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UKMLA Prep > Resp Physiology And Anatomy > Flashcards

Resp Physiology And Anatomy Flashcards

1
Q

What doctrine governs pressure within the cranium?

A

Monroe-Kelly doctrine

This doctrine considers the skull as a closed box.

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2
Q

What happens to CSF when there is an increase in mass in the cranium?

A

Loss of CSF

Once a critical point is reached, ICP rises sharply.

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3
Q

What is the critical volume of CSF loss that leads to a rise in ICP?

A

100-120ml of CSF

Beyond this volume, no further compensation can occur.

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4
Q

What occurs when pressure in the cranium equates with MAP?

A

Neuronal death

Herniation will also accompany this process.

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5
Q

How does the CNS autoregulate its blood supply?

A

Vasoconstriction and dilatation of cerebral blood vessels

Extremes of blood pressure can exceed this capacity.

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6
Q

What metabolic factor causes vasodilation in head-injured patients?

A

Hypercapnia

Important for ventilating head-injured patients.

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7
Q

What is the primary fuel the brain metabolizes?

A

Glucose

Falling glucose levels impair consciousness.

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8
Q

Which part of the brain coordinates automatic control of respiration?

A

Medulla

It controls respiratory rate and depth.

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9
Q

What is the function of the medullary respiratory center?

A

Controls inspiratory and expiratory neurons

Depressed by opiates.

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10
Q

Where is the apneustic center located?

A

Lower pons

Stimulates and prolongs inhalation.

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11
Q

What is the role of the pneumotaxic center?

A

Inhibits inspiration

Fine-tunes the respiratory rate.

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12
Q

Which gas levels are most important in ventilation control?

A

pCO2 levels

O2 levels are less important.

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13
Q

Where are peripheral chemoreceptors located?

A

Bifurcation of carotid arteries and arch of the aorta

They respond to changes in pO2, H+, and pCO2.

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14
Q

What do central chemoreceptors respond to?

A

Increased H+ in brain interstitial fluid

They do not respond to O2 levels.

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15
Q

What do stretch receptors in the lungs respond to?

A

Lung stretching

Causes a reduced respiratory rate.

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16
Q

What is pleural pressure?

A

Pressure surrounding the lung within the pleural space

During quiet breathing, pleural pressure is negative.

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17
Q

What determines lung size?

A

Transpulmonary pressure

Difference between alveolar pressure and pleural pressure.

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18
Q

What are Type 1 pneumocytes?

A

Very thin squamous cells covering 97% of the alveolar surface

Critical for gas exchange.

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19
Q

What is the role of Type 2 pneumocytes?

A

Secrete surfactant

They can differentiate into Type 1 pneumocytes during lung damage.

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20
Q

What is surfactant primarily made of?

A

Phospholipids, carbohydrates, and proteins

The main component is dipalmitoyl phosphatidylcholine (DPPC).

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21
Q

What is the effect of surfactant on alveoli?

A

Reduces alveolar surface tension

Helps prevent alveoli from collapsing.

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22
Q

What is the definition of lung compliance?

A

Change in lung volume per unit change in airway pressure

It indicates the lung’s ability to stretch.

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23
Q

What can cause increased lung compliance?

A

Age, emphysema

Emphysema results from loss of alveolar walls.

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24
Q

What can cause decreased lung compliance?

A

Pulmonary edema, pulmonary fibrosis, pneumonectomy, kyphosis

These conditions restrict lung expansion.

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25
Q

Where does the trachea bifurcate?

A

Upper border of T5 vertebra

Extends from C6 vertebra to T5.

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26
Q

What supplies arterial blood to the trachea?

A

Inferior thyroid arteries

Venous supply is from the thyroid venous plexus.

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27
Q

What is the anterior relation of the trachea?

A

Isthmus of the thyroid gland, inferior thyroid veins, etc.

Includes the manubrium and remains of the thymus.

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28
Q

What structures are found laterally to the trachea in the neck?

A

Common carotid arteries, thyroid gland lobes

Also includes inferior thyroid arteries and recurrent laryngeal nerves.

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29
Q

What are the lateral relations of the trachea in the thorax?

A

Pleura and right vagus on the right; left recurrent nerve and aortic arch on the left

Includes left common carotid and subclavian arteries.

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30
Q

What is the superior root of the ansa cervicalis?

A

Branch of C1 anterolateral to carotid sheath

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31
Q

What is the inferior root of the ansa cervicalis derived from?

A

Derived from C2 and C3 roots, passes posterolateral to the internal jugular vein

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32
Q

Which muscles are innervated by the ansa cervicalis?

A
  • Sternohyoid
  • Sternothyroid
  • Omohyoid
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33
Q

Where does the ansa cervicalis lie in relation to the carotid sheath?

A

Anterior to the carotid sheath

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34
Q

What is the incidence rate of cervical ribs?

A

0.2-0.4%

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35
Q

What symptoms do most cases of cervical ribs present with?

A

Neurological symptoms

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36
Q

What is a common anatomical feature of cervical ribs?

A

Anomalous fibrous band that often originates from C7

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37
Q

What clinical sign may indicate compression of the subclavian artery due to cervical ribs?

A

Absent radial pulse and positive Adson’s test

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38
Q

What is the traditional operative method for excision of cervical ribs?

A

Transaxillary approach

39
Q

What are the general indications for chest drain insertion?

A
  • Trauma
  • Haemothorax drainage
  • Pneumothorax or pleural effusion drainage
40
Q

What is the preferred method for chest drain insertion?

A

Anatomical guidance

41
Q

In which area should chest drains be placed?

A

Safe triangle

42
Q

What borders define the safe triangle for chest drain insertion?

A
  • Anterior edge latissimus dorsi
  • Lateral border of pectoralis major
  • A line superior to the horizontal level of the nipple
  • Apex below the axilla
43
Q

What is the triangle of auscultation bounded by?

A
  • Above: trapezius
  • Below: latissimus dorsi
  • Laterally: vertebral border of the scapula
44
Q

What structures perforate the diaphragm at level T8?

A

Inferior vena cava

45
Q

What structures perforate the diaphragm at level T10?

A

Oesophagus, vagal trunk

46
Q

What structures perforate the diaphragm at level T12?

A
  • Aorta
  • Thoracic duct
  • Azygos vein
47
Q

What is the approximate length of the external auditory meatus?

A

2.5 cm long

48
Q

What are the three anatomically distinct regions of the ear?

A
  • External ear
  • Middle ear
  • Internal ear
49
Q

What is the function of the organ of Corti?

A

Sense organ of hearing

50
Q

What is the innervation of the middle ear?

A

Glossopharyngeal nerve

51
Q

What is the diameter of the tympanic membrane?

A

Approximately 1 cm

52
Q

What forms the laryngeal skeleton?

A

A number of cartilaginous segments

53
Q

What are the paired cartilages of the laryngeal skeleton?

A
  • Arytenoid
  • Corniculate
  • Cuneiform
54
Q

What are the single cartilages of the laryngeal skeleton?

A
  • Thyroid
  • Cricoid
  • Epiglottic
55
Q

What is the function of the vocal folds?

A

Control sound production

56
Q

Which muscle abducts the vocal fold?

A

Posterior cricoarytenoid

57
Q

What is the blood supply of the larynx?

A

Laryngeal arteries, branches of the superior and inferior thyroid arteries

58
Q

What is the lymphatic drainage of the supraglottic part of the larynx?

A

Upper deep cervical nodes

59
Q

What are the two lobes of the left lung divided by?

A

Oblique fissure

60
Q

What is the apex of both lungs located above?

A

Approximately 4 cm superior to the sterno-costal joint of the first rib

61
Q

What is the pleura’s relationship to the lung levels?

A

Runs two ribs lower than the corresponding lung level

62
Q

Name the four paired paranasal air sinuses.

A
  • Frontal sinuses
  • Maxillary sinuses
  • Ethmoid air cells
  • Sphenoid sinuses
63
Q

What is the carotid sinus?

A

Dilatation of the internal carotid artery containing baroreceptors

64
Q

How many pharyngeal arches develop during embryonic growth?

A

Six

65
Q

What is the muscular contribution of the first pharyngeal arch?

A
  • Muscles of mastication
  • Anterior belly of digastric
  • Mylohyoid
  • Tensor tympanic
  • Tensor veli palatini
66
Q

What is the skeletal contribution of the second pharyngeal arch?

A
  • Stapes
  • Styloid process
  • Lesser horn and upper body of hyoid
67
Q

What is the origin of the phrenic nerve?

A

C3, 4, 5

The phrenic nerve originates from cervical spinal roots C3, C4, and C5.

68
Q

What does the phrenic nerve supply?

A

Diaphragm, sensation central diaphragm and pericardium

The phrenic nerve provides motor innervation to the diaphragm and sensory innervation to the central part of the diaphragm and the pericardium.

69
Q

Where does the right phrenic nerve run in the superior mediastinum?

A

Anterior to right vagus and laterally to superior vena cava

The right phrenic nerve’s pathway is important for understanding its anatomical relationships.

70
Q

What is the pathway of the right phrenic nerve as it enters the thorax?

A

Runs posterior to the subclavian vein and posterior to the internal thoracic artery

This pathway is crucial for surgical considerations and understanding potential complications.

71
Q

What structures does the left phrenic nerve pass lateral to?

A

Left subclavian artery, aortic arch and left ventricle

The left phrenic nerve’s course is significant for cardiac and thoracic surgeries.

72
Q

What are the two parts of the scalenus anterior muscle?

A

Anterior and posterior parts

The scalenus anterior muscle has two parts through which the subclavian artery passes.

73
Q

What is the commonest incision utilized to access the heart and great vessels?

A

Median sternotomy

A median sternotomy is a standard approach in cardiac surgery.

74
Q

What is the relationship of the left brachiocephalic vein during a sternotomy?

A

Important posterior relation at the superior aspect of the sternotomy incision

Awareness of this relationship is crucial to avoid vascular injury during surgery.

75
Q

What does the suprascapular nerve innervate?

A

Supraspinatus and infraspinatus

These muscles are important for shoulder abduction and stabilization.

76
Q

What is the transpyloric plane?

A

Level of the body of L1

The transpyloric plane is an important anatomical landmark in abdominal surgery.

77
Q

Fill in the blank: The thoracic outlet is where the subclavian artery and vein and the _______ exit the thorax and enter the arm.

A

brachial plexus

The brachial plexus is critical for upper limb nerve supply.

78
Q

True or False: The right phrenic nerve exits the diaphragm at T8.

A

True

The exit point at T8 is important for understanding its anatomical course.

79
Q

What structures are associated with the transpyloric plane? (13)

A
  • Pylorus of stomach
  • Left kidney hilum
  • Right hilum of kidney
  • Fundus of gallbladder
  • Neck of pancreas
  • Duodenojejunal flexure
  • Superior mesenteric artery
  • Portal vein
  • Left and right colic flexure
  • Root of the transverse mesocolon
  • 2nd part of the duodenum
  • Upper part of conus medullaris
  • Spleen

These structures are significant for understanding abdominal anatomy and surgery.

80
Q

What is the mnemonic to remember the key structures of the transpyloric plane?

A

Larry’s Pancakes And Syrup Make Real Breakfasts Ridiculously Sweet, Damn Perfect And Delicious

This mnemonic helps to recall the 13 structures associated with the transpyloric plane.

81
Q

What does the ‘L’ in the mnemonic represent?

A

L1 vertebral body

The L1 vertebral body is considered the backbone of the transpyloric plane.

82
Q

What does the ‘P’ in the mnemonic stand for?

A

Pylorus

The pylorus is where the meal begins in the digestive process.

83
Q

What is represented by the ‘A’ in the mnemonic?

A

Ampulla of Vater

The Ampulla of Vater is where bile and pancreatic juices mix.

84
Q

What does ‘S’ refer to in the mnemonic?

A

Superior mesenteric artery

The superior mesenteric artery provides the main blood supply to the intestines.

85
Q

What does the ‘M’ in the mnemonic indicate?

A

Midpoint between the suprasternal notch and pubic symphysis

This midpoint serves as a reference point for the transpyloric plane.

86
Q

What does the ‘R’ in the mnemonic represent when mentioned for the first time?

A

Renal hila

The renal hila are associated with the kidneys, which control blood quality.

87
Q

What does the ‘B’ stand for in the mnemonic?

A

Body of pancreas

The body of the pancreas is likened to the chef overseeing the kitchen.

88
Q

What does the second ‘R’ in the mnemonic refer to?

A

Root of transverse mesocolon

This structure is compared to a tablecloth spread under the digestive organs.

89
Q

What does ‘S’ refer to when it appears later in the mnemonic?

A

Spinal cord ends (conus medullaris)

The conus medullaris marks the end of the spinal cord.

90
Q

What does ‘D’ denote in the mnemonic?

A

Duodenojejunal flexure

This is the location where the small intestine changes direction, likened to a pancake flip.

91
Q

What does ‘P’ represent in the context of the mnemonic?

A

Portal vein formation

The portal vein is formed from the superior mesenteric vein (SMV) and splenic vein, supplying blood to the liver.

92
Q

What does ‘A’ refer to when mentioned again in the mnemonic?

A

Apex of gallbladder

The apex of the gallbladder is likened to the syrup in this breakfast analogy.

93
Q

What does the last ‘D’ in the mnemonic signify?

A

Deep inguinal ring

This structure is considered optional, representing dessert delivery in the analogy.

94
Q

True or False: The spinal cord keeps the whole system upright and functioning according to the mnemonic.

A

True

The spinal cord is likened to a support system in the breakfast analogy.

UKMLA Prep (46 decks)

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