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Anatomy Outlines HB2 > Thorax - heart and lungs > Flashcards

Thorax - heart and lungs Flashcards

1
Q

true ribs

A

costal cartilages of the upper 7 rib pairs articulate with the sternum

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2
Q

false ribs

A

ribs 8, 9 and 10, attach to cartilage of 7th rib

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3
Q

floating ribs

A

11 and 12, do not connect with anything

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4
Q

flail chest

A

multiple rib fractures can create this, can impede respiration

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5
Q

typical rib

A

 Head, Neck, Tubercle, Body

 Articulates with transverse process and vertebral body of vertebrae – costovertebral joints

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6
Q

sternum

A

o Manubrium – top part of sternum, where 1st rib and clavicle articulate
 Sternal angle – between manubrium and body, where 2nd rib articulates
o Body – main part
o Xiphoid process – bottom, approximately around T9

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7
Q

thoracic apertures

A

o Superior thoracic aperture – 1st rib to manubrium

o Inferior thoracic aperture – costal cartilage of 7-10 ribs, diaphragm lines this

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8
Q

external intercostal muscles

A

forms V shape, “hands in pockets”, superolateral to inferomedial

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9
Q

internal intercostal muscles

A

forms mountain, expiration and proprioception

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10
Q

innermost intercostals

A

vessels run between innermost and internal

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11
Q

intercostal muscles are innervated by

A

intercostal nerves

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12
Q

chest tube

A

should be inserted superior to rib because inferior to rib the intercostal bundle (n. a. v.) are inferior to the rib

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13
Q

diaphragm

A 
moves up and down when you breathe
o	Caval opening – inferior vena cava at T8
o	Esophageal hiatus – esophagus at T10
o	Aortic hiatus – aorta at T12
o	Inspiration – contracts and flattens 
o	Expiration – relaxes and rises
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14
Q

intercostal nerves

A

(ventral rami of spinal nerves TI to T11)

o Lateral and anterior cutaneous branches

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15
Q

intercostal vessels

A

branches of aorta

o Lateral cutaneous branches

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16
Q

pleural cavity

A

true cavity in thorax

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17
Q

visceral pleura

A

autonomic innervation sensitive to stretch

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18
Q

parietal pleura

A 
have somatic innervation and very sensitive to pain
o	Four parts 
	Diaphragmatic – superior 
	Mediastinal – lines lung and heart
	Costal – lines internal ribs 
	Cervical (cupola)
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19
Q

costodiaphragmatic recess

A

right lung, inferior

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20
Q

costomediastinal recess

A

left lung, anterior near midline around where heart is

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21
Q

4 lung surfaces

A

o Costal – against ribs
o Diaphragmatic – base, against diaphragm
o Mediastinal – contains hilum
o Hilar – where main bronchus, pulmonary arteries and veins are

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22
Q

fissures of right lung

A

oblique and horizontal because 3 lobes

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23
Q

fissures of left lung

A

only oblique

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24
Q

carina of trachea

A

ridge of cartilage where trachea splits into 2 bronchi, at sternal angle

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25
Q

main primary bronchi

A

 Right main bronchus – bigger than left, higher chance of catching debris
 Left main bronchus

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26
Q

lobar secondary bronchi

A

 Right – superior, middle and inferior (3)
 Left – superior and inferior (2)
 Do not memorize bronchopulmonary segments

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27
Q

pulmonary arteries

A

carry deoxygenated blood from heart to lungs

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28
Q

pulmonary veins

A

carry oxygenated blood from lungs to heart

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29
Q

bronchial arteries

A

supply bronchi with blood from thoracic aorta

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30
Q

superior mediastinum

A

trachea and esophagus

o Sternal angle and intervertebral disc between T4 and T5, separates superior from inferior

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31
Q

inferior mediastinum

A

o Middle mediastinum – heart
o Anterior mediastinum – fat, lymph tissue, thymus
o Posterior mediastinum – inferior-most, aorta, esophagus

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32
Q

pericardial sac

A

holds heart, has fibrous and serous layers

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33
Q

fibrous pericardium

A

strong dense collagen material that blends with tunica externa

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34
Q

serous pericardium

A

lines inner surface of fibrous pericardium

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35
Q

parietal layer of pericardium

A

of serous, outer, has space between it and visceral layer

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36
Q

visceral layer of pericardium, epicardium

A

follows heart contours, at root it is continuous with pericardium, single layer of epithelium
• The aorta attaches the heart to the body; essentially only anchor
• Pericardial effusion – when it ruptures and heart bleeds into the pericardial cavity, the heart can’t fill and is dangerous

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37
Q

endocardium

A

layer of heart muscle most susceptible to ischemia

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38
Q

transverse pericardial sinus

A

space about heart and around aorta

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39
Q

oblique pericardial sinus

A

below the heart, in serous pericardium near vena cava

40
Q

musculophrenic artery

A

supplies pericardium

41
Q

right coronary artery

A

arises from aorta superior to right cusp of valve, along groove
 Sinoatrial nodal artery – passes between right atrium and superior vena cava to supply blood to SA node
 Marginal artery – supplies right ventricular wall
 Posterior interventricular artery (posterior descending artery, PDA) – supplies inferior wall, posterior intraventricular septum and papillary muscles

42
Q

Sinoatrial nodal artery

A

branch of RCA, passes between right atrium and superior vena cava to supply blood to SA node

43
Q

Marginal artery

A

branch of RCA, supplies right ventricular wall

44
Q

Posterior interventricular artery (posterior descending artery, PDA)

A

branch of RCA, supplies inferior wall, posterior intraventricular septum and papillary muscles

45
Q

left coronary artery

A

left cusp of aortic valve, shorter but supplies larger area
 Anterior interventricular artery – LAD, left ventricle, anterolateral myocardium, apex, anterior intraventricular septum and papillary muscles
 Circumflex artery -wraps left side to posterior and supplies left ventricle and left marginal branches

46
Q

anterior interventricular artery

A

branch of LCA, “LAD” left ventricle, anterolateral myocardium, apex, anterior intraventricular septum and papillary muscles
** MI most often occurs here **

47
Q

circumflex artery

A

wraps left side to posterior and supplies left ventricle and left marginal branches

48
Q

coronary sinus

A

largest draining of heart muscle, collects and returns to right atrium

49
Q

great cardiac vein

A

apex to IV groove, drains into coronary sinus

50
Q

middle cardiac vein

A

apex to post intraventricular sulcus, drains into coronary sinus

51
Q

small cardiac vein

A

acute margin of heart, runs with marginal artery
• Majority of coronary circulation is either right or left dominant, meaning where the posterior interventricular artery is coming from
o Most are right dominant (~70%)

drains into coronary sinus

52
Q

anterior cardiac veins

A

drain directly into right atrium – anterior portion of the right ventricle goes directly to right atrium not through a sinus

53
Q

right atrium

A

receives deoxygenated blood from systemic circulation
 Auricle
 Crista terminalis
 Fossa ovalis
 Ostium of the coronary sinus
 Ostium of the superior & inferior vena cava
 Right atrioventricular orifice

54
Q

right ventricle

A

receives blood from right atrium, crescent shape, smaller

55
Q

auricle

A

out pouch of tissue from fetal atrium on both atria

56
Q

crista terminalis

A

internal vertical ridge that separate smooth from rough

57
Q

ostium of coronary sinus

A

where coronary sinus enters flow

58
Q

right AV orifice

A

oval aperture for communication between right atrium and right ventricle

59
Q

trabeculae carneae

A

projective ridges of muscle in ventricle

60
Q

papillary muscle

A

attached to ventricle wall to stabilize valves

61
Q

septomarginal trabecula (moderator band)

A

ridge of heart muscle that conducts to AV node, present in 60% of hearts; only in right ventricle to differentiate

62
Q

chordae tendineae

A

attach the papillary muscles to valve, prevent prolapse during flow

63
Q

tricuspid valve

A

3 cusps, in right ventricle

64
Q

infundibulum or conus arteriosus

A

region before the pulmonary valve

65
Q

left atrium

A

gets oxygenated blood from pulmonary veins

66
Q

left ventricle

A

wall is much thicker than right ventricle

67
Q

mitral valve

A

2 cusps, bicuspid valve in left side

68
Q

parasympathetic innervation of heart

A

from medulla oblongata through the vagal nerves, decrease heart rate and force of contraction, dilate coronary arteries

69
Q

sympathetic innervation of heart

A

increase heart rate and force of contraction, constricts arteries

70
Q

visceral afferents and referred pain

A

visceral sensory send back to brain, sensitive to ischemia, leads to the pain of a MI or angina, could cross over with dermatomes in upper chest and left arm
• Referred pain to left neck and shoulder is from sympathetic T1-T5

71
Q

SA node

A

“pacemaker” for rhythm, sweeps down atrium, contract

~100 bpm

72
Q

AV node

A

above coronary sinus, receives from SA node, sends to Bundle of His
~40-60 bpm

73
Q

Bundle of His

A

– ensure ventricular contraction begins at apex and ends near valves
• Right bundle branch – in moderator area
• Left bundle branch
~20-40 bpm

74
Q

superior vena cava

A

receives blood from upper body and sends to heart

75
Q

inferior vena cava

A

receives blood from lower body and sends to heart

passes through the diaphragm at T8

76
Q

pulmonary veins

A

delivers blood from lungs to left atrium

77
Q

pulmonary arteries

A

takes deoxygenated blood to lungs

78
Q

aorta

A

takes oxygenated blood from heart to body

has ascending, descending, thoracic and abdominal areas

79
Q

ligamentum arteriosum

A

remnant of the fetal ductus arteriosus (between aortic arch and pulmonary artery)

80
Q

thoracic descending aorta

A

o Branches
 Posterior intercostal arteries – 3-11 supply intercostals
 A variable number of bronchial, esophageal, and tracheal arteries supply their respective structures; a pair of superior phrenic arteries to diaphragm

81
Q

azygos vein

A
  • receives the right posterior intercostal veins and converges with superior vena cava via the arch of the azygous
    on right side of body
82
Q

hemiazygos vein

A

receives left posterior intercostal veins and then joins with azygous vein; communicates with left renal vein , lower left

83
Q

accessory hemiazygos vein

A

receives left posterior intercostal veins and then joins with azygous vein; communicates with left renal vein , upper left

84
Q

thoracic duct

A

main lymph receiving channel, all body except right upper quadrant
o Enters venous system at junction of internal jugular and subclavian

85
Q

twelve thoracic ganglia

A

o White ramus communicans – myelinated

o Gray ramus communicans – unmyelinated

86
Q

splanchnic nerves

A

greater (T5-9), lesser (T10-11), least (T12) – preganglionic sympathetic fibers en route to the abdomen

87
Q

dermatomes

A

come off spinal segments, you can use dermatomes to see what nerves may be affected in spinal cord injury
o T4 -nipples
o T6 – xiphoid
o T10 – umbilicus

88
Q

thymus

A

produces t cells

89
Q

esophagus

A

posterior to trachea, leads to stomach, innervated by vagus

90
Q

branches of aorta

A

o brachiocephalic (right)
o left common carotid
o left subclavian arteries

91
Q

brachiocephalic veins

A

off superior vena cava, makes subclavian veins

92
Q

vagus nerves

A

contribute to cardiac, pulmonary and digestive function, cranial nerve X (10)
o Right vagus nerve splits to right recurrent laryngeal nerve – loop back up; goes around subclavian vein
o Left vagus nerve splits to left recurrent laryngeal nerve – goes down trachea; on left side to the aorta

93
Q

phrenic nerves

A

comes out of neck, anterior to root of lung down to diaphragm
o Derived from ventral rami of spinal nerves C3,4,5. (C345 - keep the diaphragm alive!)
o Innervate the skeletal muscle of the diaphragm
o Sensory to fibrous pericardium, parietal layer of the serous pericardium, mediastinal pleurae, and the inner portions of the diaphragmatic pleurae

94
Q

right vagus nerve

A

splits to right recurrent laryngeal nerve – loop back up; goes around subclavian vein

95
Q

left vagus nerve

A

splits to left recurrent laryngeal nerve – goes down trachea; on left side to the aorta

Anatomy Outlines HB2 (5 decks)

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