of coronary artery diminishes blood supply to conducting system

46
Q

what are the conducting system problems in the atria

A

tachycardia - inc in cardiac rate; > 100 bpm

atrial flutter - tachycardia > arrhythmia; usually regular

atrial fibrillation - more chaotic atrial arrhythmia; fast and irregular ventricular rate

47
Q

what is the causes right sided heart failure

A

as a result of left sided heart failure

COPD and pulmonary fibrosis

48
Q

what is the causes left sided heart failure

A

LV loses its ability to contract normally = cant pump w enough force to push blood into circulation

LV loses ability to relax = cant fill up during resting period

49
Q

describe congestive heart failure

A

as blood flows out of heart:
- it slows
- blood returning to heart through veins back up = congestion in body tissues

swelling - edema
fluid collects in lungs
- dyspnea
- easily fatigue
- shortness of breath when laying down - orthopnea

50
Q

what is v-tach

A

rapid heartbeat from ventricles; keeps heart from adequately filling

51
Q

what is v-fib

A

erratic disorganized firing of impulse from ventricles

52
Q

what is tetralogy of fallot

A

4 anatomic abnormalities:
- stenosed pulmonary trunk
- large ventricular septal defect
- overriding of aorta
- hypertrophy of RV

53
Q

what is atrial septal defect

A

small opening at foramen ovale causing mixture of O2 rich blood from LA

54
Q

what is ventricular septal defect

A

most common congenital heart malformation

closes in growth - no surgery

blood shift from left to right > RV enlarges

55
Q

what is patent ductus arteriosus

A

distal aortic arch connects w left pulmonary artery

high psi in pulmonary artery = pulmonary hypertension and hypertrophy of RV

56
Q

what is the coarctation of aorta

A

dilatation or aneurysm of aorta showing as pulsalite swelling in suprasternal notch

narrowing of aorta = decrease pulse in femoral artery

collaterals to compensate develops

57
Q

what is CABG

A

coronary artery bypass graft

used to treat CAD by bypassing the blocked portion of coronary artery

sources of graft:
- internal thoracic artery
- radial artery
- saphenous vein

pt momints ver 2.0 (14 decks)

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