Quiz 3 Flashcards
What is the dividing line between superior and inferior mediastinum?
Stern also angle (about T4 down to diaphragm)
Sympathetics going to the abdominopelvic organs go through the splancnic nerves. What are the dividing points between Greater, lesser, and least splancnic nerves
Greater = T5-T9 Lesser = T10-T11 Least = T12
Remember that these arise from the lateral horn, and they course through but do not synapse in the sympathetic chain ganglia!!! Rather, they synapse in the pre-aortic ganglion
The azygous system of veins drain into the ___ vena cava
Superior
The left intercostals are drained by ___ and ___, (separate at the ___ spinal level) feeding into ____.
Accessory hemiazygous (superior)
Hemiazygous
T8
Azyougous
The anterior intercostal veins drain into…
Internal thoracic vein
The right internal thoracic artery comes off of ____ whereas the left comes off of ____
Right brachiocephalic
Left subclavian
The esophogus passes through the diaphragm at what spinal level?
T10
The serous fluid sits in the ____
Pericardial space
Describe what makes each border of the heart
Right border/superior border = right atrium
Anterior border = right ventricle
Posterior border = left atrium
Inferior border = left ventricle
What ventricle of the heart makes up the apex?
Left ventricle
The closing of what valves make the S2 sound “dub”?
Semilunar valves
During this time, the ventricles are relaxing
Describe where you put your stethoscope to listen to each valve of the heart
All physicians take money
Aortic valve = right of sternum 2nd intercostal space
Pulmonary valve = left of sternum 2nd intercostal space
Tricuspid = left of sternum 4th intercostal space
Mitral = even more left of the sternum 4th intercostal space
Name the branches of the right coronary artery in order
Right marginal
PDA
*if right coronary serves the PDA (most likely) it is a right dominant heart, if the left coronary artery serves the PDA it is a left dominant heart
Name the branches of the left coronary artery in order
Left anterior descending artery (LAD)
Left circumflex
The middle cardiac vein is on the ___ surface of the heart
Inferior
The great cardiac vein runs along with…
LAD
true or false… some sympathetics reach the heart by the cervical sympathetic nerve
True. Although the preganglionic neuron arises in T1, it goes all the way up to the cervical region to synapse with the post gangiononc, this is due to development
How many sympathetic nerves reach the heart?
3 from cervical
4 from thoracic
How do visceral afferents go back to the CNS?
By the same pathway the efferents get to the heat
Heart pain will be referred where?
Dull diffuse pain to T1, T2, T3, and a little of T4 dermatomes. (Shoulder, pec, medial elbow of left side)
In muscle contraction, for ___ to occur, a new ATP must bind to the myosin head and undergo partial hydrolysis
Detachment
Free cytosolic ATP provides the immediate source of energy for muscle contractions. However, it is only enough to fuel about 5 seconds of activity. Three other sources of ATP come from….
Creatine phosphate - produces 1 ATP per CP (lasts about 15 seconds)
Glycogenolysis - 2 ATPs per glucose, produces lactic acid in the process. (Lasts about a minute)
Cellular aerobic respiration - one glucose gives rise to about 38 ATP. This can last for hours
Define oxygen debt
This is the amount of O2 needed to convert the accumulated lactic acid to glucose and to restore the supplies of ATP and creatinine phosphate
Describe the optimal sarcomere length
Muscle is slightly stretched and there is slight overlap between the myofibrils allowing maximum overlap of myofilaments
80-120% sarcomere length
Describe henneman’s size principle:
motor units are recruited in the order of the size of the motor unit based on the force/resistance needed .
What is the difference between type one and type 2 muscle fibers
Type 1 = slow twitch (first ones fired, used in prolonged activities)
Type 2 = when load is increased these are used to *supplement the type 1 fibers, Type 2b are supplement supplement fibers
In comparison to type 2 fibers, describe type 1 fibers in regards to… speed, resistance to fatigue, mitochondria, myoglobin, SR
Speed: slow
Resistance to fatigue = high
Mitochondria = many Myoglobin = high (red muscle) SR = less extensive
Describe the stretch reflex
Stretching of the muscle spindle will depolarize it, sending a signal to the spinal cord. It will activate the alpha motor neuron to cause the muscle to contract. (This resists the muscle from being stretched further). Gamma neurons will contract the muscle spindle. Also note that reciprocal innervation will occur. This will inhibit the antagonist muscles
Which, the nuclear bag fibers or the nuclear chain fibers detect static change in a muscle?
Nuclear chain. Nuclear bag fibers detect fast dynamic change
Describe the golgi tendon reflex
The golgi tendon organs are located in tendons. They respond to tension of the tendon during muscle contraction, they inhibit the alpha neuron to prevent damage.
The ___ the movement, the greater the number of muscle spindles in a muscle
Finer
The serous fluid in the lungs is held in the…
Pleural space (in between the parietal and visceral pleural membranes)
What is significant about the costodiaphragmatic recess?
Fluid can pool in here
The costal and cervical surface of the pareital pleura of the lung have pain receptors from…
Intercostal somatic nerves
The diaphragmatic and mediastinal parietal surface has receptors from… Is this somatic?
The phrenic nerve. ***this is the only somatic nerve that refers pain!
The phrenic nerve refers pain to ___ because it arises from ____
The shoulder, neck, and collar, because it arises from C3, C4, and C5 (this is its dermatome)
The visceral pleura of the lung has ____ receptors
Autonomic, stretch receptors only. (No pain receptors?)
True or false… the visceral afferents for the visceral pleura run along sympathetic and parasympathetic pathways
True
Name the fissures on the right and left lung
Right = horizontal and oblique
Left = just oblique
Which lung has the lingual?
Left lung
Which bronchous is shorter and steeper? Thus stuff gets in here more easily
Right bronchus
What three things pass through the diaphragm?
Esophagus, inferior vena cava, descending aorta
Name some accessory muscles for inhalation
Serratus anterior
Intercostals (external)
Scalene
Sternocliedomastoid
Where is the dividing line between upper resiratory tract and lower respiratory tract?
Larynx
At the border with the esophagus, the ends of the C shaped cartilaginous rings on the trachea are joined by smooth muscle called the… and what are its functions?
Trachealis
Important for caughing and swallowing
What are the glands found in the trachea? What do they do?
Mixed seromucus glands. Located in the submucosa. They contribute to humidification of the air and also trapping contaminants
What are the three cell types found in the trachea (all of equal abundance)
Mucous goblet cells
Basal cells (progenitor cells)
Ciliated columnar cells
What are the general trends as you descend down the respiratory tract?
Epithelium height and complexity decreases
Cartilage rings are replaced by isolated blocks (no cartilage past the terminal bronchioles)
Trachealis muscle is replaced with bundles of spiraling smooth muscle
Amount of elastic fibers and smooth muscle proportionally increases
Goblet cells and glands decrease
Each tertiary bronchus supplies ….
An isolated ‘bronchopulmonary segment’
Where would you find club cells? What is their function?
These are in the terminal bronchioles. They are the progenitor cell population. They also secrete surfactant and antimicrobial peptides
Alveoli are connected by pores called… what is their funciton?
Alveolar pores (AKA pores of Kohn)
These function to distribute air evenly, equalizing pressure. Also help prevent total loss of ventilation in the even of bronchioles being blocked.
*bacteria easily spread through these pores
Describe the differences between type 1 pneuomocytes, type 2, and dust cells
Type 1 pneumocyte- physically make very thin membrane for gas exchange, joined by tight junctions
Type 2 - make surfactant, large cuboidal cells, progenitor cells.
Dust cells - macrophage of the alveoli
What is the pH of plasma?
7.4. (Slightly alkaline)
Nonvolatile acids are removed by
The kidney
Kidneys can retain HCO3, but they can also produce new CO3. Explain how this works
Metabolizing glutamine which makes NH4 and HCO3
True or false… the larger the Ka, the more it dissociates
True
Buffers are most effective when the ph = pKa with a ___ range
+ or - 1
True or false… the inside of cells is more acidic than outside
True. ~7.1. This correlates nicely with the phosphate buffer system
Respiratory acidosis could be caused by ____ and compensated by ____
Obstructive lung disease (increases CO2 in blood, thus more acidic)
Retaining more HCO3 in the kidneys
