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Anatomy 1 > Thorax,Heart and Lungs > Flashcards

Thorax,Heart and Lungs Flashcards

1
Q

Explain inspiratory action and the muscles that control it

A 
Diaphragm contracts and descends.
Inspiratory muscles:
Sternocleidomastoid muscles and ext intercostals and scalenes expand ribs outward.
low pressure generated
High volume generated and air comes in.
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2
Q

Explain Exporatoty action

A

Elastic recoil of lungs and thoracic wall causes passive exhalation.

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3
Q

Exhalation is passive, for active exhalation what muscles may be involved

A

Abdominal muscles assist in active exhalation

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4
Q

What is FRC

A

the volume of air in the lungs at end passive exhalation; opposing elastic recoil forces of the lungs and chest wall in equilibrium

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5
Q

What’s the function of the thoracic wall

A

Protect the Thoracic and abdominal organs
Provides attachment for and Supports the weight of Upper limbs, Neck, ABd, Back and the muscles of respiration.
Resist the negative internal pressure generated by the elastic recoil of the lungs.
Maintain FRC

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6
Q

Thoracic apertures are divided into 2 namely

A
  1. Superior thoracic Aperture

2. In ferior Thoracic Aperture.

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7
Q

Name the function of the Superior Thoracic Aperture and what makes up this Aperture.

A

Allows communication between the upper limb, the thoracic cavity, and the neck

Its made up by :
Anteriorly by The superior border of the Manubrium
Laterally by the First part of Rib and their coastal cartilage
Posteriorly by T1

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8
Q

What makes up the Inferior Thoracic aperture and whats the function of this Segment

A

Allows communication between the thoracic cavity and the abdomen

Posteriorly by the T12 vertebra
Posterolaterally by the 11-12th pair of ribs
Anterolaterally by the joined costal cartilages of 7-10 ribs
Anteriorly by the xiphisternal joint
Diaphragm closes this space almost completely separating the two cavities

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9
Q

Name and number the 3 types of ribs we have

A

True ribs(Vertebrosternal)-1-7
False ribs 8-10(Vertebochondral)
Floating(Free) ribs 11-12

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10
Q

How do we name intercostal spaces

A

Intercostal spaces are named in relation to the rib on the superior border

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11
Q

Where is the Subcostal space located?

A

Immediately below the 12th rib

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12
Q

What’s the Location of the Manubrium and what are the important landmarks

A

Manubrium
Lies T3-T4

Clinical landmarks

Jugular (suprasternal) notch

Articulating point for clavicle and first rib

Sternal angle (of Louis)(bifurcation of the trachea)
Opposite 2nd pair of costal cartilages
Level of T4-T5

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13
Q

Name the position of the body of the sternum

A

T5-T9 level(Ribs 3-6)
Xiphoid process
T10 level

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14
Q

Function and Innervation of Thoracic wall muscle:

Ext intercostal

A

Forced inspiration, Elevate Ribs
run from the vertebral column, stops short of the sternum

Intercostal nerve

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15
Q

Function and Innervation of Thoracic wall muscle:

Int intercostal

A

Forced respiration;
interchondral part elevates ribs
interosseous part depresses ribs;
run from the sternum, stops short of the vertebral column

Intercostal Nerves

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16
Q

Function and Innervation of Thoracic wall muscle:

Innermost intercostal

A

Forced Inspiration :
InterChondral part Elevates ribs
Interosseous part Depresses ribs

found at the most lateral parts of the intercostal spaces

Intercostal nerves

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17
Q

Where does the neurovascular bundle lie within the intercostal muscles

A

Between internal and innermost layers of the intercostal muscles

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18
Q

Function and Innervation of Thoracic wall muscle:

Transversus thoracis

A

Intercostal Nerve
and Weakly depresses the rib

Anterior thoracic wall

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19
Q 
Subcostal intercostal muscle
function and Innervation
A

Posterior thoracic wall
Act in the same manner as internal intercostal

Forced respiration; interosseous part depresses ribs; intercontinental part elevates ribs
Intercontinental nerve

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20
Q

What’s the chief muscle of inspiration

A

Diaphragm
Dome-shaped with left and right domes
The right dome is slightly higher than left due to the presence of liver

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21
Q

Name the Diaphragmatic apertures and their function

A

Caval opening
Located in central tendon
Allows IVC and terminal branches of phrenic nerve to pass into abdominal cavity
During inspiration, diaphragm contracts causing this opening to widen which allows for dilation of the IVC and increased blood return to the heart

Esophageal hiatus
The diaphragm acts as a muscular sphincter for the esophagus that constricts when diaphragm contracts
Transmits the vagus nerve to the abdominal cavity

Aortic hiatus
Opening posterior to the diaphragm, therefore, blood flow is not affected by respiration
Transmits the descending aorta, azygos vein and thoracic duct to the abdominal cavity

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22
Q

The thoracic segment of the spinal cord supplies what nerves

A

12 pairs of thoracic nerves

Anterior and posterior Rami

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23
Q

What does the Anterior Rami form

A

T1-T11 form the Intercostal nerves

T12 forms the subcostal nerves

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24
Q

What does the Posterior Rami supply

A

Deep Muscles of the back

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25
How does the Intercostal nerve do their supply
Intercostal nerves 1 and 2 passes on the internal surfaces of 1st and 2nd ribs. all others along the inferior margin of the costal grooves (VAN-NAV) Lateral and anterior cutaneous branches(skin over sternum)
26
What do intercostal nerves 7-11 supply
Intercostal nerves 7th-11th continue to supply abdominal skin and muscles Lateral and anterior cutaneous branches(skin over sternum)
27
From the Thoracic wall nerves, what does the innervation of the Gray Rami supply via sympathetic trunk
Rami communications with sympathetic trunk to reach blood vessels, sweat glands, and smooth muscles
28
Name the important dermatome landmark | T4,6,8,10
T4 ..nipple line T6 xiphoid process T8 last rib T10 umbilicus
29
NAme the Thoracic Wall Arterial supply and their divisions
Thoracic aorta Intercostal and subcostal branches Subclavian artery Supreme intercostal arteries Internal thoracic arteries
30
name the components of the Thoracic wall Venous system
Anterior intercostal veins: empty into the internal thoracic veins to brachiocephalic veins Posterior intercostal veins empty into the azygos, Hemi-azygos, and accessory Hemi-azygos veins which convey blood to the vena cava Hemi-azygos and accessory Hemi-azygos empty into the azygos vein
31
where does the lymph of the body transmit to
Thoracic duct
32
Explain the thoracic duct tract
Originates from the cisterna chyli Beaded appearance due to valves Empties into the venous system near left internal jugular and left brachiocephalic vein or left subclavian vein region
33
Difference between visceral pleura and Parietal pleura
Visceral pleura adherent to all surfaces of the lungs Parietal pleura lines the wall of the thoracic cavity, the mediastinum, and the diaphragm
34
Pleural sac function
the pleural fluid lubricates the pleural surfaces to allow the layers to slide smoothly with respiration
35
Lungs do not completely occupy the pleural cavities | they contain recesses namely?
Costodiaphragmatic and costomediastinal recesses
36
Name the Surfaces of the Lungs
Costal Mediastinal Diaphragmatic
37
Name the three borders of the lungs
Anterior Posterior Inferior
38
What are the 3 lobes of the right lung
Superior, Middle inferior
39
In the right lung, what is the function of the Hilum
Joins the lungs to heart and trachea
40
Name the components of the roots of the right lungs
Pulmonary artery (deoxygenated blood)- anterior superior 2 Pulmonary veins (oxygenated blood)- inferior Bronchus/Bronchi-superior posterior Note vena cava, azygos vein and esophagus
41
Name the fissures of the right lung
Horizontal and oblique fissure
42
NAme the fissure of the left lung
Oblique fissure
43
NAme the lobes of the left lung
Superior and inferior lobe
44
what are the components of the left lung
``` Cardiac notch and cardiac impression Lingula The root of the lung Hilum- joins lung to heart and trachea Pulmonary artery (deoxygenated blood)- most superior 2 Pulmonary veins (oxygenated blood)- anterior inferior Bronchus/Bronchi- posterior Note aorta and esophagus ```
45
whats the location of the Carina
Level of the sternal angle T4
46
MAinstem Bonchi division and characteristics
Right mainstem bronchi is 2.5 cm long with angle of 25º and wider than left Left mainstem bronchi is 5 cm long with an angle 45º
47
COmponents of Lobar bronchi
``` Lobar bronchi (secondary bronchi) Right has 3; left has 2 ```
48
component of segmental bronchi
20-25 generations of branches that end in terminal bronchioles Respiratory bronchioles (beginning of gas exchange) Alveolar ducts Alveolar sacs (basic structural unit of gas exchange)
49
Explain the flow of blood in the pulmonary arteries(1 to each lung)
Deoxygenated blood Enters hilum Lobar and segmental arteries
50
Explain the flow of blood in the pulmonary veins (2 each Lung)
Oxygenated blood | Empty into the left atrium
51
Bronchial arteries supply blood to?
``` Roots of the lungs, Lung tissues, and Visceral pleura resp bronchiole Run posterior to main bronchiole ```
52
Bronchial veins drain blood into?
Drain only part of the blood supplied by bronchial arteries R) into the azygos vein and left into accessory Hemi-azygos vein
53
Pulmonary veins drain blood into?
blood is drained by pulmonary veins (oxygenated blood) into left atrium Physiologic shunt
54
Bronchial arteries are branches of ?
Aorta and run posterior to the main bronchi
55
What are the vasculature of the lungs made up of
Bronchial arteries and Bronchial veins
56
Bronchial arteries supply blood to?
structures that makeup roots of the lungs, supporting tissues of the lungs and visceral pleura Main bronchi and respiratory bronchiole
57
whats the innervation of the tracheobronchial tree
1.Pulmonary plexus Anterior and posterior to roots of the lung 2.Parasympathetic fibers Vagus (CN X) 3.Sympathetic fibers Sympathetic trunks
58
what does the Vagus(PNS) do in the bronchial tree
Motor to smooth muscle- bronchoconstrictor Inhibitory to pulmonary vessels- vasodilator Secretory to glands bronchial tree- secretomotor
59
what does the Sympathetic fiber do in the bronchial tree
Sympathetic- paravertebral sympathetic ganglia Inhibitory to bronchial smooth muscle- bronchodilator Motor to pulmonary vessels- vasoconstrictor Inhibitory to alveolar glands of the bronchial tree
60
Name the component of the mediastinum
Occupied by the viscera between the pulmonary cavities Contains all of the thoracic viscera, except the lungs 1.Superior mediastinum 2.Inferior mediastinum i) Anterior mediastinum Lymph nodes, fat and connective tissue ii) Middle mediastinum iii)Posterior mediastinum
61
Components of the superior Mediastinum
``` Thymus* Brachiocephalic vein* SVC* Pulmonary Trunk Bifurcation Pulmonary artery Artery roots Arch of Aorta(Brachiocephalic, Left common carotid, Aorta)* Ligamentum arteriosum* Vagus* Phrenic* Cardia plexus* Trachea* Esophagus* Thoracic duct* BLASTTTVEPPPC ```
62
Components of the posterior mediastinum
``` Thoracic Aorta Thoracic Duct Lymph nodes Azygos, hemi-azygos, and accessory hemi-azygos veins sympathetic trunks(Thoracic) Splanchnic nerves(Thoracic) Esophagus Esophageal plexus Vagus nerve ``` LASSTTVEE
63
Middle mediastinum components
``` Pericardium Heart Ascending aorta Pulmonary trunk Superior vena cava Arch of the azygos vein Main bronchi ```
64
What are the layers of trhe Pericardium
1. Double-walled membrane 2. Encloses the heart and roots of the great vessels Outermost layer is the parietal layer Reflected onto the heart and great vessels Innermost layer is the visceral layer Comprises the epicardium (external layer of the heart wall) Pericardial cavity Contains serous fluid Frictionless movement of the heart
65
Vasculature of the pericardium is made up of ?
Pericardiacophrenic artery (branch of the internal thoracic artery) and pericardiacophrenic veins
66
Nerve supply of the pericardium is made up of?
Phrenic nerve for sensory Referred pain to C3-C5 dermatomes Sympathetic trunks vasomotor
67
NAme the heart layers
Thin external layer formed by the visceral layer of the pericardium Myocardium Thick, middle layer composed of cardiac muscle Endocardium Thin internal layer that lines the heart and covers the valves
68
apex location of the heart
Anteriorly and to the left Inferolateral part of the left ventricle 5th intercostal space, 9 cm from median plane
69
Base location of the heart
Posterior aspect Left atrium T6-T9
70
The anterior surface of the heart is the?
Right ventricle
71
The inferior(Diaphragmatic) surface of the heart is the ?
Left ventricle and right ventricle
72
Left pulmonary surface of the heart is the ?
Left ventricle, | cardiac impression of left lung
73
The right pulmonary surface of the heart is?
By the right atrium
74
Components of the right atrium are?
Coronary Sinus receives blood from the Coronary veins(between right AV orifice and IVC orifice) ``` Sinus Venarum(smooth area) :SVC level 3rd intercostal and IVC level 5th intercostal ``` ``` Cristae Terminale Fossa ovale Pectinate muscles Interatrial septum(separates the atria) Right auricle ```
75
Location of the Right AV Orificeis?
4th to 5th intercostal space
76
The function of the papillary muscles is
Prevent valve from prolapsing during ventricular contraction (systole)
77
Tricuspid valve)Right AV Valve Function and component
Guards right AV orifice (4th-5th intercostal spaces) Three cusps Anterior, septal and posterior Chordae tendineae attach to anterior, septal and posterior papillary muscles: Prevent valve from prolapsing during ventricular contraction (systole) Papillary muscles contract slightly before ventricle to draw cusps together Normal valve opening: 4-6 cm2
78
Right ventricle component and function are?
Sends blood to the pulmonary system Conus arteriosus Leads to pulmonary trunk Trabeculae carneae Irregular muscular elevations Papillary muscles Connect to chordae tendineae Intraventricular septum Separates left and right ventricles Bulges into the right ventricle due to increased pressure in left septomarginal trabecula (moderator band) Carries part of the right bundle branches of the AV bundle to the anterior papillary muscle Facilitates conduction time and allows for coordinated contraction of the anterior papillary muscle
79
Components and function of the pulmonary valve
Semilunar valve Apex of the conus arteriosus (3rd costal cartilage) Three cusps Anterior, right and left Pulmonary sinus just superior to valve, start of the pulmonary trunk Blood prevents cusps from reopening during diastole Normal valve opening: 2 cm2
80
Components of the Left Atrium and function
``` Receives well-oxygenated blood from pulmonary system Left auricle Overlaps pulmonary trunk Contains pectinate muscles Four valve less pulmonary veins Right and left superior and inferior Posterior wall Slightly thicker wall than right atrium Left AV orifice ```
81
Mitral valve component and function
Left atrioventricular (AV) valve; Bicuspid valve Guards left AV orifice (4th costal cartilage) Two cusps Anterior and posterior Chordae tendineae attach to anterior and posterior papillary muscles Prevent valve from prolapsing during ventricular contraction (systole) Papillary muscles contract slightly before ventricle to draw cusps together Normal valve opening: 4-6 cm2
82
Left ventricle components and function
Walls are 2-3 times thicker than the right ventricle Trabeculae carneae Finer but more numerous than right ventricle Anterior and posterior papillary muscles Larger than those in right ventricle Aortic vestibule Smooth walled area leading to aortic orifice Aortic orifice Outflow to ascending aorta Contains aortic valve
83
Where do the right and left coronary arteries arise from
Right aortic sinus contains the opening of the right coronary artery Left aortic sinus contains the opening of the left coronary artery
84
AOrtic valve components and function
Semilunar valve Apex of the aortic vestibule Three cusps Left, right and posterior Aortic sinus just superior to the cusps, start of the ascending aorta Right aortic sinus contains the opening of the right coronary artery Left aortic sinus contains the opening of the left coronary artery Posterior aortic sinus does not contain a coronary artery Normal valve opening: 2.5- 4.5 cm2
85
what are the valve auscultation point and when do the close for s1 and s2 heart sounds
First heart sound, S1 Closure of the AV valves Systole Tricuspid valve Near left sternal border in 5th intercostal space Mitral valve apex of heart in 5th intercostal space, midclavicular line Second heart sound, S2 Closure of semilunar valves Early diastole Aortic valve 2nd intercostal space, right of sternal border Pulmonary valve 2nd intercostal space, left of sternal border
86
What vessels supply the Epicardium and the myocardium
coronary arteries
87
RCA branches are(R Dom)
Arises from right aortic sinus Runs along the coronary sulcus Sinu-atrial (SA) nodal branch SA node Right marginal branch Right border of the heart AV nodal branch Crux of the heart (junction of septa and walls of the four chambers) AV node Posterior interventricular branch Left and right ventricles Interventricular septum
88
RCA supplies(R Dom)
``` Right atrium Most right ventricle Part of left ventricle Part of IV septum (posterior third) SA node (60% of people) AV node (80% of people) ```
89
Left coronary artery branches(R Dom)
Runs along the coronary sinus Anterior interventricular branch (left anterior descending) Left and right ventricles Interventricular septum Anastomoses with the posterior IV branch of RCA Circumflex branch Left posterior ventricle Left marginal artery Left ventricle
90
LCA supplies? (R Dom)
``` Left atrium Most of the left ventricle Part of the right ventricle Most of the IV septum (anterior two-thirds) AV bundle of conducting tissue SA node in 40% of people ```
91
Veinous drainage of the heart is made up of ?
Great cardiac vein Close proximity to LAD and circumflex Empty into coronary sinus Middle cardiac vein Close proximity to posterior interventricular branch Empty into coronary sinus Small cardiac vein Close proximity to RCA Empty into coronary sinus Coronary sinus Empties into right atrium Anterior cardiac veins empty directly into right atrium
92
Explain the conduction system of the heart and the location ?
Sinu-atrial (SA) node Nodal tissue that initiates and regulates heartbeat; 60-100 bpm Deep to epicardium, junction of SVC and right atrium Internodal tracts to depolarize atria Atrioventricular (AV) node Smaller collection of nodal tissue Directs SA nodal signal to septum and initiates and regulates heartbeat (if SA node fails); 40-60 bpm Interatrial septum near the opening of the coronary sinus Atrioventricular bundle of HIS Distributes signal to ventricles Right and left bundle branches ``` Purkinje fibers (subendocardial branches) Nodal tissue; if SA/AV nodes fail to fire will initiate heartbeat; 20-40 bpm ```
93
Where are the presynaptic fibers cell body of Superficial and deep cardiac plexuses Sympathetic located
intermediolateral cell columns of the superior 5-6 thoracic segments of spinal cord.
94
Where are the postsynaptic fibers cell body of Superficial and deep cardiac plexuses Sympathetic located and what are the function of this fibre
cervical and superior thoracic paravertebral ganglia of the sympathetic trunks Postsynaptic fibers end in the SA and AV nodes and close to coronary arteries Increases heart rate and force of contraction Dilation of coronary arteries by inhibiting their constriction
95
Where are the presynaptic fibers cell body of Superficial and deep cardiac plexuses paraSympathetic located
Vagus nerve
96
Where are the postsynaptic fibers cell body of Superficial and deep cardiac plexuses paraSympathetic located and the function
Postsynaptic cell bodies located near SA and AV nodes and along coronary arteries Slows heart rate and reduces the force of contraction Constricts coronary arteries

Anatomy 1 (8 decks)

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