Quiz 3 Flashcards

1
Q

What is the dividing line between superior and inferior mediastinum?

A

Stern also angle (about T4 down to diaphragm)

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2
Q

Sympathetics going to the abdominopelvic organs go through the splancnic nerves. What are the dividing points between Greater, lesser, and least splancnic nerves

A
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

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3
Q

The azygous system of veins drain into the ___ vena cava

A

Superior

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4
Q

The left intercostals are drained by ___ and ___, (separate at the ___ spinal level) feeding into ____.

A

Accessory hemiazygous (superior)

Hemiazygous

T8

Azyougous

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5
Q

The anterior intercostal veins drain into…

A

Internal thoracic vein

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6
Q

The right internal thoracic artery comes off of ____ whereas the left comes off of ____

A

Right brachiocephalic

Left subclavian

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7
Q

The esophogus passes through the diaphragm at what spinal level?

A

T10

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8
Q

The serous fluid sits in the ____

A

Pericardial space

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9
Q

Describe what makes each border of the heart

A

Right border/superior border = right atrium

Anterior border = right ventricle

Posterior border = left atrium

Inferior border = left ventricle

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10
Q

What ventricle of the heart makes up the apex?

A

Left ventricle

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11
Q

The closing of what valves make the S2 sound “dub”?

A

Semilunar valves

During this time, the ventricles are relaxing

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12
Q

Describe where you put your stethoscope to listen to each valve of the heart

A

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

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13
Q

Name the branches of the right coronary artery in order

A

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

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14
Q

Name the branches of the left coronary artery in order

A

Left anterior descending artery (LAD)

Left circumflex

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15
Q

The middle cardiac vein is on the ___ surface of the heart

A

Inferior

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16
Q

The great cardiac vein runs along with…

A

LAD

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17
Q

true or false… some sympathetics reach the heart by the cervical sympathetic nerve

A

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

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18
Q

How many sympathetic nerves reach the heart?

A

3 from cervical

4 from thoracic

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19
Q

How do visceral afferents go back to the CNS?

A

By the same pathway the efferents get to the heat

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20
Q

Heart pain will be referred where?

A

Dull diffuse pain to T1, T2, T3, and a little of T4 dermatomes. (Shoulder, pec, medial elbow of left side)

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21
Q

In muscle contraction, for ___ to occur, a new ATP must bind to the myosin head and undergo partial hydrolysis

A

Detachment

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22
Q

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….

A

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

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23
Q

Define oxygen debt

A

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

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24
Q

Describe the optimal sarcomere length

A

Muscle is slightly stretched and there is slight overlap between the myofibrils allowing maximum overlap of myofilaments

80-120% sarcomere length

25
Q

Describe henneman’s size principle:

A

motor units are recruited in the order of the size of the motor unit based on the force/resistance needed .

26
Q

What is the difference between type one and type 2 muscle fibers

A

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

27
Q

In comparison to type 2 fibers, describe type 1 fibers in regards to… speed, resistance to fatigue, mitochondria, myoglobin, SR

A

Speed: slow
Resistance to fatigue = high

Mitochondria = many
Myoglobin = high (red muscle)
SR = less extensive
28
Q

Describe the stretch reflex

A

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

29
Q

Which, the nuclear bag fibers or the nuclear chain fibers detect static change in a muscle?

A

Nuclear chain. Nuclear bag fibers detect fast dynamic change

30
Q

Describe the golgi tendon reflex

A

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.

31
Q

The ___ the movement, the greater the number of muscle spindles in a muscle

A

Finer

32
Q

The serous fluid in the lungs is held in the…

A

Pleural space (in between the parietal and visceral pleural membranes)

33
Q

What is significant about the costodiaphragmatic recess?

A

Fluid can pool in here

34
Q

The costal and cervical surface of the pareital pleura of the lung have pain receptors from…

A

Intercostal somatic nerves

35
Q

The diaphragmatic and mediastinal parietal surface has receptors from… Is this somatic?

A

The phrenic nerve. ***this is the only somatic nerve that refers pain!

36
Q

The phrenic nerve refers pain to ___ because it arises from ____

A

The shoulder, neck, and collar, because it arises from C3, C4, and C5 (this is its dermatome)

37
Q

The visceral pleura of the lung has ____ receptors

A

Autonomic, stretch receptors only. (No pain receptors?)

38
Q

True or false… the visceral afferents for the visceral pleura run along sympathetic and parasympathetic pathways

A

True

39
Q

Name the fissures on the right and left lung

A

Right = horizontal and oblique

Left = just oblique

40
Q

Which lung has the lingual?

A

Left lung

41
Q

Which bronchous is shorter and steeper? Thus stuff gets in here more easily

A

Right bronchus

42
Q

What three things pass through the diaphragm?

A

Esophagus, inferior vena cava, descending aorta

43
Q

Name some accessory muscles for inhalation

A

Serratus anterior
Intercostals (external)
Scalene
Sternocliedomastoid

44
Q

Where is the dividing line between upper resiratory tract and lower respiratory tract?

A

Larynx

45
Q

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?

A

Trachealis

Important for caughing and swallowing

46
Q

What are the glands found in the trachea? What do they do?

A

Mixed seromucus glands. Located in the submucosa. They contribute to humidification of the air and also trapping contaminants

47
Q

What are the three cell types found in the trachea (all of equal abundance)

A

Mucous goblet cells
Basal cells (progenitor cells)
Ciliated columnar cells

48
Q

What are the general trends as you descend down the respiratory tract?

A

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

49
Q

Each tertiary bronchus supplies ….

A

An isolated ‘bronchopulmonary segment’

50
Q

Where would you find club cells? What is their function?

A

These are in the terminal bronchioles. They are the progenitor cell population. They also secrete surfactant and antimicrobial peptides

51
Q

Alveoli are connected by pores called… what is their funciton?

A

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

52
Q

Describe the differences between type 1 pneuomocytes, type 2, and dust cells

A

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

53
Q

What is the pH of plasma?

A

7.4. (Slightly alkaline)

54
Q

Nonvolatile acids are removed by

A

The kidney

55
Q

Kidneys can retain HCO3, but they can also produce new CO3. Explain how this works

A

Metabolizing glutamine which makes NH4 and HCO3

56
Q

True or false… the larger the Ka, the more it dissociates

A

True

57
Q

Buffers are most effective when the ph = pKa with a ___ range

A

+ or - 1

58
Q

True or false… the inside of cells is more acidic than outside

A

True. ~7.1. This correlates nicely with the phosphate buffer system

59
Q

Respiratory acidosis could be caused by ____ and compensated by ____

A

Obstructive lung disease (increases CO2 in blood, thus more acidic)

Retaining more HCO3 in the kidneys