REVIEW Flashcards

1
Q

level of suprasternal notch?

A

TV2 TV3

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2
Q

sternocostal joint?

A

1st synchondrosis

2-7 synovial

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3
Q

costochondral joint?

A

synchondrosis

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4
Q

interchondral joint?

A

8-10 costal cartilage above and below

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5
Q

costovertebral joint?

A

synovial plane joints

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6
Q

ribs 1, 10, 11, 12

A

articulate with that numbered TV

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7
Q

costotransverse joint?

A

rib tubercle and transverse process

synovial

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8
Q

innervation of levator costarum?

A

C8-T11

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9
Q

intercostal nerves?

A

ventral rami
preganglionic sympathetic - white rami 14

postganglionic sympathetic - gray rami 31

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10
Q

intercostobrachial cutaneous nerve?

A

lateral cutaneous intercostal number 2

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11
Q

dermatome at nipple?

A

T4

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12
Q

dermatome at umbilicus?

A

T10

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13
Q

expiration muscles?

A

internal intercostal
innermost intercostal
subcostal
transverse thoracic

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14
Q

inspiration muscles?

A

external intecostal

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15
Q

greater, lesser, least splanchnic nerves?

A

greater - 5-9
lesser - 10-11
least - 12

preganglionic sympathetic!

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16
Q

cardiac plexus?

A

parasympathetic - preganglionic

sympathetic - postganglionic (T1-T4)

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17
Q

pleuritis

A

phrenic nerve C345

aka pleurisy

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18
Q

visceral vs parietal pleura

A

MCL 6-8
MAL 8-10
SL 10-12

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19
Q

number of bronchopulmonary segments?

A

left - 8

right - 10

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20
Q

number of bronchial arteries?

A

2 left

1 right

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21
Q

virchow’s node?

A

supraclavicular node

indicates cancer spread

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22
Q

innervation of parietal pleura?

A

mediastinal and diaphragmatic - phrenic

costal - intercostal nerves

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23
Q

empyema?

A

pus in thorax

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24
Q

horner’s?

A

ptosis
miosis
anhidrosis

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25
Q

innervation of lungs?

A

preganglionic sympathetic T2-T6

primary sympathetic - cardiopulmonary splanchnic nerves -

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26
Q

cardiopulmonary splanchnic nerves

A

postganglionic**

most splanchnic, preganglionic

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27
Q

pericardiocentesis?

A

left of sternum 5 or 6 ICS

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28
Q

pericardial pain?

A

phrenic nerve
C345
shoulder dermatomes

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29
Q

pain fibers in visceral pericardium?

A

no

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30
Q

beck’s triad?

A

cardiac tamponade

muffled heart sounds
hypotension
distended neck veins

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31
Q

dressler syndrome

A

post MI pericarditis

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32
Q

heart sulci

A

atrioventricular (coronary)

anterior and posterior interventricular

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33
Q

apex of heart?

A

5th ICS

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34
Q

base of heart?

A

left atrium

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35
Q

borders of heart?

A

3
right - right atrium
inferior - 2/3 right ventricle, 1/3 left ventricle
left - left ventricle, auricular appendage

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36
Q

surfaces of heart?

A

anterior - 2/3 right ventricle, 1/3 left ventricle
right - right atrium
left - left ventricle, auricular appendage
diaphragm - 2/3 left ventricle, 1/3 right ventricle

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37
Q

left trigone?

A

aortic mitral valve separation

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38
Q

right trigone?

A

aortic, mitral, tricuspid valve separation

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39
Q

layers of myocardium?

A

superficial and deep

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40
Q

ratio of myocardium?

A

1:3:9

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41
Q

SA node?

A

sub-epicardium

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42
Q

AV node

A

sub-endocardium

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43
Q

conus arteriosus?

A

smooth right ventricle

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44
Q

aortic vestibule?

A

smooth left ventricle

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45
Q

blood supply to AV and SA node?

A

right coronary artery

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46
Q

blood supply to bundle of his and other conduction system?

A

left coronary artery

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47
Q

lymph?

A

RCA - left

LCA - right

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48
Q

widow maker?

A

entire left coronary artery

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49
Q

most common coronary artery occlusion?

A

anterior interventricular artery

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50
Q

heart innervation?

A

T1-T4

postganglionic cardiopulmonary splanchnic

parasympathetic vagus

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51
Q

superior vena cava?

A

1-3 ICS on right side

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52
Q

vagus nerve?

A

preganglionic parasympathetic

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53
Q

thoracic duct?

A

cisterna chyli LV2

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54
Q

parasympathetic to heart?

A

AcH

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55
Q

sympathetic to heart?

A

NE

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56
Q

tube thoracostomy?

A

air - 2-3 ICS

fluid 4-5 ICS

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57
Q

spontaneous pneumothorax?

A

visceral pleura

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58
Q

traumatic pneumothorax?

A

parietal pleura

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59
Q

AN at AV junction?

A

long pathway

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60
Q

N at AV junction?

A

slows signal

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61
Q

left bundle branch?

A

thin anterior, thick posterior

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62
Q

purkinje fibers

A

lack T tubules

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63
Q

order of depolarization?

A

endocardium - epicardium

apex - base

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64
Q

biomarkers for cardiac damage?

A

cTnT, cTnI

CK-MB

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65
Q

ECF calcium release?

A

L -type channels

leads to Ca2+ induced calcium release through RyR

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66
Q

relaxation of cardiac AP?

A

3 Na+/1 Ca2+ antiport - to ECF

SERCA - to SR

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67
Q

phase 0

A

rapid depolarization

68
Q

phase 1

A

early rapid depolarization

69
Q

phase 2

A

plateau

70
Q

phase 3

A

final rapid depolarization

71
Q

phase 4

A

resting potential

72
Q

slow type APs?

A

SA/AV nodes

73
Q

fast type APs?

A

atrial myocytes, purkinje, ventricular myocytes

74
Q

plateau phase?

A

Ca2+ vs. K+

75
Q

I-Ca vs. I-Na

A

calcium smaller

therefore, slower depolarization of SA/AV nodes (slow type)

76
Q

potassium channel blocker?

A

longer AP

77
Q

hyperkalemia?

A

depolarizes RMP, slows HR

inactivation of sodium gates, slows conduction

78
Q

effective refractory?

A

absolute

79
Q

relative refractory?

A

can get signal

80
Q

afterdepolarizations?

A

can result in tachycardia

81
Q

funny current?

A

mainly due to sodium influx during hyperpolarization

non-specific cation channels

82
Q

Q wave

A

left to right IV septum

83
Q

R’

A

second upward in EKG

84
Q

tiny box?

A

0.04s

85
Q

box?

A

0.2s or 0.5mV

86
Q

PR interval?

A

normal 3-5 small boxes

shows AV nodal delay

87
Q

ST segment?

A

myocardial injury

should be isoelectric

88
Q

QT interval?

A

total ventricle activity

normal 0.44-0.35s

89
Q

long QT syndrome?

A

more likely to cause torsades de point

can’t inactivate sodium (hyperkalemia)

90
Q

anterior leads?

A

V2 V3 V4

91
Q

left lateral leads?

A

I aVl V5 V6

92
Q

right ventricular leads?

A

aVr V1

93
Q

inferior leads?

A

II III aVf

94
Q

range of MEA?

A

-30 to +110

95
Q

left ventricular hypertrophy?

A

V1 and V5 > 35mm

96
Q

primary block?

A

long PR interval

97
Q

secondary block?

A

mobitz 1 - PR gradually lengthens

mobitz 2 - every nth missing

98
Q

tertiary block?

A

complete, AV disocciation

99
Q

WPW syndrome?

A

alternate conduction pathway

wide QRS

100
Q

arteries?

A

pressure reservoir

101
Q

arterioles?

A

resistance vessels

drop in BP**

102
Q

capillaries?

A

exchange

103
Q

veins?

A

blood reservoir

104
Q

what maintains MAP?

A

arteries

105
Q

MAP = ?

A

DBP + 1/3 (SBP - DBP)

*exercise - 1/2

106
Q

gravity?

A

when standing, BP higher in feet

differences of arterial/venous remains same

107
Q

compliance?

A

C = change in volume/change in pressure

108
Q

most compliant?

A

veins

109
Q

wall stress?

A

T ~ PxR / 2h

LaPlaces Law

110
Q

causes of turbulence?

A
increased velocity (sudden local decrease in diameter)
increased diameter
decreased viscosity (increases velocity)
111
Q

cause of change in blood viscosity?

A

anemia

112
Q

reynold’s number

A

= diameter x velocity x density / viscosity

113
Q

Fick Principle?

A

CO = VO2 / A-V O2 difference

114
Q

driving force of blood?

A

pressure gradient

-change in pressure

115
Q

CO= ?

A

MAP/TPR

116
Q

how is flow distribution regulated?

A

resistance

117
Q

in series?

A

resistance increases overall resistance

118
Q

in parallel?

A

resistance decreases overall resistance

-redirects flow

119
Q

poiseuilles law

A

radius to the 4th** with flow

inverse, length and velocity

120
Q

vasoconstriction?

A

alpha1

121
Q

vasodilation?

A

beta2

122
Q

active hyperemia?

A

flow keeps up

123
Q

reactive hyperemia?

A

blood flow increases after occlusion

124
Q

factors affecting diffusion?

A
concentration gradient
permeability
membrane SA
molecular weight
distance
125
Q

outward pressure forces?

A

P-c and Pi-IF

126
Q

inward pressure forces?

A

P-IF and Pi-c

127
Q

coronary steal?

A

coronary artery downstream already dilated

vasodilator will cause blood to go to other areas than target

128
Q

PTCA

A

stent

129
Q

CABG

A

bypass with vein

130
Q

most blood flow to heart when?

A

diastole

131
Q

LCA blood flow?

A

during isovolumetric relaxation

132
Q

RCA blood flow?

A

more during systole

133
Q

rate pressure product?

A

RPP = HR x SBP

134
Q

MVO2=?

A

MVO2 = CBF x (AO2 - VO2)

135
Q

extraction?

A

near max at rest

exercise requires increase in FLOW

136
Q

adenosine?

A

decreased O2 leads to increased adenosine

-vasodilation

137
Q

tachycardia?

A

less time in diastole - less coronary flow

can be problematic for those with heart conditions

138
Q

ST elevation?

A

MI

139
Q

cardiopulmonary splanchnic nerves

A

superior, middle, inferior cervical cardiac nerves
-sympathetic postganglionic

thoracic cardiac nerves
-sympathetic postganglionic

140
Q

vagal cardiac nerves

A

superior, inferior cervical cardiac branch
-parasympathetic preganglionic

thoracic cardia branch
-parasympathetic preganglionic

141
Q

serratus anterior

A

long thoracic nerve

142
Q

ductus venosus

A

allows blood from umbilical vein to bypass fetal liver

143
Q

premature fetus

A

no surfactant!

respiratory distress

144
Q

five densities of Xray?

A
air
fat
soft tissue/water
calcification (bone)
metal

all allow for contrast

145
Q

consolidation

A

filling of alveoli with air

146
Q

interstitial

A

holds up bronchial tree

147
Q

atelectasis

A

volume loss

148
Q

opacity

A

area that is more white

attenuates the xray beam and appears more opaque

149
Q

consolidation

A

exudate or other product of disease that replaces alveolar air
-renders lungs as solid

type of opacity

150
Q

interstitial

A

connective tissue through the lung

lots of disease processes here**

151
Q

three subdivisions of interstitial?

A

bronchovascular
parenchymal
subpleural

152
Q

major pathological patterns of interstitial?

A

reticular
nodular
septal

153
Q

silhouette sign

A

shadows

154
Q

CXR frontal anatomy?

A

trachea
right paratracheal stripe - adenopathy**
carina - endotracheal tube placement** 3-7cm above
left mainstem bronchus - more horizontal

155
Q

CXR lateral anatomy?

A

trachea
right upper lobe bronchus
carina
left mainstem bronchus - horizontal (round circle)

**useful for localization

156
Q

CXR frontal anatomy?

A

mediastinum
left - 3 moguls

right - SVC, hilum, right atrium**

157
Q

3 moguls

A

aortic arch
main pulmonary artery
left ventricle**

158
Q

mediastinal lines

A

junctional lines - where lungs meet up

azygoesophageal recess - indicator of hiatal hernia

159
Q

CXR lateral anatomy

A

windows - retrosternal, retrotracheal, retrocardiac

vessels- aorta, left pulmonary artery, inferior vena cava

heart - right ventricle, left atrium

160
Q

3 windows?

A

retrosternal
retrotracheal
retrocardiac

161
Q

valves

A

can be seen on CXR

can differentiate on lateral
line from left mainstem bronchus to cardiophrenic angle

above - aortic valve
below - mitral valve

162
Q

CXR frontal anatomy bones?

A

spine
-cervical, thoracic, lumbar

ribs
-anterior, posterior

clavicles

scapula

humerus

163
Q

CXR lateral anatomy bones?

A

spine
-cervical, thoracic, lumbar

ribs

sternum

scapula

humerus

164
Q

heart?

A

always want heart close to film

anterior first
left side first

165
Q

CXR anatomy frontal lungs?

A

yeah, you can see them.

166
Q

echocardiography

A

real-time imaging

ultrasound