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AS - N936 Anesthesia Specialty Techniques > Thorax, Heart, & Lungs > Flashcards

Thorax, Heart, & Lungs Flashcards

1
Q

Thorax

A

Size & shape change
Superior border - 1st rib
Inferior border - diaphragm

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2
Q

Diaphragm

A

Domed muscle w/ attachments on ribs, costal cartilages, and lumbar vertebrae
Contracts to increase thoracic volume

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3
Q

Intercostals

A

Three muscle layers

  • Innermost intercostals
  • Internal intercostals (oriented superomedially & terminate to fascia in posterior thorax)
  • External intercostals (oriented inferomedially & terminate to fascia in anterior thorax)
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4
Q

Pleural Cavity

A

LUNGS

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5
Q

Mediastinum

A

Central mass tissues in the thorax

  • Heart, great vessels, major nerves (Vagus & phrenic)
  • Thoracic duct (lymphatic), azygos, & hemiazygos veins
  • Sympathetic trunk
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6
Q

Superior Mediastinum

A

Contains cardiac great vessels, trachea, & esophagus

Area behind manubrium

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7
Q

Anterior Mediastinum

A

Begins below aortic arch at T4-5

Anterior to heart

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8
Q

Middle Mediastinum

A

Heart

Phrenic nerve travel across pericardial sac

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9
Q

Posterior Mediastinum

A

Begins below aortic arch at T4-5
Contains bronchi, descending aorta, & esophagus
Thoracic duct (lymphatic channels) drains ISF & fat
- Azygos vein R
- L accessory hemiazygos & hemiazygos vein
Sympathetic chain SNS fight or flight response

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10
Q

Inferior Mediastinum

A

Contains anterior, middle, & posterior mediastinum

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11
Q

Parasympathetic Innervation

A

Vagus (cranial nerve X)
All thoracic PSNS motor signals travel via the Vagus
Long pre-ganglionic axons synapse in ganglia
Synapse on or near the target organ
Short post-ganglionic axons travel into target organ

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12
Q

Cardiac Anatomy

A

RA → tricuspid valve → RV → pulmonary valve → pulmonary arteries → pulmonary veins → LA → mitral valve → LV → aortic valve → aorta

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13
Q

Coronary Arteries

A

Coronary = crown

L anterior descending
R coronary artery
Circumflex branch

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14
Q

Aortic Valve Auscultation

A

2nd intercostal space

R sternal margin

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15
Q

Tricuspid Valve Auscultation

A

5th intercostal space

L sternal margin

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16
Q

Pulmonary Valve Auscultation

A

2nd intercostal space

L sternal margin

17
Q

Mitral Valve Auscultation

A

5th intercostal space

Midclavicular line

18
Q

Cardiac Electrical Conduction

A

Polarization & depolarization EKG

SA node → AV node → AV bundle → L & R bundle branches → Purkinje fibers

19
Q

Atria

Conduction Velocity

A

1 m/sec

20
Q

AV Node

Conduction Velocity

A

0.01-0.05 m/sec

21
Q

His-Purkinje

Conduction Velocity

A

2-4 m/sec

22
Q

Upper Respiratory System

A

Mouth
Nasal cavity
Pharynx
Larynx

23
Q

Lower Respiratory System

A

Trachea
Bronchi
Lungs

Enclosed in thorax
Ribs, spine, & diaphragm border

24
Q

Conducting Zone

A

DEAD SPACE

Larynx & trachea

25
Q

Respiratory Zone

A

Gas exchange

Bronchioles & alveoli

26
Q

Left Lung

A 
2 lobes
- Superior
- Inferior
Lingula
Only oblique fissure
27
Q

Right Lung

A 
3 lobes
- Superior
- Middle
- Inferior
Horizontal & oblique fissure
28
Q

Breathing is a _____ process

A

Mechanical

29
Q

What causes air to enter the lungs?

A

PRESSURE
Diaphragm contracts decreasing Palv
Ribs & sternum elevate laterally & anteriorly
Inspiration Patm > Palv

30
Q

Expiration

A

Diaphragm relaxes
Palv > Patm
Air moves out

31
Q

Vagus nerve innervates _____

A

Lungs

Dilates & constricts bronchi

32
Q

Phrenic nerve innervates _____

A

Diaphragm

33
Q

Thorax Muscles

Scalene

A

Pull on 1st & 2nd ribs to raise ribs similar to bucket handles
↑thoracic volume lateral & anterior

34
Q

Thorax Muscles

Intercostal

A

“Dynamic ligaments”
Transfer scalene action to all ribs
WOB

35
Q

Thorax Muscles

Serratus Anterior & Pectorals

A

Heavy respiration when arms fixed

AS - N936 Anesthesia Specialty Techniques (6 decks)

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