Quiz 2: Lecture 4-6 Flashcards
✔️How many chambers in the heart? What are they? What do they do?
4 chambers
- left ventricle: pumps oxygenated blood to the body
- right ventricle: pumps deoxygenated blood to the lungs
- left atrium: holding chamber, collects oxygenated blood from lungs, then sends it to left ventricle
- right atrium: holding chamber, collects deoxygenated blood from inferior vena cava, then sends it to right ventricle
✔️What is the mediastinum?
The cavity (region) between the lungs, sternum, and spine
(Broken up into superior, and inferior mediastinum)
✔️Phrenic nerve is located where?
Anterior to the anterior scalene, then deep into the thorax, then ANTERIOR to the HEART
✔️Where is the vagus (parasympathetic) nerve?
Anterior to the anterior scalene, medial to the phrenic nerve, then goes POSTERIOR to the HEART
✔️How is the mediastinum divided?
Superior and Inferior
Inferior mediastinum also contains anterior, middle, and posterior mediastinum
✔️What does the superior mediastinum contain? (Think nerves, pipes, cardiac structures)
Brachiocephalic veins, superior vena cava, aortic arch (+ branches), trachea, esophagus, phrenic and vagus nerves, thoracic duct and lymphatics
What is the pericardium?
The pericardium is the surrounding covering of the heart that is broken into 3 separate layers; the fibrous pericardium, and serous pericardium [2 layers; parietal (outer), and visceral (inner)
Describe the fibrous pericardium (and innervations, blood supply, etc.)
- creates the boundaries within the mediastinum cavity
- very tough and strong layer
- innervated by the phrenic nerves as they pass to the diaphragm
- blood is supplied via internal thoracic artery (pericardiophrenic vessels)
Describe the serous pericardium
Parietal layer: divides the fibrous pericardium and visceral layer of pericardium
Visceral layer: directly on the heart
What is the pericardial cavity?
- Space between parietal and visceral layers of the heart
- contains a small amount of serous fluid to allow for frictionless movement when the heart beats
What is cardiac tamponade?
A medical emergency when fluid or blood builds up in the pericardial cavity around the heart
What are the two loop systems within the cardiorespiratory system?
Pulmonary loop: transports blood to and from the lungs
Systemic loop: transports blood to and from the rest of the body
Explain the process in which blood goes to and from the lungs (pulmonary loop)
Right atrium —> right ventricle —> pulmonary trunk —> (splits into right and left pulmonary arteries) —> lungs -> pulmonary veins —> left atrium
Explain the superior and inferior vena cava
Superior vena cava: blood returned from arms, neck, face, and skull
Inferior vena cava: blood returned from lower extremity, liver, and abdominal viscera
Both drain into the right atrium
Which vessels lead into the brachiocephalic veins
Internal jugular veins, and subclavian veins
Which vessels lead into the superior vena cava (SVC)
Right and left brachiocephalic veins
Function of azygos vein
Drain blood from thorax into the superior vena cava
⁉️Where does the renal vein and hepatic vein go?⁉️
Inferior Vena Cava (IVC)
Describe the pulmonary arteries
- Carry deoxygenated blood from pulmonary trunk (powered by the right ventricle) to the lungs
- posterior orientation in relation to the other trunks
Describe the pulmonary veins
- Carry oxygenated blood from lungs to heart (left atrium)
- located inferior to where the pulmonary arteries come out of the heart
- 2 sites of attachments for the veins on each side of heart (4 total)
In regards to the two loop systems, which side of the heart corresponds with each system?
Right: pulmonary circulation
Left: systemic circulation
What is ventricular contraction called? What is ventricular relaxation called?
Contraction: systole (sis-toe-lee)
Relaxation: diastole (die-ass-toe-lee)
Where does all the deoxygenated blood in the body go to?
Right atrium
The coronary sinus (CS) drains _______ into the right atrium
The deoxygenated blood of the heart
Where are the pectinate muscles? What is the function?
Where?: anterior part of the inner walls of the right and left atria
Function: increases the power of contractions
What is the fossa ovalis?
A hole between the right and left atrium during fetal development that is then closed shortly after birth
If the fossa ovalis remains open, what could happen?
- Stroke
- decreased endurance
What type of valve allows blood to go from the right atrium to the right ventricle?
Tricuspid valve (atrio-ventricular valve)
- anterior cusp
- posterior cusp
- septal cusp (along the septum)
What are the names of the ventricle muscles?
- Trabeculae carneae
- Papillary muscles
What type of valve is the pulmonary valve?
Semilunar valve
- anterior
- right
- left
Left atrium receives blood from where?
Pulmonary veins (carrying oxygenated blood from the lungs)
Where is the mitral valve?
Bicuspid valve located between the Left atrium and Left ventricle
What is the function of the left ventricle?
Pump oxygenated blood to the entire body
The __________ valve is located between the right ventricle, and pulmonary trunk
Pulmonary valve (tricuspid)
- right cusp
- left cusp
- posterior cusp
The ___________ valve is located between the right atrium and right ventricle
Tricuspid
- anterior
- posterior
- septal
The ______ valve is located between the left atrium and left ventricle
Mitral (only valve with 2 cusps)
- anterior
- posterior
The ________ valve is located between the left ventricle and aorta
Aortic valve
- left cusp
- right cusp
- posterior cusp
What is another word for a “cusp”
Leaflet (leaf-let)
Sympathetic nervous system does what?
Responsible for intentional responses
Parasympathetic nervous system does what?
Responsible for unintentional responses
What is the mediastinum? Describe it in further depth
The mediastinum is the area that lies between the lungs, and holds many organs. This is further broken down into the superior mediastinum, and the interior mediastinum. The inferior mediastinum is also broken down into anterior, middle, and posterior
What is the mediastinum? Describe it in further depth
The mediastinum is the area that lies between the lungs, and holds many organs. This is further broken down into the superior mediastinum, and the interior mediastinum. The inferior mediastinum is also broken down into anterior, middle, and posterior
Where is the vagus nerve (cranial nerve 10) in relation to the phrenic nerve?
Medial (runs on top of the anterior scalenes, and posterior to the heart)
How does cardiac bypass surgery work?
Disconnect the internal thoracic artery from the sternum, then plug it in distal to a blockage
This allows blood flow to continue since the original artery was obstructed
What is a fetal shunt?
When the foremen ovale (between right and left atrium) ductus arteriosum (between pulmonary artery and aortic arch), or ductus venous (umbilical vein to IVC) gets filled in and access gets cut off
What is the SA node? Where is it?
Pacemaker of the heart
- Right atrium
- anterior to SVC
What happens after the SA node is stimulated?
Impulses spread to Bachmans bundle
What do the purkinje fibers do?
Contract the papillary muscles in the ventricles
SA node can fire without external stimulation at ____ to _____ bpm
60-100
If the SA node fails, the AV node will contract ____ to _____ times per minute
40 to 60
If the SA and AV nodes both fail to fire, the purkinje fibers will contract at a rate of ____ to ____ bpm
15 to 40
✔️Where does the sympathetic nervous system originate? Function?
Origin: T1-T4 spinal cord
Function: increase rate and force of contraction
Innervation: SA, AV, atria, ventricles
Where does the parasympathetic innervation of the heart come from? Function?
Vagus nerve [cranial nerve 10 (X)]
Function: decrease the rate
What else innervates the heart?
Cardiac plexus
The right lung has 3 lobes
- upper/superior lobe
- middle lobe
- lower/inferior lobe
The left lung has 2 lobes
- upper/superior lobe
- lower/inferior lobe
Also has the cardiac notch where the middle lobe would be if it were bilateral
What is the purpose of the pleura?
Surrounds each lung (has the same purpose on the lungs as the pericardium does with the heart)
- has 2 layers
Explain the difference between the pericardium layers and the pleura layers
Pericardium has three layers (fibrous, and two serous… parietal and visceral), pleura layers consist of parietal and visceral
What is the lingula?
The point at the bottom of the cardiac notch (inferior to the heart)
Which vein flows into the superior vena cava (SVC)?
Azygos vein
Orientation of the hilum differs from right to left lung. How?
Left lung: artery is superior to bronchus
Right lung: artery is anterior to bronchus
[Hint: think “RALS”… (Right is anterior, Left is superior]
What are the bronchi?
Pipes that split from the trachea and into the lung. They transport air
How do the right and left bronchus differ? Which one is someone more likely to choke with?
Right is wider and longer… which leads to more choking hazards than the left
Parietal pleura is innervated by what nerves?
Intercostal and phrenic nerves
✔️Which nerve provides sensory innervation to the parietal pleura?
Phrenic and intercostal nerves
Which nerve innervates the trachea and bronchi parasympathetically (relaxes the bronchi)?
Vagus nerve
_______ nerve has a sensory nerve for the cough reflex
Vagus
Differentiate between primary bronchi, secondary bronchi, tertiary bronchi, bronchioles
Primary bronchi splits from trachea
Secondary bronchi branches off those (3 right, 2 left)
Tertiary bronchi solids off those
Bronchioles
Sympathetic innervation come from ________________, parasympathetic innervation comes from _______________
Spinal cord, vagus nerve
Venous blood from bronchial veins goes into the ___________ system
Azygous
What is pneumothorax?
A collapsed lung
What are some obstructive diseases of the lungs?
- shortness of breath (SOB)
- chronic obstructive pulmonary disease (COPD)
- asthma
- Cystic Fibrosis
What are some restrictive disorders of the lungs?
- pulmonary fibrosis
- obesity
- ALS
What happens with tension pneumothorax?
The air in n the pleural cavity from the collapsed lung pushes the mediastinum to the opposite side
What is hydrothorax in comparison to hemothorax?
Hydrothorax: when water accumulates in the pleural cavity (pleural effusion)
Hemothorax: when blood accumulates in the pleural cavity (caused by contact trauma)
Where is the diaphragm? what does it do?
A dome shaped muscle that concaves inferior underneath the lungs. Runs from T8 to L2/L3
Also separates the abdominal cavity from the thoracic cavity
Where are the attachments for the diaphragm? Which nerve innervates it?does contraction help increases thoracic inspiration volume?
Attachments:
- xiphoid process
- Costal margin of thoracic wall
- ribs XI and XII
- L1 to L3
Innervation: phrenic nerve (from C3,C4,C5)
Yes, thoracic volume increases during contraction (inhalation)
Which tendon does the the diaphragm attach to?
Central tendon
Where does the pericardium attach to?
pericardium attaches to the thoracic side of central tendon
What role do bronchial arteries play in pulmonary circulation?
Unlike pulmonary arteries that bring blood to the lungs to become oxygenated, bronchial arteries bring blood to the tracheobronchial tree and lung tissue
After the lung tissue uses the blood, where does the venous blood empty into?
Azygos, hemiazygos, and or intercostal veins which then make their way back to the right atrium
Where is the line drawn between the superior and inferior mediastinum?
Plane of Louis (sternal angle and bottom of T4) (also known as thoracic plane)
Where in the mediastinum is the heart?
Inferior, middle mediastinum (the heart marks the center, everything else is relative to the heart. For example, anterior mediastinum is anterior to the heart)
What are the holes (that allow structures to pass through in the diaphragm called?
Apertures
- aortic aperture (descending aorta) (T12)
- esophageal aperture (esophagus) (T10)
- caval aperture (inferior vena cava) (T8)
Esophagus and vagus nerve go through the diaphragm at which vertebral level? Inferior vena cava?
Esophagus and Vagus nerve: T10
Inferior vena cava: T8
(Hint: I 8 10 eggs at 12)
- I: inferior vena cava (8)
- eggs: esophagus (10)
- at: aorta (12)
Which arteries come off the aorta to supply the diaphragm?
Left and Right inferior phrenic arteries
What are the crura?
The tendons from L1 through L3 that anchors the diaphragm
Thoracic wall gets its blood supply from where?
Posterior intercostal arteries (come off the thoracic aorta)
Anterior intercostal arteries which come off the musculophrenic artery and the internal thoracic artery
The subcostal artery supplies where?
12th intercostal
Where does venous blood from the intercostals go?
Azygos, hemiazygos, and accessory Azygos veins, then drains jnto the superior vena cava
What is the primary role of the lymphatic system?
To drain any excess fluid within the body
What is the primary role of the lymphatic system?
- To drain any excess fluid within the body
- also helps the immune system fight infection
Where does lymph go?
Into lymph vessels, then back into the blood stream
Where is the right lymphatic duct? What does it drain
Location: Runs near where the brachiocephalic split is
Function: drains the right thorax, right upper limb, right side of the head
What does the thoracic duct do?
Drains everything that the right lymphatic duct doesn’t
The thoracic duct runs where?
Through the posterior mediastinum
Lymph contains _______________ and ______________
Lymphocytes, macrophages
Where is the thymus? Is it present in adults?
A gland that is found between the lungs, and anterior to the heart. It trains lymphocytes to attack different pathogens
No, it is not present in adults… only adolescents
Where are the tonsils? What are they used for?
In the back of the mouth/throat
Protects the Gastrointestinal (GI) (digestive system) tract from bacteria
Which nerve is responsible for parasympathetic innervation?
Vagus nerve
Which nerve is responsible for sympathetic innervation?
Spinal cord
Which lung has an impression for the superior vena cava and Azygos vein
Right lung
Which nerve(s) provide sensory information to the parietal pleura?
Phrenic and intercostal nerves
Which of the following is true in regards to the right lung?
- the medial surface has an impression for the aorta
- at the hilum, the pulmonary artery is anterior to the primary bronchus
- it has two lobes
- Blood supply is via the pulmonary veins
At the hilum, the pulmonary artery is anterior to the primary bronchus
The circumflex artery is a branch of which artery
Left coronary artery
True or False?: in the left lung, the pulmonary artery is anterior to the primary bronchus
False, superior
(Hint: when thinking of the hilum orientation of the lungs, use RALS in relation the the bronchus….. Right Anterior, Left is superior)
What are alimentary organs?
Alimentary organs are the primary structures that food goes through during digestion
- mouth
- pharynx
- esophagus
- stomach
- small intestine
- large intestine
- rectum
- Anus
What are accessory organs of the GI system?
Accessory organs are the organs that indirectly aid in digestion
- teeth
- tongue
- salivary glands
- gallbladder
- liver
- pancreas
Which organs are in the upper right quadrant of the abdomen?
Liver, gallblader, hepatic flexure of colon, head of pancreas, right kidney
Which organs are in the upper left quadrant if the abdomen?
Stomach, spleen, splenic flexure of colon, tail of pancreas, left kidney
Which organs are in the lower right quadrant of the abdomen?
Cecum and appendix
Which organs are in the lower left quadrant of the abdomen?
Sigmoid colon
Differentiate between mediastinum, peritoneum
Mediastinum is the cavity above the diaphragm in the thoracic region, peritoneum is the cavity beneath the diaphragm in the abdomen
Differentiate between mediastinum, peritoneum
Mediastinum is the cavity above the diaphragm in the thoracic region
Peritoneum is the cavity beneath the diaphragm in the abdomen
- visceral peritoneum: lines organs
- parietal peritoneum: lines the body walls
What is the mesentery?
A double layer of peritoneum
What is the pleura?
The covering of the lungs
- parietal pleura (costal, diaphragmatic, mediastinal, cervical)
- visceral pleura (inner layer)
What is the foregut? What is in it?
The first part of the GI tract: Esophagus, stomach, duodenum, liver, hepatic ducts, gallbladder, bile duct, and pancreas
What is the midgut? What’s in it?
2nd part of GI tract
Distal Duodenum to bile duct, small intenstine, appendix, ascending colon, proximal 2/3 of transverse colon
What is the hindgut? What’s in it?
Distal 1/3 of transverse colon, descending colon, sigmoid colon, rectum, anus
Secretion of ________ in the stomach begins protein digestion
Pepsin
What structure in the stomach allows food to go into the duodenum?
Pyloric sphincter
What is the duodenum?
First part of small intestine
What are the3 parts of small intestine?
Duodenum, jejunum, ileum
How many lobes to the liver? What does it do?
2, right and left (right is bigger)… also has two small lobes on bottom called quadrate lobe and caudate lobe
(Divided by falciform ligament)
Filters blood from GI tract
✔️All the all the venous blood from GI tract has to go to the liver via the _____________ vein. Once clean, it goes to the __________ veins, then the inferior vena cava
Portal veins, hepatic veins
✔️✔️What is the arterial supply, venous drainage, sympathetic and parasympathetic innervation of the foregut?
Foregut:
- arterial supply: celiac trunk
- venous drainage: gastric and splenic veins
- sympathetic innervation: greater splanchnic nerves
- parasympathetic innervation: vagus
✔️✔️What is the arterial supply, venous drainage, sympathetic and parasympathetic innervation of the midgut?
Midgut:
- Arterial supply: superior mesenteric artery
- venous drainage: superior mesenteric vein
- Sympathetic innervation: lesser splanchnic nerves
- Parasympathetic innervation: vagus
✔️✔️What is the arterial supply, venous drainage, sympathetic and parasympathetic innervation of the hindgut?
Hindgut
- Arterial supply: inferior mesenteric artery
- Venous drainage: inferior mesenteric vein
- Sympathetic innervation: lumbar splanchnic nerves
- Parasympathetic innervation: pelvic splanchnic nerves
✔️What do the liver and gallbladder do?
Liver creates bile, gallbladder stores it
When needed to be secreted, it comes out of bile duct
✔️What does the pancreas do?
Breaks down food with enzymes
✔️What is AAA?
Abdominal aortic aneurysm
(Weakening on artery wall, may present as low back pain)
✔️Which of the following is true regarding the mediastinum?
- the vagus nerve innervates the diaphragm
- phrenic nerve passes posterior to the heart
- phrenic nerve passes through the thorax, into the abdomen to innervates the GI system
- vagus nerve is medial to the phrenic nerve
Vagus nerve is medial to the phrenic
✔️What is the sympathetic innervation of the heart? What does it do for it?
T1-T4 of spinal cord, helps it contract faster and with more power
✔️What is the parasympathetic Innervation of the heart? What does it do?
Vagus nerve, slows the heart down
Which nerve innervates the parietal pleura?
Phrenic and intercostal nerves
What is a mesentery?
Double layer of peritoneum
What is the fatty apron that hangs over top of the abdominal contents and intestines?
Greater omentum
✔️Where does venous blood from the GI Tract have to go before it goes back to the heart? Which vein brings it there?
Liver, portal vein
What is the porta hepatis?
Similar to the hilum of the lung, it’s where all the vessels go into the liver
What is the porta hepatis?
Similar to the hilum of the lung, it’s where all the vessels go into the liver
What is the lymphatic system?
The lymphatic system drains any unwanted fluids/toxins from the body, brings it to the lymph nodes to get filtered, then it’s put back into the bloodstream
What are the two atrioventricular valves?
Tricuspid and mitral valve
What are the two atrioventricular valves?
Tricuspid and mitral valve
What are the 2 semilunar valves
Aortic and pulmonary valve
What are the 2 semilunar valves
Aortic and pulmonary valve
✔️✔️3 types of fetal shunt systems in newborns in utero are?
- ductus arteriosis
- ductus venosus
- foramen ovale
How do electrical signals travel through the heart?
SA Node to AV Node to bundle of his
How is the heart muscle (myocardium) supplied with blood, how is the venous blood removed?
Supplied by coronary arteries, then the venous blood is removed by cardiac veins
✔️✔️What innervates the heart?
Parasympathetic: vagus nerve
Sympathetic: T1-T4 of spinal cord
