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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
Q

How does the Intercostal nerve do their supply

A

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)

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26
Q

What do intercostal nerves 7-11 supply

A

Intercostal nerves 7th-11th continue to supply abdominal skin and muscles
Lateral and anterior cutaneous branches(skin over sternum)

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27
Q

From the Thoracic wall nerves, what does the innervation of the Gray Rami supply via sympathetic trunk

A

Rami communications with sympathetic trunk to reach blood vessels, sweat glands, and smooth muscles

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28
Q

Name the important dermatome landmark

T4,6,8,10

A

T4 ..nipple line
T6 xiphoid process
T8 last rib
T10 umbilicus

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29
Q

NAme the Thoracic Wall Arterial supply and their divisions

A

Thoracic aorta
Intercostal and subcostal branches

Subclavian artery
Supreme intercostal arteries
Internal thoracic arteries

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30
Q

name the components of the Thoracic wall Venous system

A

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

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31
Q

where does the lymph of the body transmit to

A

Thoracic duct

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32
Q

Explain the thoracic duct tract

A

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

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33
Q

Difference between visceral pleura and Parietal pleura

A

Visceral pleura adherent to all surfaces of the lungs

Parietal pleura lines the
wall of the thoracic cavity,
the mediastinum,
and the diaphragm

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34
Q

Pleural sac function

A

the pleural fluid lubricates the pleural surfaces to allow the layers to slide smoothly with respiration

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35
Q

Lungs do not completely occupy the pleural cavities

they contain recesses namely?

A

Costodiaphragmatic and costomediastinal recesses

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36
Q

Name the Surfaces of the Lungs

A

Costal
Mediastinal
Diaphragmatic

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37
Q

Name the three borders of the lungs

A

Anterior
Posterior
Inferior

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38
Q

What are the 3 lobes of the right lung

A

Superior, Middle inferior

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39
Q

In the right lung, what is the function of the Hilum

A

Joins the lungs to heart and trachea

40
Q

Name the components of the roots of the right lungs

A

Pulmonary artery (deoxygenated blood)- anterior superior
2 Pulmonary veins (oxygenated blood)- inferior
Bronchus/Bronchi-superior posterior
Note vena cava, azygos vein and esophagus

41
Q

Name the fissures of the right lung

A

Horizontal and oblique fissure

42
Q

NAme the fissure of the left lung

A

Oblique fissure

43
Q

NAme the lobes of the left lung

A

Superior and inferior lobe

44
Q

what are the components of the left lung

A 
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
Q

whats the location of the Carina

A

Level of the sternal angle T4

46
Q

MAinstem Bonchi division and characteristics

A

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
Q

COmponents of Lobar bronchi

A 
Lobar bronchi (secondary bronchi)
Right has 3; left has 2
48
Q

component of segmental bronchi

A

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
Q

Explain the flow of blood in the pulmonary arteries(1 to each lung)

A

Deoxygenated blood
Enters hilum
Lobar and segmental arteries

50
Q

Explain the flow of blood in the pulmonary veins (2 each Lung)

A

Oxygenated blood

Empty into the left atrium

51
Q

Bronchial arteries supply blood to?

A 
Roots of the lungs,
 Lung tissues, and
 Visceral pleura
resp bronchiole
Run posterior to main bronchiole
52
Q

Bronchial veins drain blood into?

A

Drain only part of the blood supplied by bronchial arteries
R) into the azygos vein and
left into accessory Hemi-azygos vein

53
Q

Pulmonary veins drain blood into?

A

blood is drained by pulmonary veins (oxygenated blood) into left atrium
Physiologic shunt

54
Q

Bronchial arteries are branches of ?

A

Aorta and run posterior to the main bronchi

55
Q

What are the vasculature of the lungs made up of

A

Bronchial arteries and Bronchial veins

56
Q

Bronchial arteries supply blood to?

A

structures that makeup roots of the lungs,
supporting tissues of the lungs and
visceral pleura
Main bronchi and respiratory bronchiole

57
Q

whats the innervation of the tracheobronchial tree

A

1.Pulmonary plexus
Anterior and posterior to roots of the lung

2.Parasympathetic fibers
Vagus (CN X)

3.Sympathetic fibers
Sympathetic trunks

58
Q

what does the Vagus(PNS) do in the bronchial tree

A

Motor to smooth muscle- bronchoconstrictor
Inhibitory to pulmonary vessels- vasodilator
Secretory to glands bronchial tree- secretomotor

59
Q

what does the Sympathetic fiber do in the bronchial tree

A

Sympathetic- paravertebral sympathetic ganglia

Inhibitory to bronchial smooth muscle- bronchodilator
Motor to pulmonary vessels- vasoconstrictor
Inhibitory to alveolar glands of the bronchial tree

60
Q

Name the component of the mediastinum

A

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
Q

Components of the superior Mediastinum

A 
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
Q

Components of the posterior mediastinum

A 
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
Q

Middle mediastinum components

A 
Pericardium
Heart
Ascending aorta
Pulmonary trunk
Superior vena cava
Arch of the azygos vein
Main bronchi
64
Q

What are the layers of trhe Pericardium

A
  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
Q

Vasculature of the pericardium is made up of ?

A

Pericardiacophrenic artery (branch of the internal thoracic artery) and pericardiacophrenic veins

66
Q

Nerve supply of the pericardium is made up of?

A

Phrenic nerve for sensory
Referred pain to C3-C5 dermatomes

Sympathetic trunks
vasomotor

67
Q

NAme the heart layers

A

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
Q

apex location of the heart

A

Anteriorly and to the left
Inferolateral part of the left ventricle
5th intercostal space, 9 cm from median plane

69
Q

Base location of the heart

A

Posterior aspect
Left atrium
T6-T9

70
Q

The anterior surface of the heart is the?

A

Right ventricle

71
Q

The inferior(Diaphragmatic) surface of the heart is the ?

A

Left ventricle and right ventricle

72
Q

Left pulmonary surface of the heart is the ?

A

Left ventricle,

cardiac impression of left lung

73
Q

The right pulmonary surface of the heart is?

A

By the right atrium

74
Q

Components of the right atrium are?

A

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
Q

Location of the Right AV Orificeis?

A

4th to 5th intercostal space

76
Q

The function of the papillary muscles is

A

Prevent valve from prolapsing during ventricular contraction (systole)

77
Q

Tricuspid valve)Right AV Valve Function and component

A

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
Q

Right ventricle component and function are?

A

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
Q

Components and function of the pulmonary valve

A

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
Q

Components of the Left Atrium and function

A 
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
Q

Mitral valve component and function

A

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
Q

Left ventricle components and function

A

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
Q

Where do the right and left coronary arteries arise from

A

Right aortic sinus contains the opening of the right coronary artery
Left aortic sinus contains the opening of the left coronary artery

84
Q

AOrtic valve components and function

A

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
Q

what are the valve auscultation point and when do the close for s1 and s2 heart sounds

A

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
Q

What vessels supply the Epicardium and the myocardium

A

coronary arteries

87
Q

RCA branches are(R Dom)

A

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
Q

RCA supplies(R Dom)

A 
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
Q

Left coronary artery branches(R Dom)

A

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
Q

LCA supplies? (R Dom)

A 
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
Q

Veinous drainage of the heart is made up of ?

A

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
Q

Explain the conduction system of the heart and the location ?

A

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
Q

Where are the presynaptic fibers cell body of Superficial and deep cardiac plexuses
Sympathetic located

A

intermediolateral cell columns of the superior 5-6 thoracic segments of spinal cord.

94
Q

Where are the postsynaptic fibers cell body of Superficial and deep cardiac plexuses
Sympathetic located and what are the function of this fibre

A

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
Q

Where are the presynaptic fibers cell body of Superficial and deep cardiac plexuses
paraSympathetic located

A

Vagus nerve

96
Q

Where are the postsynaptic fibers cell body of Superficial and deep cardiac plexuses
paraSympathetic located and the function

A

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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