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thorax Flashcards

1
Q

how many pairs of ribs are there?

A

12

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2
Q

what are the two types of ribs:

A

typical
atypical

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3
Q

structure of the typical rib (3)

A

head
neck
shaft

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4
Q

where does the the typical rib head articulate:

A
  • into corresponding vertebrae and one above
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5
Q

what does the neck of a typical rib contain and why?

A
  • a roughed tubercle
  • for articulation with vertebrae
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6
Q

what does the internal side of the atypical rib shaft contain?

A
  • neurovasulcar supply
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7
Q

what are the atypical ribs of the body? (5)

A

1
2
10
11
12

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8
Q

what is difference about rib 1: (2)

A
  • is shorter and wider
  • contains only one facet on head (as no need for 2 as doesnt attach to vertebrae above)
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9
Q

what is different about rib 2? (3)

A
  • thinner and shorter
  • single facet for articulation
  • contains tuberosity for serratus anterior
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10
Q

what is different about rib 10? (1)

A
  • contains only one facet
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11
Q

the atypical rib 11 and 12 structure: (2)

A
  • no neck
  • only one facet
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12
Q

what are considered the floating ribs of the body?

A

11 & 12

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13
Q

what are considered the false ribs of the body (3)and why?

A
  • ribs 8, 9 & 10
  • they dont contain a direct attachment to the sternum
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14
Q

the 4 parts of the vertebrae and their main function, from superior to inferior

A
  • Cervical - responsible for supporting head’s movement and weight
  • thoracic - provides structural support to ribcage
  • lumbar - bearing bodys weight
  • sacral - sturdy attachment for lower body
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15
Q

what are the 5 parts of the vertebrae?

A

body
foramen
spinous process
transverse process
pedicle

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16
Q

the osteology differences of the pelvic region which can determine sex (7)

A
  • pelvic brim
  • subpubic angle
  • greater sciatic notch
  • sacrum shape
  • pubic arch
  • obturator foramen
  • acetabulum
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17
Q

the 4 quadrants of the abdomen:

A
  • right upper quadrant
  • left upper quadrant
  • left lower quadrant
  • right lower quadrant
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18
Q

what are the 2 planes splitting up the 4 quadrants of the abdoment?

A

median plane
transumbilical plane

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19
Q

the 9 regions of the abdomen, from left superior side to right, layer by layer

A
  • left hypochondriac region
  • epigastric region
  • right hypochondriac region
  • left lumbar region
  • umbilical region
  • right lumbar region
  • left inguinal region
  • pubic region
  • right inguinal region
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20
Q

the 4 planes separating the 9 regions of the stomach

A
  • 2 midclavicular planes
  • subcostal plane
  • transtubercular plan
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21
Q

what is the anterolateral abdominal wall? (3)

A
  • the front and sider region of the abdominal cavity
  • provides support and protection to abdominal organs
  • also allows for movement and flexibilty
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22
Q

what is campus fascia also known as?

A

superficial fascia

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23
Q

what is the arcuate line? (2)

A
  • an imaginary line where the inferior epigastric vessels disappears into rectus abdominal sheath
  • respresents a change in the structure of the rectus sheath
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24
Q

the abdominal muscles from superficial to deep (4)

A
  • external oblique muscle
  • internal oblique muscle
  • transversus abdominis
  • posterior rectus sheath
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25
Q

rib origin and insertion (general)

A

origin = vertebrae
insertion = sternum

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26
Q

what do ribs joining to the sternum form, and why?

A

cartilage
allows for expansion of thorax during respiration

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27
Q

what are he 3 parts of the sternum:

A
  1. manubrium
  2. body
  3. xiphoid process
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28
Q

what is the angle of louis? (2)

A
  • a point between the manubrium and body of sternum
  • is an important anatomical landmark
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29
Q

rib 1-6 attachment:

A
  • 1 = manubrium
  • 2 = sternal angle
  • 3-6 = body of sternum
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30
Q

what is the clavicular notch? (3)

A
  • a specific area on the medial end of the clavicle
  • smooth, concave and articular surface
  • attaches to the sternum
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31
Q

what is the sternoclavicular joint?

A
  • joint formed between articulation of clavicular notch and sternum
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32
Q

what important structures can be found along the sternal angle when cut horizontally: (4)

A
  • T4-T5 joint
  • aortic arch
  • azygous vein entering heart
  • bifurcation of trachea
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33
Q

what are the false ribs?

A
  • ribs 8-10
  • attach to sternum by joining cartilages from ribs 6 and 7
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34
Q

important landmarks to remember in thorax: (3)

A
  • mid clavicular line
  • mid scapula line
  • mid axillary line
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35
Q

margin of the lung and pleura in the midclavicular landmark

A
  • lung margin - 6th rib
  • margin of pleura - 8th rib
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36
Q

margin of the lung and pleura of the mid axillary line:

A

lung margin - 8th rib
pleura margin - 10th rib

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37
Q

margin of the lung and pleura of the midscapular line:

A

lung margin - 10th rib
pleura margin - 12th rib

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38
Q

what is the pleura? (1)

A
  • a membrane that covers the lungs
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39
Q

the two parts of the pleura:

A
  • visceral - inner layer
  • parietal layer - outer layer
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40
Q

how the landmarks differ from left lung to right lung, and why

A

midclavicular line:
* right lung - 6th rib
* left lung - 4th rib
differs because of where heart is situated

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41
Q

how does a collapsed lung occur? (2)

A
  • puncture of the parietal pleura due to physical injury
  • lung and pleura is damaged due to COPD
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42
Q

what happens in a collapsed lung? (3)

A
  • air fills the pleural cavity
  • results in compression of lung
  • forces lung to deflate
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43
Q

what is the pleural cavity?

A
  • a cavity of fluid between the visceral and parietal pleura
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44
Q

how many intercostal muscle groups are there, and what are their names?

A

3:
* external intercostal muscle
* internal intercostal muscle
* innermost intercostal muscle

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45
Q

what do the external intercostal muscles do?

A

elevates ribs during forced inspiration

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46
Q

what do the internal intercostal muscles do?

A

pull ribs down and inward during forced expiration (coughing)

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47
Q

what do the innermost intercostal muscles do? (2)

A
  • pull ribs downward and inward during forced expiration
  • provide structural support
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48
Q

how to tell the difference between internal and innermost intercostal muscle fibres, as they both direct the same way (2)

A
  • relative postion to the intercostal neurovascular bundle
  • internal muscles lie superficial to it
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49
Q

what is the hilum of the lung? (2)

A
  • a triangular depression on the medial surface of each lung
  • various important structures enter and eit the lung here
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50
Q

what are the important structures that enter and exit the lung at the hilum? (6)

A
  • bronchi
  • pulmonary arteries
  • pulmonary veins
  • bronchial arteries and veins
  • lymphatic vessels
  • nerves
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51
Q

what is the mediastinum? (3)

A
  • a central compartment within the thoracic cavity
    • Responsible for housing and protecting vital organs
  • facilitates communication and transport of blood, air and food between these regions
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52
Q

what are the 2 main parts of the mediastinum

A

superior mediastinum
inferior mediastinum

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53
Q

what direction does the muscle fibres of the external oblique muscles run? (2)

A

downward and medial

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54
Q

what direction does the internal oblique muscles run? (2)

A

upward and medially

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55
Q

what direction do the fibres of the transversus abdominis muscle run?

A

horiontally (transverse)

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56
Q

location of the superior mediastinum (1)

A

above level of pericardium

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57
Q

what is the pericardium? (1)

A

the sac surrounding the heart

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58
Q

what does the superior mediastinum contain? (4)

A
  • aortic arch
  • brachiocephalic veins
  • trachea
  • oesophagus
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59
Q

what are the 3 parts of the inferior mediastinum?

A
  • anterior
  • middle
  • posterior
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60
Q

what does the anterior mediastinum contain? (3)

A
  • fat
  • lymph nodes
  • connective tissue
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61
Q

what does the middle mediastinum contain? (4)

A
  • heart
  • pericardium
  • aorta
  • pulmonary vessels
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62
Q

what does the posterior mediastinum contain? (6)

A
  • oesophagus
  • thoracic aorta
  • thoracic duct
  • lymph nodes
  • azygos vein
  • hemiazygos vein
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63
Q

the boarders of the mediastinum? (5)

A

lateral - medial aspect of pleural cavitys
superior - thoracic inlet
inferior - diaphragm
posterior - thoracic vertebrae column
anterior - sternum

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64
Q

where does the aorta emerge from?

A

the left ventricle of the heart

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65
Q

branches of the ascending aorta:

A
  • coronary arteries
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66
Q

what sits right of the ascending aorta?

A

the vena cava

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67
Q

what connects the pulmonary arteries to the aortic arch?

A

the ligamentum arteriosum

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68
Q

what is located beneath the aortic arch? (3)

A
  • the pulmonary trunk (divides into pulmonary arteries)
  • the left main bronchus
  • left pulmonary veins
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69
Q

the 3 major arteries that arise from the aortic arch:

A
  1. brachiocephalic trunk
  2. left common carotid artery
  3. left subclavian artery
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70
Q

what does the brachiocephalic trunk divide and form? (2)

A
  • the right subclavian artery
  • the right common carotid artery
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71
Q

what does the right common carotid artery supply?

A

right side of head and neck

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72
Q

what are the 3 main branches of the subclavian artery?

A
  • the thyrocervical
  • the vertebral
  • the internal thoracic
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73
Q

what is the passage of the left subclaian artery? (2)

A
  • arches over upper rib
  • passes behind anterior scalene muscle
74
Q

what branches does the descending aorta give off?

A
  • posterior intercostal arteries
75
Q

what intercostal spaces does the posterior intercostal arteries not supply?

A

the first 2

76
Q

the internal thoracic artery: its path, what it supplies, and its distal continuation name:

A
  • runs down inside of posterior chest wall
  • supplies anterior chest wall with blood
  • distal continuation is the superior epigastric artery
77
Q

what does the superior epigastric artery supply?

A

the anterior abdominal wall

78
Q

what are the principle veins of the thorax? (6)

A
  • superior vena cava
  • inferior vena cava
  • Brachiocephalic veins
  • azygous veins
  • hemiazygous vein and accessory hemiazygous veins
  • internal thoracic veins
79
Q

what are the major veins which contribute to the superior vena cava? (2)

A

subclavian vein
internal jugular vein

80
Q

what part of the body is the subclavian vein the principle vein for?

A

the upper extremity (upper liimbs)

81
Q

what is the internal jugular vein the principle vein for?

A
  • the head and neck
82
Q

the name of the vein

what does the anastamoses of the subclavian and internal jugular vein form?

A

the brachiocephalic vein

83
Q

where do the subclavian vein and the internal jugular vein connect?

A

behind the medial end of the clavicle

84
Q

what to veins form the superior vena cava?

A

the 2 brachiocephalic veins (from either side of body)

85
Q

what separates the subclavian vein and artery?

A

the anterior scalene muscle

86
Q

what does the azygous vein drain into?

A

the superior vena cava

87
Q

path of the azygous vein: (3)

A
  • runs up right side of vertebral column
  • arches over right main bronchus
  • drains into superior vena cava
88
Q

where does the azygous vein receive blood from?

A
  • posterior and lateral parts of chest wall
89
Q

what are the tributaries of the azygous vein, and what they specifically drain: (3)

A
  • hemiazygous vein - drains lower left side of thoracic wall
  • accessory hemiazygous vein - drains middle left side of thoracic wall
  • right posterior intercostal veins - right side of thoracic wall
90
Q

why is the left and right side drainage into the azygous vein different?

A
  • on the left side, posterior intercostal veins empty into hemiazygous veins before draining into the azygous vein
91
Q

what is large, inferior or superior vena cava?

A

inferior vena cava

92
Q

the main 4 nerves of the thorax:

A
  • vagus nerve
  • phrenic nerve
  • sympathetic trunk
  • intercostal nerves
93
Q

vagus nerve supply (2)

A
  • parasympathetic supply to all organs of thorax and abdomen
94
Q

phrenic nerve supply: (2)

A
  • motor and sensory nerves of the diaphragm
95
Q

the main nerves of the sympathetic trunk: (2)

A
  • rami communicantes
  • splanchnic nerves
96
Q

path of the sympathetic trunk: (2)

A
  • runs down vertebral column
  • from T1 down to sacrum
97
Q

what do the rami communicantees do? (1)

A
  • connect the sympathetic trunk and anterior rami of the spinal nerves
98
Q

what do the splanchnic nerves do? (2)

A
  • innervate the internal organs
  • conveys autonomic and sensory innervation
99
Q

what do the intercostal nerves do? (2)

A
  • motor innervation - intercostal muscles
  • sensory innervation - chest wall
100
Q

what do the intercostal nerves run closely with?

A
  • the intercostal blood vessels
101
Q

similarites of the vagus and phrenic nerve route: (3)

A
  • starts in neck
  • runs downwards in medistinum
  • runs through diaphragm
102
Q

how to tell difference between phrenic nerve and vagus nerve path:

A
  • phrenic nerve is slightly more lateral
103
Q

what is tension pneumothorax? (2)

A
  • a condition where air enters the pleural space and cannot escape due to external physical injury
  • can cause collapsed lung
104
Q

how can tension pneumothorax be treated?

A

decompression needles

105
Q

pneumonic to remember the contents of the superior mediastinum

A

BATS & TENT

106
Q

BATS & TENT pneumonic:

A

Brachiocephalic veins
Arch of aorta branches
Thymus
Superior vena cava
Thoracic duct
Oeseophagus
Nerves (vagus, phrenic, recurrent laryngeal)
Trachea

107
Q

where the tricuspid, pulmonary valve, aortic valve, and mitral valve are located:

A

tricuspid - right atrium to right ventricle
pulmonary valve - right ventricle to pulmonary artery
aortic valve - left ventricle to aorta
mitral valge - left atrium to left ventricle

108
Q

what are the 4 valves of the heart?

A
  • tricuspid valve
  • pulmonary valve
  • aortic valve
  • mitral valve
109
Q

how many pulmonary veins enter the left atrium, and from where?

A

4
* 2 from left lung
* 2 from right lung

110
Q

what does the right coronary artery divide into?

A
  • the posterior descending artery
  • acute marginal artery
111
Q

where does the right coronary artery arise from?

A
  • the right aortic sinus
112
Q

what does the right coronary artery supply? (4)

A
  • right atrium
  • right ventricle
  • sinoatrial node
  • atrioventricular node
113
Q

what does the left coronary artery divide into?

A
  • left anterior descending coronary artery
  • circumflex coronary artery
114
Q

where does the left coronary artery arise?

A

left aortic sinus

115
Q

what does the left coronary artery supply?

A
  • left atrium
  • left ventricle
116
Q

what usually surrounds and hides the coronary arteries?

A
  • epicardial fat
117
Q

what are the coronary veins (6)

A
  • coronary sinus
  • small cardiac vein
  • middle cardiac vein
  • posterior vein
  • great cardiac vein
  • anterior vein
118
Q

what is the only coronary vein that does not drain into the coronary sinus, and where does it drain instead?

A

anterior vein
drains dirrecly into right atirum

119
Q

the coronary sinus, location, job, and size:

A
  • left side of heart
  • brings deoxygenated blood from heart muscle cells to right atrium
  • largest coronary vein
120
Q

the small cardiac vein: location, where it drains, where it brings blood from

A
  • right side of the heart
  • joins to coronary sinus
  • brings deoxygenated blood from right atrium
121
Q

middle cardiac vein: location, where it brings blood from

A
  • most medial vein of heart
  • brings deoxygenated bood from right ventricle
122
Q

posterior vein: location and where it brings blood from?

A
  • left side
  • brings deoxygenated blood from left ventricle
123
Q

great cardiac vein: location and where it brings blood from:

A
  • left side
  • deoxygenated blood from left atrium
124
Q

what are the 3 veins seen on the front of the heart

A
  • small cardiac vein
  • anterior vein
  • great cardiac vein
125
Q

what are the right and left atrium connected by?

A

the interatrial septum

126
Q

what are the right and left ventricle seperated by?

A

the interventricular septum

127
Q

what are trabeculae carnae? (4)

A
  • intersecting bands of muscle found in the heart
  • primarily the ventricles
  • help prevent suction and aid in pumping action
  • form dense criss-cross pattern over most of ventricular wall
128
Q

how many cusps does the tricuspid valve have, and what are they called?

A

3
* septal
* anterior
* posterior

129
Q

what are chordae tendinae? (3)

A
  • tendon like material attached to the edge of valve cusps in the heart
  • arise from papillary muscles from the ventricle wall
  • prevent cusps from prolapsing back into atrium during dystole
130
Q

what is the infundibulum? (3)

A
  • the tapering part of the right ventricle
  • leads to the pulmonary valve
  • has a smooth lining unlike rest of right ventricle
131
Q

what is the infundibulum also known as?

132
Q

what is cardiomegaly?

A

an abnormal enlargment of the heart

133
Q

how cardiomegaly is diagnosed? (2)

A
  • through X-ray
  • the hearts shadow is large than half of the thoracic shadow
134
Q

the wall thickness of the ventricles comparison:

A
  • left ventricle wall is much thicker
135
Q

what are the two cusps of the mitral valve:

A
  • anterior cusp
  • posterior cusp
136
Q

what is the pericardial sac surrounding the heart attached to for stability? (4)

A
  • anterior part - sternum by mediastinal fat
  • posterior - mediastinal strucutres by connective tissue
  • inferior - diaphragm
  • laterally - parietal pleura
137
Q

thorcic level of the heart in the mediastinum:

138
Q

location of the heart in the mediastinum relative to ribs:

A
  • between 2nd and 6th ribs
139
Q

location of the apex (base) of the heart: (2)

A
  • 5th intercostal space
  • in left mid-clavicular line
140
Q

what are auscultatory sites? (3)

A
  • specific locations on the chest wall
  • where healthcare professionals listen with a stethoscope
  • to asscess sounds produced by the heart
141
Q

what are the auscultatory sites of the heart: (4)

A
  • aortic valve - right second intercostal space
  • pulmonary valve - left second intercostal space
  • tricuspid valve - left 4th, 5th intercostal spaces
  • mitral valve - apex beat, just below left nipple
142
Q

what are the two layers of the pericardium of the heart:

A
  • fibrous pericardium
  • serous pericardium
143
Q

the fibrous pericardium: (4)

A
  • outermost layer
  • tough
  • loose-fitting
  • inelastic
144
Q

serous pericardium: (3)

A
  • smooth
  • thin
  • double layered
145
Q

what are the two layers of the serous pericardium, and their location:

A
  • parietal - lines inside of fibrous pericardium (outer layer)
  • visceral- adheres to outside of heart (inner layer)
146
Q

what is the space between the parietal and visceral layer of the serous pericardium called?

A

the pericardial space

147
Q

the openings of the right atrium (4)

A
  • the superior vena cava
  • the inferior vena cava
  • coronary sinus
  • impression for fossal ovalis
148
Q

features of the wall of the right atrium: (2)

A
  • pectinate muscles - thought to contribute to contraction
  • crista terminalis - serves as landmark for various structures in atrium, separating the posterior part of the right atrium
149
Q

the classifications of valves: (2)

A
  • semi-lunar valves = between ventricle and vesel leaving the heart
  • atrioventricular valves - between atrium and ventricle
150
Q

what is the fossa ovalis? (2)

A
  • a depression in the interatrial septum
  • formed by the closing of the foreamen ovale
151
Q

what are the functions of chordae tendineae, papillary muscles, and trabeculae carneae?

A
  • chordae tendineae - stablises the valves
  • papillary muscles - pull valves open
  • trabceulae carneae - preevnt suction & facilitate contraction
152
Q

what is the thoracic duct?

A
  • a large important lymphatic channel
153
Q

boundaries of the posterior mediastinum: (5)

A
  • superior - sternal angle
  • inferior - diaphragm
  • anterior - pericardium
  • posterior - T5-T12 vertebrae
  • lateral - medial aspect of parietal pleural
154
Q

what is the primary role of the lymphatic system? (3)

A
  • absorbs extra fluid thats squeezed out of capillaries
  • which is not absorbed by venules
  • drains it back into circulatory system
155
Q

what vessels does the lympathetic system drain the fluid back into the circulatory system? (2)

A
  • internal jugular vein
  • subclavian vein
156
Q

what ducts drain the lymphatic fluid into the circulatory system? (2)

A
  • thoracic duct
  • right lymphatic duct
157
Q

what is the innervation of the recurrent laryngeal nerve? (2)

A
  • motor - all intrinsic muscles of larynx (except 1)
  • sensory innervation - mucosa of larynx below vocal cords
158
Q

approx how much blood does the lympathetic system recover per day?

A

3 litres of blood

159
Q

the main parts of the lymphatic system: (5)

A
  • lymph
  • lymph nodes
  • mucosa-associated lymphoid tissues (MALTS)
  • lymphatic vessels
  • lymphoid organs
160
Q

what is lymph? (1)

A
  • the watery fluid that flows through the lymphatic system
161
Q

what are lymph nodes, and what do they contain a large amount of?

A
  • ‘checkpoints’ that monitor and cleanse lymph as it filters through
  • contains large amounts of lymphocytes
162
Q

how many lymph nodes are there in the body?

163
Q

where are lymphocytes matured and found?

A
  • in loose reticular connective tissue (makes up large part of nodes)
164
Q

says it in the name!

what are MALTs?

A
  • lymphoid tissues found outside of lymphaetic vessels in mucus membrane
165
Q

what are 3 examples of MALTs?

A
  1. tonsils
  2. peyer’s patches
  3. appendix MALT
166
Q

what are the 2 lymphatic ducts?

A
  • right lymphatic duct
  • thoracic duct
167
Q

where does the right lymphatic duct collect lymph from (3), and where it drains into

A
  • upper right torso, right arm and right side of head
  • drains into right internal jugular vein
168
Q

where does the thoracic duct collect lymph from, and where it drains into?

A
  • rest of body!
  • feeds into left subclavian vein
169
Q

which of the lymphatic ducts are large?

A

the thoracic duct

170
Q

what are considered the lymphoid organs? (4)

A
  • spleen
  • thymus
  • adenoids
  • tonsils
171
Q

what is the diaphragm made up of? (2)

A
  • a thin continuous sheet of muscle
  • fibres of muscle convege to insert on a flat tendon (the central diaphragm tendon)
172
Q

where is the line of attachment of the diaphragm? (3)

A
  • bottom of sternum
  • trevels along the inside of the costal arch
  • travels to the tip of the 12th rib
173
Q

what are the three important structures that pass through the diaphragm?

A
  1. oesophagus
  2. inferior vena cava
  3. descending aorta
174
Q

what are the holes of the diaphragm called? (3)

A
  • the vena caval foramen
  • oseophageal hiatus
  • aortic opening
175
Q

what is the thickening of the diaphragm on the opening of the oesophageal hiatus and aortic opening?

A

the Crus (pleural for crura)

176
Q

the two crura: path and what it forms

A
  • arches over the aortic opening
  • forms the median arcuate ligament
  • fibres cross over to surround oesophageal hiatus
177
Q

what does the opening of the caval hiatus contain? (2)

A
  • inferior vena cava
  • terminal branches of right phrenic nerve
178
Q

what does the oesophageal hiatus contain? (3)

A
  • oesophagus
  • right and left vagus nerves
  • oesophageal branches of the left gastric vessels
179
Q

what does the aortic hiatus contain? (3)

A
  • aorta
  • thoracic duct
  • azygous vein
180
Q

how would you get a paralysed diaphragm?

A
  • injury to the phrenic nerve
181
Q

lobes and fissures of the right and left lung:

A

right:
* 3 lobes: superior, middle, inferior
* 2 fissues: horizontal, oblique

left:
* 2 lobes: superior and inferior,
* 1 fissure - oblique

182
Q

what are pleural recesses? (2)

A
  • potential spaces within the pleural cavity where the parietal pleura folds back in on itself
  • allows for lung expansion during inspiration

Anatomy (5 decks)

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