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(1) Organ Anatomy > S1_L4: Large Vessels and Clinical Notes > Flashcards

S1_L4: Large Vessels and Clinical Notes Flashcards

1
Q

The dilatation (aneurysm) of the aorta showing as a pulsatile swelling in the suprasternal notch. It is caused by narrowing of aorta just proximal, opposite or distal to the attachment of the ligamentum arteriosum, its most common site.

A

Coarctation of the aorta

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2
Q

The sign of coarctation of the aorta is decreased pulse in the ___ artery of both limbs.
Collaterals develop with dilatation of the intercostal arteries, internal thoracic, and subclavian arteries as a form of compensation.

A

femoral

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3
Q

Determine the corresponding descriptions of the congenital heart diseases

  1. Most common congenital cardiac malformation
  2. Foramen ovale fails to close
  3. Distal part of the aortic arch connects with left pulmonary artery
  4. Causes high pressure aortic blood passing to pulmonary artery producing pulmonary hypertension and hypertrophy of R ventricle
  5. Membranous or fibrous part of septum fails to close
  6. Blood under high pressure passes from left to right causing enlargement of right ventricle

A. Atrial septal defect
B. Ventricular septal defect
C. Patent ductus arteriosus

A
  1. B
  2. A
  3. C
  4. C
  5. B
  6. B
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4
Q

Enumerate the components of the Tetralogy of Fallot

A
  1. Stenosis (narrowing) of the pulmonary trunk
  2. Large ventricular septal defect (membranous)
  3. Overriding of aorta
  4. Severe hypertrophy of R ventricle due to high pressure in right ventricle
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5
Q

Characterized by inflammation in the valve causing the edges of the valve cusps to stick together, causing fibrous thickening then loss of flexibility and shrinkage. The heart ceases to function as an efficient pump. Narrowing (or valvular stenosis) or regurgitation (valvular incompetence) may occur.

A

Valvular heart disease

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6
Q

In Rheumatic heart disease (RHD), which valve is most commonly affected?

A

Mitral valve

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7
Q

Pain due to reduce or lack of blood supply to the muscles of the heart (myocardium). It is a symptom of coronary artery disease. The patient may feel pressure on chest, squeezing, heaviness or tightness, pain in arms, neck, jaw, shoulder or back. It is accompanied by dizziness, fatigue, nausea, or shortness of breath.

A

Angina / Angina pectoris

Additional: This is aggravated by exertion and relieved by rest due to narrowing of the coronary arteries leading to myocardial ischemia. Exertion causes the heart to demand more blood supply.

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8
Q

Nitroglycerine is a drug for the treatment of angina pectoris. It is a vasodilator for the ___ artery.

A

coronary

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9
Q

A chronic bacterial infection that can develop after you inhale droplets sprayed into the air (as from a cough or a sneeze) by somebody who is infected. It can travel to any part of the body and one of its signs/symptoms is a cough with thick, cloudy, and sometimes bloody mucus (sputum) from the lungs for more than 2 weeks.

A

Tuberculosis

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10
Q

Term for TB in children

A

Primary complex

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11
Q

The most common cause of emphysema and bronchogenic carcinoma is?

A

cigarette smoking

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12
Q

The (1)___ provides the systemic circuit flow, while the (2)___ provides the pulmonary circuit flow in the thorax.

A
  1. aorta
  2. pulmonary trunk
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13
Q

The main arterial trunk that delivers oxygenated blood from left ventricle to tissues of body

A

Aorta

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14
Q

Determine the corresponding descriptions of the parts of the aorta

  1. Its branches are the Brachiocephalic artery, Left common carotid, and Left subclavian arteries
  2. Its from left ventricle (base) up to sternal angle and found in the middle mediastinum
  3. Its branches are Posterior intercostal arteries, Subcostal artery, Pericardial, esophageal, and bronchial arteries, and a mediastinal branch
  4. Found in superior mediastinum behind the manubrium
  5. Found in posterior mediastinum and it becomes the abdominal aorta at the 12th thoracic vertebra
  6. Its branches are the coronary right and left arteries

A. Ascending aorta
B. Aortic arch
C. Descending thoracic aorta
D. Abdominal aorta

A
  1. B
  2. A
  3. C
  4. B
  5. C
  6. A
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15
Q

Refers to the 3 bulges behind the aortic valve cusp

A

sinuses of the aorta

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16
Q

These make up the “nutritive” vascular system of the pulmonary tissue.

A

Bronchial arteries & veins

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17
Q

The right bronchial artery arises from the ___ artery or upper left bronchial artery, while the left arises from the descending thoracic aorta.

A

3rd posterior intercostal

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18
Q

This artery is found to the right of the trachea. It divides into the right common carotid and right subclavian artery behind right SC joint.

A

Brachiocephalic artery

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19
Q

Bifurcation of pulmonary trunk (into R and L pulmonary arteries) occurs to the left of the midline inferior to what thoracic level/s?

A

T4-T5

(Or also occurs anteroinferior to the left of the bifurcation of the trachea)

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20
Q

This is a fibrous band that used to be an open artery. It connects the bifurcation of pulmonary trunk to the aortic arch and allows blood to bypass lungs during development. It is also important during embryonic circulation when ductus arteriosus is patent.

A

Ligamentum arteriosum / Ligamentum arteriosus

Additional: This closes after birth. As the child breathes, the pressure prevents blood to go through the ductus arteriosum, thus becoming non-functioning and closes.

20
Q

Determine the corresponding descriptions of the right and left pulmonary arteries

  1. Lies posterior to superior pulmonary vein
  2. Longer and passes horizontal across mediastinum
  3. Gives off 3 branches, a large branch to superior lobe and gives a second recurrent branch to divide and supply the middle & inferior lobes
  4. Lies anterior to descending aorta
  5. Lies posterior to ascending aorta, SVC, upper right pulmonary vein
  6. Lies anterior to bifurcation of aorta and right main bronchus

A. Right pulmonary artery
B. Left pulmonary artery

A
  1. B
  2. A
  3. A
  4. B
  5. A
  6. A
21
Q

This vein pierces the central tendon opposite 8th thoracic vertebra (caval opening) and enters the lowest part of the right atrium. It receives blood from the body below the level of the diaphragm (LE, abdomen).

A

Inferior vena cava

22
Q

Determine the corresponding descriptions of the branches of the descending thoracic aorta

  1. Supply the upper part of the esophagus
  2. Run along lower border of the 12th rib to enter abdominal wall
  3. Supply the lungs, pleura, mediastinum
  4. Supply the lower 9 intercostal spaces

A. Posterior intercostal arteries
B. Subcostal artery
C. Pericardial branch
D. Esophageal branch
E. Bronchial arteries
F. Mediastinal branch

A
  1. D
  2. B
  3. E
  4. A
23
Q

A bypass is done by harvesting a segment of blood vessel and using that to circumvent a blockage in a coronary artery. What 2 blood vessels are the usual options used to make the bypass?

A
  1. Great saphenous vein
    OR
  2. Internal thoracic artery
24
Q

A method for treating coronary artery disease where an instrument like a balloon is placed to open / dilate the coronary artery

A

Angioplasty

25
Q

TRUE OR FALSE: Abdominal conditions in the wall or viscera, such as when the esophagus or stomach is involved, can cause chest pain.

A

True

26
Q

General degeneration and fibrosis of the myocardium that gradual cause narrowing of the coronary arteries (blockage). There is plaque formation (caused by fat) around the wall of the coronary arteries, causing coronary artery disease.

A

Atherosclerosis

27
Q

TRUE OR FALSE: The brachiocephalic and azygos veins and the superior vena cava receive blood drainage from the head, neck, upper limbs and thorax.

A

True

28
Q

The superior vena cava conveys all venous blood from head and neck and both UE. It passes down to end at the R atrium of the heart. What veins join to form the superior vena cava?

A

2 brachiocephalic veins

29
Q

The azygos vein joins the ___ part of the superior vena cava

A

posterior

30
Q

The right and left brachiocephalic vein form at the root of the neck on each side from the union of what 2 veins?

A

Subclavian and internal jugular veins

Additional:
Head, neck = received by internal jugular
UE = received by subclavian

31
Q

On each side, 2 pulmonary veins (a superior pulmonary vein and inferior pulmonary vein) carry ___ blood from lungs back to the left atrium of heart, beginning from the hilum and passing the root of lung to drain to the left atrium.

A

oxygenated

32
Q

Determine the corresponding descriptions of the thoracic lymphatics

  1. Posterior thoracic wall drains into the
  2. Mediastinum drains into the
  3. Receives the right jugular, right subclavian, and right bronchomediastinal trunks which drain from the right side of head and neck, right upper limb, and right side of thorax
  4. Anterior thoracic wall drains into the
  5. Intercostal spaces drains into the

A. Anterior axillary nodes
B. Internal thoracic nodes
C. Posterior axillary nodes
D. Bronchomediastinal trunk and thoracic duct
E. Right lymphatic duct

A
  1. C
  2. D
  3. E
  4. A
  5. B
33
Q

Part of the thoracic lymphatics that starts below the abdomen at the cisterna chyli and ascends and enters the thorax via the aortic opening. It receives the left jugular, left subclavian, and left bronchomediastinal lymph trunks.

A

Thoracic duct (Main)

34
Q

Most inferior part of the thoracic duct; its abdominal origin

A

cisterna chyli

35
Q

Determine the corresponding descriptions of the azygos veins

  1. Formed from the union of right ascending lumbar vein and right subcostal vein, ascends the aortic opening to the right of aorta at T5
  2. Joins the azygos at T7
  3. Seen in the right side so it receives blood from the right side of the thoracic wall
  4. Joins the azygos at T8
  5. From the union of left ascending lumbar vein and left subcostal vein, enters left crus of diaphragm

A. Main azygos vein
B. Superior hemiazygos / Accessory hemiazygos
C. Inferior hemiazygos

A
  1. A
  2. B
  3. A
  4. C
  5. C
36
Q

The azygos veins join the ___ before entering the pericardium.

A

superior vena cava (posterior aspect)

37
Q

The phrenic nerve receives sensation from the peritoneum covering the (1)__ part of diaphragm, pleura pericardium, and (2)__ pleura.

A
  1. central
  2. mediastinal parietal
38
Q

What are the 2 major nerves supplying the thoracic cavity?

A
  1. vagus nerve
  2. phrenic nerve
39
Q

TRUE OR FALSE: With less alveolar walls, there is lesser gas exchange in the alveoli.

A

True

In smokers, their alveoli is a single wall because the numerous walls were destroyed. Lungs are unable to recoil adequately causing incomplete expiration.

40
Q

Emphysema and pulmonary fibrosis causes loss of ___ of the lungs

A

elasticity

41
Q

Inflammation or swelling of the lining of the tracheobronchial tree (respiratory tract) that results in increased mucus production causing hoarseness, cough, and fever.

A

Bronchitis

42
Q

TRUE OR FALSE: Acute bronchitis is most often caused by cigarettes, inhaling dust or chemicals. Chronic bronchitis is usually the result of an infection in the respiratory tract, caused by a cold or flu virus, or, less often, bacteria.

A

False; interchange the causes to make the statements true

43
Q

TRUE OR FALSE: Both 1st and 2nd hand smokers can develop bronchitis, but it is more common and severe on the 1st.

A

True

44
Q

These are caused by airway hyperresponsiveness, the overreaction of the bronchi and bronchioles to various environmental and physiological stimuli.

A

Asthma attacks

Additional: Treatment for asthma is to give bronchodilators (medicines or nebulize), mucolytic, and steroids (to prevent inflammation).

45
Q

The irritation to the tracheobronchial tree when a person is hypersensitive to dust or pollen, causing an allergic reaction. This results in spasms of the smooth muscles in the bronchioles reducing the diameter of bronchioles during expiration (bronchoconstriction and inflammation).

A

Bronchial Asthma

46
Q

Bronchial Asthma causes a greater difficulty in expiring than inspiring, resulting in ___. The lungs become distended and the thoracic cage becomes permanently enlarged (barrel chest) and excess mucus is present.

A

wheezing

47
Q

The most common pain due to Bronchogenic Carcinoma is located where in the body?

A

In the spine

48
Q

A highly malignant primary lung tumor that is common in male and female and between the ages of 45 and 70. It spreads / metastasizes very fast via the blood and lymphatics.

A

Bronchogenic Carcinoma

This is very hard to treat because when the tumor is discovered, usually the tumor has already metastasized and is at the last stage of cancer.

(1) Organ Anatomy (11 decks)

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