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Cardiorespiratory 2 Anatomy and Physiology > Pratical 1 > Flashcards

Pratical 1 Flashcards

1
Q

what are the divisions of the mediastinum

A

superior and inferior

inferior divides into anterior, middle, posterior

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2
Q

What structures does the superior mediastinum contain?

A

trachea.
esophagus.
great vessels. the arch of the aorta. thoracic portions of the left common carotid and the left subclavian arteries;
Veins. the innominate veins and the upper half of the superior vena cava; …
thymus.
phrenic and vagus nerves and left recurrent nerves.
thoracic duct

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3
Q

What are the nerve roots of the phrenic nerve?

A

C3 C4 C5

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4
Q

Where does the phrenic nerve travel in the neck? Is it medial or lateral to the carotid sheath

A
  • Nerve arises at the lateral border of the anterior scalene muscle
  • passes inferiorly over the anterior surface of the anterior scalene
  • deep to cervical fascia
  • runs posterior to the subclavian vein
  • runs lateral to the carotid sheath
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5
Q

Does the phrenic nerve pass anteriorly or posteriorly to the lung root?

A

right phrenic nerve - descends anteriorly along the right lung root
left phrenic nerve - descends anterior to the left lung root

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6
Q

Where does the vagus nerve travel in the neck?

A
  • The right vagus nerve passes anterior to the subclavian artery and posterior to the sternoclavicular joint, entering the thorax.
  • The left vagus nerve passes inferiorly between the left common carotid and left subclavian arteries, posterior to the sternoclavicular joint, entering the thorax.
  • there are several branches that arise in the neck these include pharyngeal branches, superior laryngeal nerve and the recurrent laryngeal nerve
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7
Q

Does the right recurrent laryngeal nerve pass through the thoracic inlet? Which vessel does it hook around?

A
  • subclavian

- passes through the thoracic inlet

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8
Q

Does the left recurrent laryngeal nerve pass through the thoracic inlet? Which vessel does it hook around?

A
  • aortic arch

- passes through the thoracic inlet

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9
Q

Where do the recurrent laryngeal nerves ascend in relation to the trachea and the oesophagus?

A
  • they ascend in a groove at the junction of the trachea and oesophagus
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10
Q

identify where the internal jugular and the subclavian veins travel. Where is the venous angle?

A

the venous angle is the junction of the internal jugular and subclavian veins at both side of the neck

  • internal jugular vein goes towards head and drains from important body organs such as the brain face and neck
  • subclavian veins drain substances from the arms
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11
Q

What is a Virchow’s node and why is it found in the left supraclavicular area? Why is the metastasis commonly of a visceral – abdominal origin?

A
  • virchows node is a left sided supraclavicular lymph node
  • because they receive the lymphatic draining of most of the body from the htoraicci duct, it enters the venous circulation at the left subclavian vein
  • it is usually of a abdominal organ because they take their supply from lymph vessels in the abdominal cavity
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12
Q

Where are central lines commonly placed and why?

A
  • intneral jugular vein
  • subclavian vein
  • femoral vein
  • normal it is the right internal jugular vein and the left subclavian vein
  • they are superficial and easier to access
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13
Q

what are three features on an X ray that is typical of congestive cardiac failure

A
  • blunted costophrenic angles
  • cardiomegaly
  • pleural effusions
    pulmonary intersisital oedema
  • pulmonary alveolar oedema
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14
Q

what is pleural effusion

A
  • this is the build up of excess fluid between the layers of the pleura outside the lungs (between the visceral and parietal pleura)
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15
Q

what is pulmonary oedema

A
  • this is a condition caused by excess fluid in the lungs

- the fluid collects in air sacs in the lungs which make it difficult to breath

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16
Q

why are the electrodes placed in the ventricle and atria

A
  • becasuse there is complete heart block so both need to be stimulated for example if the ventricles stop working and don’t receive a signal they need to be stimulated and vis versa for the atria
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17
Q

why in atrial fibrillation and ventricular asystole is the electrode from the pacemaker only placed in the ventricle

A
  • atria don’t need more stimulation as they are already contracting quite fast
  • ventricles are not contracting as they are asystole therefore they need to be activated
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18
Q

what typical feats of pulmonary oedema can be seen on an x ray

A
  • Kerely B lines
  • increased cardiothoracic ratio
  • pleural effusions
  • upper lobe pulmonary venous diversion
  • thickening of interlobar fissures
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19
Q

what causes pulmonary oedema

A
  • congestive heart failure
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20
Q

how is pulmonary oedema treated

A
  • diuretcis
  • morphine
  • blood pressure medication
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21
Q

what is a bat wing sign

A

this refers to bilateral penihilar shadowing

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22
Q

what are the most common sites of atherosclerosis

A 
lower abdominal aorta
coronary arteries 
popliteal arteries
internal carotid arteries
arteries in the circle of willis which supply blood to the cerebral hemispheres
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23
Q

why do aneurysms usually occur just above the bifurcation of the abdominal aorta

A

collateral vessels enter

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24
Q

how can abdominal aneurysm be detected in examination

A
  • found on ultrasound
  • x rays
  • CT scan
  • MRI
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25
Q

what complications can occur in aneurysms

A

burst
vasopasm
re-bleeding
stroke

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26
Q

how can a thoracic aneurysm be detected

A
  • Chest X rya
  • CT scan
  • ultrasound
  • MRI
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27
Q

what area of the heart is supplied by LAD

A
  • front and left side of the heart
28
Q

what are the common causes of valvular disease

A
  • being born with an abnormal valve or valves (congenital heart disease)
  • having had rheumatic fever.
    cardiomyopathy - a disease of the heart muscle.
  • damage to the heart muscle from a heart attack.
  • getting older.
  • a previous infection with endocarditis.
29
Q

what are the pros and cons of mechanical and biological valves used for replacement

A

Mechanical valves

  • increase risk of blood clot formation and severe bleeding from anti-clotting medication
  • more durable

tissue valves

  • blood clot risk is lower
  • women who plan to have children as warfarin cannot be used
  • less durable
30
Q

what is the cause of an enlarged left atrium and what are the consequences

A

Age. It’s important to note that normal aging itself isn’t a cause. Instead, changes that occur to your body as you age can influence the size of the left atrium.
Gender. Men typically have a larger left atrium than women.
Body size. The size of the left atrium increases with body size.

  • hypertension
  • dysfunction of the mitral valve
  • dysfunction of the left ventricle
  • atrial fibrillation

complications

  • cognitive heart failure
  • atrial fibrillation
  • stroke
31
Q

what are the four characteristics of tetralogy of fallot

A
  • VSD
  • pulmonary stenosis
  • right ventricular hypertrophy
  • overriding aorta
32
Q

where does the trachea arise from

A

The trachea arises from the inferior end of the larynx at the level of the 6th cervical vertebra (C6

33
Q

how long is the trachea

A

The trachea is approximately 10 cm long

34
Q

where does the trachea end

A

ends at the level of the sternal angle (T4/5 intervertebral disc) where it divides into left and right main bronchi.

35
Q

what is the wider and shorter bronchus

A

Notice that the right main bronchus is wider and shorter (2.5cm) than the left (5cm) and passes directly to the hilum of the lung

36
Q

what is the clinical significance of the structure of the right main bronchus

A
  • the right main bronchus is more vertical than the left main bronchus therefore objects are more likely to become aspirated in this bronchus
37
Q

what structures make up the hilum of the lung

A

pulmonary artereis
pulmonary veins
bronchopulmonary
bronchi entrance to each lobe - superior and inferior

38
Q

which lobes for the anterior surface of the chest wall

A

superior and inferior of the left lung

superior and inferior and middle of right lung

39
Q

how many bronchopulmoanry segments are there

A

10 in the right lung

8 or 9 in the left lung

40
Q

how do the lungs receive there blood supply

A

The bronchi, connective tissue and the visceral pleura receive their blood supply from the bronchial arteries

41
Q

where do bronchial veins drain into

A

Bronchial veins drain to the azygos and hemiazygos veins (but also communicate with the pulmonary veins).

42
Q

where do alveoli receive deoxygenated blood from

A

they receive blood from the terminal branches of the pulmonary arteries

43
Q

where do the alveoli send there oxygenated blood

A

The oxygenated blood leaving the alveolar capillaries drain to the tributaries of the pulmonary vein.

44
Q

where does the superficial lymphatic plexus of the lung lie

A

The superficial plexus (sub-pleural) lies beneath the visceral pleura and drains over the surface of the lung to the lung hilum. (Often they contains carbon deposit, giving the lungs their darker appearance.)

45
Q

where does the deep lymphatic plexus of the lung lie

A
  • deep plexus travels along the bronchi and pulmonary vessels towards the hilum of the lung
  • goes through pulmonary nodes located in the lung
  • ## lymph then enters bronchopulmonary nodes which are concentrated around the lung Lum
46
Q

where does all the lymph from the lung leave and drain

A

All the lymph from the lung leaves the hilum and drains into the tracheobronchial nodes and then into bronchomediastinal lymh trunks.

47
Q

what is the nerve supply of the lung

A

At the root of each lung is a pulmonary plexus composed of efferent and afferent autonomic nerve fibres. The plexus is formed from branches of the sympathetic trunk (T1-T5) and receives parasympathetic fibres from the vagus nerve (X)

48
Q

What is the effect of sympathetic innervation to the bronchi, bronchial and pulmonary vessels?

A

causes bronco dilation

causes pulmonary constriction

49
Q

What is the effect of parasympathetic innervation to the bronchi, bronchial and pulmonary vessels and pulmonary glands?

A

causes bronchoconstriction

casues vasodialtion

50
Q

what are the three parts in which the diaphragm attaches to the thorax

A

1) The sterna part
2) The costal part
3) The lumbar part (the crura)

51
Q

where does the right and left dome of the diaphragm reach in terms of diaphragm level

A

The right dome reaches as high as the upper border of the 5th rib, and the left dome reaches the lower border of the 5th rib

52
Q

how does the vagus nerve pass through the diaphragm

A

passess with the oesophagus

53
Q

what is the motor supply of the diaphragm

A

phrenic nerve is the only motor supply to the diaphragm

54
Q

what is the phrenic nerve sensory to

A

It is sensory to the mediastinal pleura and pericardium, and to the some of the parietal pleura covering the diaphragm.

55
Q

name 2 functions of the diaphragm

A
  • separates thoracic cavity from the abdominal cavity

- performs respiration

56
Q

What type of muscle is the diaphragm

A

skeletal

57
Q

What type of nerve is the phrenic nerve?

A

somatic

58
Q

is the azygous on the right or left

A

azygous on the right

hemi azygous on the left

59
Q

in what direction does the external intercostal muscle go

A

anterior inferior

60
Q

in what direction does the internal and innermost intercostal muscles travel

A

anterior superior

61
Q

In the intercostal space, where does the neurovascular bundle lie in relation to:

a) The rib?
b) The intercostal muscles?

A

a - inferior in the intercostal groove

b - between the external and internal intercostal muscles

62
Q

what muscles are used as accessory muscles during respiration

A 
SCM
Rectus abdominis 
serrates anterior 
pec minor 
pec major
63
Q

what are the surface markings of the horizontal fissure on the right side

A

level from 4th rib to the oblique fissure

64
Q

what are the surface markings for the oblique fissure on both sides

A

T3 to rib 6

65
Q

what is the function of the pleura

A

allows the lungs to expand and deflate

- reduce friction

66
Q

what are pleural reflections

A

A pleural reflection is a line or curvature that occurs when a fold is made so that the pleura can change direction.

Cardiorespiratory 2 Anatomy and Physiology (3 decks)

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