SBO ORAL Flashcards
Introduce the heart
Location: Inferior medial mediastinal space, 2/3 to the left between ribs 3-5.
Structure: Pyramid in shape with 2 valve system that receives poorly oxygenated blood to pump to the lungs and pump out oxygenated blood to supply the body.
A heart is made of 3 main layers Pericardium, Myocardium, endocardium.
Function: Propell blood around the body
What are the surfaces of the heart
4 surfaces: Sternocostal (rt ventricle), Diaphramatic (Lt- Rt ventricle) Rt Pulmonary (rt Atrium) Lt Pulmonary (lt ventricle)
What are the borders of the heart
4 Borders Superior (rt-lt auricle) Inferior (Rt - Lt ventricle) Right (Rt atrium) Left (Lt ventricle and auricle)
What is the arterial supply to the heart?
2 coronary arteries that originate from the right and left coronary sinus in the ascending aorta.
The Left coronary artery branches mainly into the circumflex artery and the anterior interventricular artery. Supplies Lt atrium and most of the lt ventricle and part of the rt ventricle. In 40%of people the SA node.
The right coronary artery exits on the right coronary sinus and moves posteriorly and branches into the rt marginal branch, and then the posterior interventricular branch. Supplies Rt atrium and most of the Rt ventricle and some of the Lt ventricle. In 60%of people the SA node.
Wat is the venous supply to the heart?
Coronary sinus runs lt to Rt in the posterior aspect of the heart where it enters the right atrium. On the anterior aspect, we have the great cardiac vein (ant. interventricular) that ascend to the coronary sulcus and accompanies circumflex artery posterior to become the coronary sinus.
The posterior aspect has the middle cardiac vein (post. interventricular) and the small cardiac vein (Rt border) accompanies the marginal artery.
What are the structures of the heart
Pericardium Atrium ventricle Valves Vena cava Pulmonary Artery + vein Aorta Ascending, arch, descending Pulmonary trunk Papillary muscles Chordae tendinae
What are the layers of the heart
Pericardium
- Fibrous
- Serous
- Parietal
- Visceral
Myocardium
EndocardiumIntroduce the Mediastinum
Location: central compartment of the thoracic cavity found between the lungs.
Structure: Includes all thoracic viscera except for the lungs. Divided into 2 main compartments sup/ inf divided by the angle of Loui, and inf divide x3
Function: Anatomical space that holds the heart and great vessels, a mobile area that allows for air passage and accommodates volume movement and pressure changes.
What are the borders of the mediastinum
Superior: Thoracic inlet
Inferiorly: diaphragm
Anteriorly Sternocostal
Posteriorly Thoracic vertebrae
What are the structures of the mediastinum?
Superior:
- Trachea and bifurcation
Inferior:
- *Thymus
- **Heart and great vessels
- lung roots
- ***Oesophagus
- Lymph nodes
- Phrenic
- vagus N.
Introduce the breast?
Location: subcutaneous tissue anterior to the pecs and serratus anterior
Structure: Connective and adipose tissue
Function: Female reproduction organ
What are the structures of the breast?
Nipple Areola Areola glands Suspensory ligaments Lactiferous ducts gland lobules
Introduce the diaphragm?
Location: between the thorax and the abdomen.
Structure: 2 domes named demi diaphragm, and a central clover shape tendon. Made of skeletal muscle.
Function: Respiration, support lungs, separating the thoracic cavity from the abdominal area.
What are the borders of the diaphragm
Costal: the internal surface of inferior 6 costal cartilage and ribs.
Lumbar: All lumbar spine - crura
Sternal: xiphoid process
Insertion: central tendon
Nerve supply to the diaphragm?
Central: Phrenic Nerve C3, C4, C5
Pheripheral: Inferior 6 intercostal and subcostal.
What are the 3 hiatus of the Diaphragm?
Caval foramen: inferior vena cava, phrenic nerve, lymph, T8
Oesophageal hiatus: T10, oesophagus and Vagus N.
aortic hiatus: descending aorta, azygous Nerves, Thoracic duct T12
What are the 5 intercostal muscles origin and insertions?
External intercostal: Rib tubercle to costocondral junction, depress rib
Internal intercostal : Sternum to rib angle, elevate rib
***Intercostal space: neurvascular bundle
Innermost intercostal: As above
Subcostal: from one rib margin 1-3 to superior rib margin.
Transverse thoracis: sternum to costal cartillage tranverse
Introduce Serratus posterior superior, origin, attachment, nerve supply?
O: Nuchal lig. SP C7-T3 - runs inferolateralI
I: Sup. border R2-R4
Action: elevate upper ribs
Intercostal N. 2-5
Introduce Serratus posterior inferior, origin, attachment, nerve supply?
O: L2- T11 SP
I: Inferior border R8-R12
A: depress inferior ribs
N: ventral Rami spinal N. T9-T12
Introduce levator costorum, origin, attachment, nerve supply?
O: TP C11 to T11
I: Rib tubercle + angle
A: Elevate the rib below during inspiration
N: Dorsal Rami C8 - T11 Spinal N.
Introduce the trachea and bronchi
Location: From larynx to the thorax, bifurcates into primary bronchus at the sternal angle.
Structure: Hyaline cartilaginous tube in c shaped rings. inside lining of smooth mm. trachialis. Divides at carina on transverse plane o T6. Nerve supply, CNX vagus.
Function: Passageway for air to reach the lungs.
What are the relations to the trachea?
Lateral: common carotid arteries and thyroid lobes
Right: Brachiocephalic trunk
Anterior: Isthmus of the thyroid gland 2/3 tracheal rings, thyroid veins
posterior: oesophagus
What is the structure of the bronchial tree?
2 primary broncus 5 secondary lobular bronchus 10 tertiary segmental broncus 20- 25 terminal bronchus respiratory bronchus aveolar ducts aveolar sacs
Introduce the lung
Location: Thoracic cavity
structure: 2 lungs, rt larger than Lt, both lungs have a pleura surrounding them, and are divided by fissures into lobes.
Function: Organ of respiration, gas exchange for blood.
What are the surfaces and borders of the lung?
3 surfaces
Costal surface
Mediastinum surface
diaphramatic surface
3 Borders
Anterior
inferior
posterior
What are the structures in the lungs?
Apex Lobes Fissures Hilum Root Cardiac impresion cardiac notch groove impresion groove aorta impresion
What is secondary cancer, ways of metastasis, a location of metastasis
A malignant tumour spread from a different body part.
Metastasis is the spread of cancer to other locations like the breast, liver, spine, bowels, through blood lymph or direct contact.
What is lung carcinoma, what types of cells are there, causes, signs, symptoms
malignant tissue made out of squamous epithelial cells.
caused by smoking, exposure to asbestos and family Hx.
Signs: Absent or dull sounds in percussion.
Symptoms: Obstructive, compressive, infection
What is pneumonia, causes, S&S?
Infection of the lung, where lung tissue is consolidated, there filling of alveoli with inflammatory cells.
Caused by straptococus, staphylococcus aerus, legionella, viral pneumonia.
Signs, chest auscultation absent or decreased sound.
Symptoms: “Nemo the gnome” Fever, headache, tachycardia, haemoptysis pain tachypnea.
What is emphysema, causes, pathology, S&S?
Airspace distal to the terminal bronchioles of the lung. caused by smoking or congenital disease.
Pathophys: the destruction of elastin in the alveolar wall leads to the production of elastase, the lung is inhibited and can’t fight the effect of elastase.
Signs: Hyperresonance in percussion, diminished breath sound
Symptoms: “pink panther” Thin, Barrel chest, wheezing, dyspnea.
What is AMI, causes, compare to angina, risks after AMI?
Acute myocardial infarction is necrosis of cardiac muscle due to lack of blood and oxygen. It is caused by plaques rupture or ulceration. underline condition for CHD. Angina is just chronic chest pain. can lead to heart failure, mitral regurgitation, AV node dysfunction.
