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ANA300 > Visceral systems > Flashcards

Visceral systems Flashcards

1
Q

structural division of respiratory system

A

1) upper: nasal cavity, nose, pharynx, larynx
2) trachea, bronchi, bronchioles

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2
Q

functional division of respiratory system

A

1) conducting: nasal cavity, pharynx, larynx, trachea, bronchi, terminal bronchioles
2) respiratory: respiratory bronchioles, alveolar ducts, alveoli

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3
Q

conducting portion features

A
  • lined by respiratory mucosa
  • function: filter, warm and moisten air
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4
Q

respiratory mucosa

A

1) pseudostratified ciliated (motile to sweep mucus and trapped contaminants towards pharynx for swallowing or expulsion) columnar epithelium with goblet cells (produce mucus) + stem cells
2) lamina propria: loose CT with BVs to warm air + mucous glands

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5
Q

respiratory portion features

A
  • respiratory bronchiole branches from terminal bronchiole, then into alveolar ducts that lead into alveolar sac (made up of alveoli)
  • function: where gas exchange takes place
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6
Q

nasal cavity features

A
  • extends anteriorly from nares (nostrils) to choanae posteriorly (continuous with nasopharynx)
  • functions: conduct air, filter/warm/humidify air, sense odorants
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7
Q

nasal septum

A
  • divides nose into left and right parts
  • formed by perpendicular plate of ethmoid and vomer
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8
Q

nasal cavity subdivision

A
  • superior, middle and inferior conchae separate cavity into air passages (meatuses)
  • curved shape keeps air in cavity for longer (swirling around)
  • sinuses also connect with nasal cavity
  • everything surrounded by mucosa
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9
Q

lateral wall of nasal cavity

A
  • superior and middle nasal conchae (ethmoid)
  • lacrimal bone
  • inferior nasal concha
  • maxilla
  • perpendicular plate of palatine
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10
Q

medial wall of nasal cavity

A
  • nasal septum: perpendicular plate of ethmoid, vomer and septal cartilage (hyaline)
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11
Q

roof of nasal cavity

A
  • cribriform plate of ethmoid
  • frontal bone
  • nasal bone
  • sphenoid bone
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12
Q

floor of nasal cavity

A
  • horizonal plate of palatine
  • palatine process of maxilla
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13
Q

paranasal sinuses

A
  • lighten mass of skull, increase surface area of respiratory mucosa, create turbulence
  • communicate with cavity via ducts
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14
Q

paranasal sinus ducts

A

1) above superior meatus: sphenoidal sinus
2) into superior meatus: posterior ethmoidal air cells
3) into middle meatus: frontal sinus, maxillary sinus
4) into inferior meatus: nasolacrimal duct

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15
Q

olfaction

A
  • superior part of nasal cavity has olfactory epithelium
  • turbulence brings odorants into contact with epithelium, where they dissolve in mucus and stimulate sensory neurons (binding to specific receptors = depolarization)
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16
Q

olfactory organs

A

1) olfactory epithelium: specialized pseudostratified ciliated columnar
2) underlying lamina propria

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17
Q

cells of olfactory epithelium

A

1) olfactory sensory neurons: bipolar, dendrites form knob that projects into nasal cavity
2) supporting cells: mechanical and metabolic support to receptor cells
3) basal cells: replace olfactory sensory neurons, decrease with age

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18
Q

olfactory knob

A
  • contains non-motile cilia with olfactory receptors on the surface
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19
Q

olfactory pathway

A

two neurons:
1) from olfactory epithelium, form CN I and pass through cribriform plate
2) in olfactory bulb, travel in olfactory tract to primary olfactory cortex (temporal lobe), hypothalamus, and limbic system
*thalamus not involved! only exception out of the senses

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20
Q

oral cavity function

A
  • analysis of food
  • mechanical processing
  • lubrication (saliva)
  • limited digestion
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21
Q

oral cavity characteristics

A
  • lined by oral mucosa: stratified squamous non-keratinized epithelium
  • buccinator muscles support mucosa of cheeks
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22
Q

oral cavity features

A

1) hard and soft palate
2) palatoglossal arch: extends directly from uvula
3) palatopharyngeal arch: posterior to 2)
4) palatine tonsil: between arches
5) uvula: extends from soft palate
6) superior labial, lingual, inferior labial frenulum
7) fauces: opening to pharynx
8) oral vestibule: space between cheek/lips and teeth
9) gingiva: gums

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23
Q

oral cavity boundaries

A

1) roof: hard (maxilla and palatine) and soft palate
2) floor: tongue
3) anterior: teeth and lips with orbicularis orbis
4) posterior: palatoglossal arch/folds, palatine tonsil, palatopharyngeal arch/golds

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24
Q

orbicularis orbis

A
  • sphincter muscle continuous around the mouth
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25
Q

soft palate function

A
  • moves up to close off nasopharynx during swallowing
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26
Q

uvula function

A
  • prevents food from entering oropharynx too soon
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27
Q

tongue muscles

A

1) extrinsic: pass to tongue from bony attachments (to external structures), function to position tongue for speech and swallowing
2) intrinsic: divided by left and right halves by median sagittal septum, within tongue in different orientations, function to alter shape of tongue

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28
Q

extrinsic tongue muscles

A

1) hyoglossus (3): attach to hyoid bone
2) palatoglossus: palatine
3) genioglossus: chin (genu of mandible)
4) styloglossus: styloid process of temporal bone

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29
Q

innervation of tongue

A

1) motor: majority by CN XII, palatoglossus by CN X
2) posterior tongue: general sensory and special (taste) by CN IX
3) anterior tongue: special by CN VII and general by CN V3

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30
Q

CN XII lesion

A
  • dysarthria: difficulty speaking
  • dysphagia: difficulty swallowing
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31
Q

floor of the mouth

A
  • mandible
  • hyoid
  • suprahyoid muscles
  • salivary glands
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32
Q

suprahyoid muscles

A
  • elevate hyoid and larynx when swallowing
    1) digastric (anterior belly, “two bellies”)
    2) stylohyoid (styloid process
    3) mylohyoid (mandible)
    4) geniohyoid (chin)
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33
Q

infrahyoid muscles

A
  • below hyoid
  • not part of floor of mouth
    1) omohyoid: scapula to hyoid
    2) sternohyoid: sternum to hyoid
    3) sternothyroid: sternum to thyroid cartilage
    4) thyrohyoid: thyroid cartilage to hyoid
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34
Q

salivary glands

A
  • three pairs: parotid, sublingual, submandibular
  • multicellular exocrine
  • enclosed by dense fibrous CT
  • produce/secrete saliva under autonomic control
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35
Q

parotid gland

A
  • duct opens into oral vestibule (by second maxillary molar)
  • largest salivary gland
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36
Q

sublingual gland

A
  • below tongue
  • numerous ducts open into floor of oral cavity (lateral to that of submandibular gland)
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37
Q

submandibular gland

A
  • below mandible
  • ducts open into floor of oral cavity lateral to lingual frenulum
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38
Q

temporomandibular joint (TMJ)

A
  • synovial joint
  • mandibular fossa (temporal bone) articulates with head of condylar process (mandible)
  • articular surfaces separated by fibrocartilage disc
  • loose capsule = highly mobile and easily dislocated
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39
Q

TMJ movements

A

1) hinge: elevation (close mouth) and depression (open mouth)
2) gliding: retraction (tuck chin), protrusion/protraction (stick chin out), lateral grinding

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40
Q

lockjaw

A
  • dislocated TMJ
  • jaw stuck open
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41
Q

muscles of mastication

A
  • produce TMJ movements
  • innervated by CN V3
    1) temporalis: elevation and retraction
    2) masseter: elevation
    3) lateral pterygoid: protrusion, side to side movement, opening jaw (mostly by gravity)
    4) medial pterygoid: elevation, side to side movement
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42
Q

pterygoid muscle attachments

A
  • to lateral pterygoid plate
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43
Q

pharynx

A
  • common space used by respiratory and digestive systems
  • muscular tube extending from base of skull to upper esophageal sphincter
  • contracts reflexively during swallowing
  • stratified squamous nonkeratinized
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44
Q

pharynx innervation

A
  • motor: CN X
  • sensory: CN IX
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45
Q

pharynx parts

A

1) nasopharynx: pharyngeal tonsils (adenoids), opening of pharyngotympanic tubes (connection to auditory tube)
2) oropharynx: palatine and lingual tonsils, first line of defense
3) laryngopharynx: opens into larynx (air) and esophagus (food)

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46
Q

cricoid caritlage

A

forms part of larynx (laryngopharynx)

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47
Q

pharyngeal muscles

A

1) circular: constrict during swallowing (ordered), overlap each other
- superior, middle and inferior pharyngeal constrictor
2) longitudinal:
- stylopharyngeus (styloid process)
- palatopharyngeus (soft palate)
- salpingopharyngeus (pharyngotympanic tube)

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48
Q

pharyngeal muscle innervation

A
  • CN X for all except stylopharyngeus (CN IX)
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49
Q

larynx features

A
  • opens anteriorly into larynx (laryngeal inlet)
  • posteriorly into esophagus
  • inferiorly into trachea
  • function: passage of air, vocalization and prevents food from entering trachea (epiglottis covers larynx)
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50
Q

larynx hyoid connection

A
  • suspended from hyoid bone by thyrohyoid membrane
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51
Q

extrinsic muscles of larynx

A
  • suprahyoid: elevate hyoid bone (and larynx)
  • infrahyoid: depress
  • during swallowing and speaking
  • specifically during swallowing: elevated larynx bends epiglottis over laryngeal inlet
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52
Q

larynx cartilage

A
  • held in place by ligaments and muscles
  • three unpaired frameworks:
    1) thyroid cartilage: anterior laryngeal prominence (“adam’s apple”), incomplete posteriorly (superior and inferior horn)
    2) cricoid cartilage: complete ring, inferior to 1)
    3) epiglottis
  • paired:
    1) arytenoid cartilages: associated with corniculate and cuneiform cartilages
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53
Q

larynx cartilage connecting membranes

A

1) thyrohyoid membrane: dense CT connecting larynx to hyoid
2) cricothyroid membrane: connects thyroid and cricoid cartilage

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54
Q

larynx intrinsic ligaments

A
  • not the same as bone-bone ligaments
  • extend between cartilage
    1) vestibular ligament: corniculate and thyroid cartilage, along with mucosa forms vestibular folds to protect vocal folds
    2) vocal ligament: arytenoid and thyroid, elastic CT, along with mucosa forms vocal folds (avascular, produce sound)
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55
Q

rima glottidis

A

space between vocal folds

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56
Q

epithelium in the larynx

A
  • above vocal folds: stratified squamous nonkeratinized
  • below: respiratory epithelium
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57
Q

sound production (phonation)

A
  • adductor intrinsic muscles adduct arytenoid cartilages
  • rima glottidis decreases in size –> air passing through vibrates folds to produce sound waves
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58
Q

vocal folds during respiration

A
  • abductors abduct arytenoid cartilages
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59
Q

tensors and relaxers

A
  • tiny muscles that adjust length of vocal ligaments by tilting thyroid cartilage
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60
Q

what affects sound production?

A

1) tone: approximation of vocal folds
2) pitch: anterior rocking of thyroid = more tension in vocal fold = higher pitch
3) volume: more air = more speed = louder voice
4) quality: vibration within larynx, pharynx, oral cavity, nasal cavity and nasal sinuses

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61
Q

what happens in whispering?

A
  • arytenoids are adducted, but not fully pulled medially
  • all but posterior portion of rima glottidis closed
  • more air passes through, vocal folds don’t vibrate as much and thus quieter pitch
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62
Q

thoracic cavity location

A

above diaphragm

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63
Q

abdominopelvic cavity location

A

below diaphragm

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64
Q

characteristics of body cavities

A
  • lined by serous membranes
  • do not open to the exterior
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65
Q

serous membrane layers

A

1) visceral layer: around organ
2) parietal layer

  • layers are continuous with each other
  • layers produce serous fluid (lubricant) that fills serous cavity between them
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66
Q

thoracic cavity subdivision

A

1) mediastinum: between pleural cavities, includes pericardial cavity with heart
2) right pleural cavity: right lung
3) left pleural cavity: left lung

67
Q

mediastinum

A
  • sternum anterior, thoracic vertebrae posterior
  • bordered laterally by lungs
  • further divisions:
    1) posterior mediastinum: trachea, primary bronchi, esophagus, great vessels, loose areolar CT
    2) middle mediastinum: contains heart
    3) anterior mediastinum
68
Q

tracheal rings

A
  • trachea surrounded by 15-20 tracheal rings (anterior, c-shaped) and muscle (posterior, in front of esophagus)
69
Q

annular ligaments

A
  • join tracheal rings
  • elastic cartilage allows for flexibility
70
Q

carina of trachea

A
  • bifurcation of trachea into right and left primary bronchi
71
Q

branching of bronchial tree

A

1) trachea
2) primary bronchi: enter hilus of each lung, one per lung
3) lobar (secondary) bronchi: one per lung lobe
4) segmental (tertiary) bronchi: one per bronchopulmonary segment
5) bronchioles: each tertiary branches several times to form these
6) terminal bronchioles

72
Q

trachea structure

A
  • connects larynx to primary bronchi
  • lined with respiratory mucosa
  • cartilage rings anteriorly
  • trachealis muscle (smooth) posteriorly: relaxes with SyNS stimulation for bronchodilation
73
Q

layers of trachea epithelium

A

1) respiratory epithelium (mucosa)
2) lamina propria (mucosa)
3) seromucous glands in submucosa
4) perichondrium
5) hyaline cartilage ring

74
Q

right/left lung lobes

A
  • right = superior, middle and inferior
  • left = superior and inferior
75
Q

bronchopulmonary segments

A
  • 9-10 in each lung
  • each has tertiary bronchus
76
Q

benefit of lung segmentation

A
  • diseased segments can be removed while preserving function of others
77
Q

bronchi histology

A
  • respiratory mucosa with fewer goblet cells
  • amount of cartilage decreases moving through bronchi (inhibit gas exchange)
  • circular layer of smooth muscle appears in bronchi (can change size of tube, modulates SA)
  • lots of lymphocytes
78
Q

bronchiole histology

A
  • epithelium becomes simple ciliated columnar/cuboidal, then simple cuboidal/low columnar (bronchiolar exocrine aka club cells)
  • no mucosal glands or cartilage
  • smaller, less circular lumen than bronchi
  • more smooth muscle (prominent bundles lead to distinct shape)
  • adjacent to blood vessels
  • surrounded by alveoli
  • lots of lymphocytes
79
Q

respiratory portion branching

A

1) respiratory bronchioles: from terminal bronchioles, decreasing smooth muscle
2) alveolar ducts: no smooth muscle
3) alveolar sac: collections of alveoli
4) alveoli

80
Q

pulmonary lobule

A
  • branches of pulmonary arteries form capillary beds around alveoli for gas exchange
  • pulmonary artery -> pulmonary arteriole -> pulmonary venules -> pulmonary vein -> heart
81
Q

respiratory bronchiole histology

A
  • lined with bronchiolar exocrine cells
  • surrounded by few alveoli
  • subdivide into alveolar ducts with simple squamous epithelium
  • pulmonary arteries and veins visible
82
Q

alveoli characteristics

A
  • site of gas exchange, resembles a pouch (open on one side to alveolar duct/sac)
  • between alveoli: interalveolar septa with fibroblasts, elastic (spongy) and reticular (maintain shape) fibers + pulmonary capillaries
  • two types of cells (pneumocytes) and macrophages
83
Q

type I alveolar cells

A
  • numerous
  • form simple squamous epithelium
84
Q

type II alveolar cells

A
  • rounded cells, vacuolated cytoplasm
  • not as numerous
  • secrete surface-active agent (surfactant) to decrease surface tension and maintain alveolar patency (sacs remain open)
85
Q

alveolar macrophage

A
  • phagocytose particulate matter
  • contribute to black remnants on lungs (some in healthy, lots in smoker lungs)
86
Q

blood-air barrier

A
  • respiratory membrane with:
    1) endothelium
    2) thin basement membrane
    3) alveolar epithelium
  • gas exchange is rapid due to thinness (~0.5 micrometer) of membrane and small, lipid-solubility of gases
87
Q

alveoli histology

A
  • lots of empty space
  • type I cells: flat, little cytoplasm
  • type II: cuboidal/round
  • macrophages: darker spots, protrude into spaces
  • capillaries: contain RBCs
88
Q

emphysema

A
  • damaged and permanently enlarged alveoli (destruction of elastic fibers in lungs)
  • breathlessness because air becomes trapped in lungs at the end of exhalation (can’t push out, gas exchange inhibited as well)
89
Q

respiratory epithelium proximal to distal

A

1) trachea: pseudostratified ciliated columnar with goblet cells
2) bronchi: transition to simple columnar with cilia and few goblet cells
3) bronchioles: transition to simple cuboidal with or without cilia, exocrine cells appear as they branch
4) alveoli: type I/II alveolar cells

90
Q

respiratory lamina propria proximal to distal

A

1) trachea: loose CT
2) bronchi: loose CT
3) bronchioles: thin or indistinct
4) alveoli: none

91
Q

respiratory secretory cells proximal to distal

A

1) trachea: seromucous glands in submucosa
2) bronchi: seromucous glands in submucosa
3) bronchioles: bronchiolar exocrine cells
4) alveoli: type II alveolar cells

92
Q

respiratory cartilage rings proximal to distal

A

1) trachea: c-shaped, joined by annular ligaments
2) bronchi: incomplete, irregular plates
3) bronchioles: none
4) alveoli: none

93
Q

respiratory smooth muscle proximal to distal

A

1) trachea: trachealis (at free ends of cartilage)
2) bronchi: discontinuous layer, more prominent as bronchi branch
3) bronchioles: prominent, large layer –> thin, indistinct, small layer
4) alveoli: none

94
Q

respiratory adventitia proximal to distal

A

1) trachea: loose CT
2) bronchi: loose CT
3) bronchioles: merges with submucosa
4) alveoli: none

95
Q

pleura

A
  • serous membrane lining wall of pleural cavity and lungs
  • mesothelium: simple squamous epithelium attached to loose areolar CT
  • layers: parietal pleura, pleural cavity (small, with pleural fluid), visceral pleural
96
Q

pleural cavity

A
  • contains transudate (pleural fluid) for lubrication and tension between membranes
97
Q

pleural recesses

A
  • spaces left behind in pleural cavity to accommodate expansion of lungs during inhalation
    1) costodiaphragmatic recess: around costal edge of base of lung
    2) costomediastinal recess: extension of cavity between sternum and mediastinum
98
Q

pleural effusion

A
  • excess fluid in pleural space, shows up as white on x-ray instead of black (empty air)
  • two types:
    1) transudative pleural effusion: caused by changes in hydrostatic pressure, leads to excess fluid
    2) exudative pleural effusion: inflammatory conditions, infection, lung injury or tumour, leads to excess fluid, protein and immune cells –> additional spaces in endothelial cells
99
Q

lung structure

A
  • cone shape with apex above clavicle and base
  • lobes separated by deep fissures
  • right lung: superior, middle, inferior lobe
  • left lung: superior, inferior
100
Q

lung lobe surfaces

A

1) costal: contact with ribs (anterior, lateral and posterior)
2) mediastinal: medial surface
3) diaphragmatic: base, close to diaphragm

101
Q

lung fissures

A

1) horizontal: separates superior and middle (right lung)
2) oblique: separates middle and inferior (right) or superior and inferior (left)

102
Q

root of the lung

A
  • contained in the hilus
  • consists of primary bronchi, pulmonary arteries, veins, nerves and lymphatics enclosed in CT
103
Q

hilus arrangement in R/L lung

A
  • right: veins inferior, arteries anterior to primary bronchi
  • left: artery most superior, primary bronchus, veins inferior to other two
104
Q

grooves and impressions in lung

A
  • right: posterior esophageal impression
  • left: posterior groove for aorta, anterior cardiac impression and cardiac notch
105
Q

thorax bones

A
  • 12 pairs of ribs (flat bones) and costal cartilages
  • 12 thoracic vertebrae and intervertebral disks
  • sternum
106
Q

sternum structure

A

1) manubrium: articulates with clavicles
2) body
3) xiphoid process

107
Q

intercostal space

A

between ribs

108
Q

costal margin

A

formed by bottom of rib cage

109
Q

types of ribs

A

1) true ribs (1-7): attach directly to sternum via a costal cartilage
2) false ribs (8-12): attach indirectly (not their own costal cartilage to sternum OR lack attachment
3) (false) floating ribs (11-12): no anterior attachment or tubercular facets

110
Q

typical rib structure

A

1) head: has two articular facets that articulate with body of thoracic vertebrae
2) neck
3) tubercle: has tubercular facet to articulate with transverse process of thoracic vertebra (corresponding)
4) angle
5) costal groove: internal aspect, protects blood vessels and nerves
5) body
6) costal cartilage (for most)

*applies to ribs 3-9

111
Q

what permits movement of thoracic wall?

A

articulations of ribs and thoracic vertebrae (synovial joints)

112
Q

superior/inferior thoracic aperture

A
  • superior: bordered by T1, 1st ribs and superior border of manubrium + contains trachea and blood vessels
  • inferior: bordered by T12, ribs 11/12, costal margins and xiphisternal joint + closed off by diaphragm
113
Q

attachments of rib cage

A

1) jugular notch
2) clavicular notch: clavicle
3) sternal angle: manubrium and body articulate, forms protrusion
4) costal notches: attachment of costal cartilage
5) xiphisternal joint: body and xiphoid process articulate, has limited movement
6) diaphragm attachment

114
Q

thoracic wall muscles

A
  • occupy and support intercostal spaces
  • overlap each other and fibers run in different directions for added strength

1) external intercostals: do not attach to sternum, fibers run inferiorly and anteriorly, elevate ribs during inhalation
2) internal intercostals: start from sternum, fibers run inferiorly and posteriorly, depress ribs during FORCED exhalation
3) innermost intercostals

115
Q

costal groove

A
  • contains VAN (vein, artery, nerve –> superior to inferior)
  • between inner and innermost intercostals
116
Q

arteries of thoracic wall

A

1) thoracic aorta
2) subclavian artery (branches off brachiocephalic)
3) internal thoracic arteries: anterior aspect inside thoracic wall, arises from 1)
4) anterior and posterior intercostal arteries: from 1) and 3), in costal groove, ant/pos anastomose with each other for collateral circulation
5) subcostal artery (last artery)

117
Q

veins of thoracic wall

A

1) internal thoracic vein: drains blood anteriorly into brachiocephalic vein and superior vena caba
2) anterior and posterior intercostal veins: most (posterior) drain into azygos venous system
3) subcostal vein
4) azygos and hemiazygos veins: drain back and thoracoabdominal walls and viscera, pathway between SVC and IVC

118
Q

azygos venous system

A

1) right intercostal veins drain into azygos
2) left intercostal veins drain into hemiazygos, then azygos
3) azygos drains into superior vena cava

119
Q

lymphatic drainage in thoracic wall

A
  • lymphatics throughout drain thoracic wall into thoracic duct
120
Q

inhalation mechanism

A
  • thoracic cavity dimensions and intrathoracic volume increases
  • draws air in because of pressure drop
  • structure of pleura and lungs enable this to occur: pleural fluid creates tension between membranes, inherent elasticity of lungs allow expansion to remain in contact with thoracic wall
  • diaphragm contracts (flattens)
121
Q

exhalation mechanism

A
  • typically passive process: recoil of lungs and relaxation of muscles
  • intrathoracic volume decreases, expelling air out
122
Q

movements of thoracic wall during inhalation

A
  • diaphragm (flattens) and external intercostals (elevates ribs and sternum) contract
  • vertical changes: diaphragm flattens
  • lateral changes: ribs elevated, thoracic cavity widens
  • anterior/posterior changes: inferior portion of sternum moves anteriorly
123
Q

movements of thoracic wall during exhalation

A
  • passive process
  • vertical changes: diaphragm relaxes, moves up, thoracic cavity narrows
  • lateral changes: ribs depressed, thoracic cavity narrows
  • anterior-posterior changes: inferior portion of sternum moves posteriorly
124
Q

diaphragm structure

A
  • forms floor of thoracic cavity
  • muscle fibers arranged radially and insert into central tendon
  • space for inferior vena cava, esophagus and aorta (posterior)
  • crura: attach diaphragm to lumbar vertebrae
125
Q

diaphragm action and innervation

A
  • contraction increases vertical dimension of thoracic cavity
  • innervated by phrenic nerves (C3-C5)
126
Q

structures that pass through diaphragm

A

1) internal vena cava: between right dome and pericardial sac
2) esophagus: behind pericardial sac, in front of thoracic vertebra
3) aorta: between thoracic vertebra and left dome

127
Q

accessory muscles of respiration

A
  • attached to thoracic wall and could be involved in breathing
128
Q

neural control of respiration

A
  • rate/depth of breathing matched with tissue oxygen and CO2 removal demands
  • controlled by brainstem nuclei (pons and medulla)

1) posterior respiratory group (medulla): efferent fibers control inspiration
2) anterior respiratory group (medulla): efferent fibers coordinate innervation of both inspiratory and expiratory muscles
3) CN IX/X (to medulla): modulate feedback based on input from baroreceptors and chemoreceptors
4) pontine respiratory group: receives higher level input (cerebral cortex, limbic system, hypothalamus), outputs to medulla to adjust respiratory pace –> some voluntary control

129
Q

heart as a double pump

A
  • right side: conveys blood through pulmonary circuit
  • left side: conveys blood through systemic circuit
  • both sides at the same time
130
Q

arteries vs veins

A

arteries carry blood away from heart, veins towards heart

131
Q

heart chambers

A

two atria superior to two ventricles

132
Q

heart position

A
  • left of midline in middle mediastinum
  • oblique angle to longitudinal axis of body (slightly rotated to left)
133
Q

heart shape

A
  • base of heart = posterior surface
  • apex located in 5th intercostal space
134
Q

pericardium

A
  • surrounds heart and roots of the great vessels
  • two parts: outer fibrous pericardium and inner serous pericardium (two layers)
  • function: stabilize position of heart and prevents overfilling (bc attached to other structures, ex. fibrous attached to diaphragm)
135
Q

serous pericardium

A

1) visceral layer: attaches to heart
- potential space (pericardial cavity) containing pericardial fluid (lubrication) between layers
2) parietal layer: attaches to fibrous pericardium

136
Q

components of heart wall

A

superficial to deep:
(parietal layer of serous pericardium: mesothelium, areolar CT and pericardial cavity)
1) epicardium (visceral layer of serous pericardium): mesothelium and areolar CT
2) myocardium: cardiac muscle tissue
3) endocardium: unique endothelium and areolar CT

137
Q

heart surfaces

A

1) right pulmonary surface: formed by right atrium
2) anterior surface: majority right ventricle
3) left pulmonary surface: left ventricle
4) diaphragmatic surface

138
Q

external heart sulci

A

1) coronary sulcus: between atria and ventricles, location of fibrous skeleton
2) anterior/posterior interventricular sulci: between ventricles, overlie interventricular septum

139
Q

anterior external heart

A

1) right atrium
2) right auricle (flap)
3) right ventricle
4) left ventricle
5) left auricle

  • cannot see left atrium
140
Q

posterior external heart

A

1) left atrium
2) right atrium
3) left ventricle
4) right ventricle

141
Q

right heart input/output

A

input: deoxygenated blood to right atrium
1) superior vena cava: drains head and upper limbs
2) inferior vena cava: below diaphragm
3) coronary sinus: heart wall
output: from right ventricle
1) pulmonary trunk
2) continues to right and left pulmonary arteries –> lungs

142
Q

left heart input/output

A

input: oxygenated blood to left atrium
1) right and left pulmonary veins (two on each side)
output: from left ventricle
1) ascending aorta
2) aortic arch
3) descending aorta

143
Q

heart borders

A

1) right border: right atrium
2) left border: left ventricle
3) inferior border: mostly right ventricle, a little left ventricle

144
Q

internal right atrium

A

1) input vessels: SVC, IVC, coronary sinus
2) interatrial septum
3) fossa ovalis: remnant of embryonic foramen ovale
4) pectinate muscles: create rough wall
5) crista terminalis: line dividing smooth and rough parts of atrium

145
Q

embryonic foramen ovale

A
  • direct connection between right and left atrium
  • no need for pulmonary circulation as an embryo
146
Q

internal right ventricle

A

1) right atrioventricular valve (tricuspid) cusps (3)
2) septomarginal trabecula: extend from septum, attach to papillary muscles and trabeculae carnea
3) pulmonary semilunar valve cusps
4) conus arteriosus

147
Q

atrioventricular valve structures

A

1) cusps attach to chordae tendineae
2) attach to papillary muscles
3) traveculae carneae: rough inner wall (no smooth parts in ventricle)

148
Q

atrioventricular valve cusp function

A
  • like a parachute: chordae tendinae are strings attached to the papillary muscle (person) –> prevent cusps from everting
  • cusp pulled taut in a curved shape
149
Q

semilunar valve cusp function

A
  • curved shape causes blood to pool in the closed cusps
150
Q

internal left atrium

A

1) left atrioventricular valve (bicuspid or mitral) cusps (two)
2) interatrial septum: smooth wall
3) left auricle: lined with pectinate muscles (rough)

151
Q

internal left ventricle

A

1) aortic semilunar valve cusps

152
Q

aorta vs pulmonary trunk

A

aorta has openings of coronary arteries early on (oxygenated blood goes to heart first)

153
Q

why is LV wall thicker than RV?

A
  • higher force needed to pump to entire body, not just lungs
154
Q

valve primary function

A
  • ensure unidirectional flow of blood
155
Q

fibrous skeleton of heart

A
  • structural foundation for heart valves
  • attachment for myocardium
  • electrical insulation of atrial myocardium from ventricular (precise coordination of contraction)
156
Q

fibrous skeleton components

A

1) pulmonary fibrous ring (anterior): pulmonary semilunar valve
2) aortic fibrous ring (posterior): aortic semilunar valves
3) left atrioventricular fibrous ring
4) right atrioventricular fibrous ring

157
Q

coronary vessels (arteries)

A

two major branches:
1) left coronary artery bifurcates almost immediately into circumflex artery and anterior interventricular artery
- circumflex: LA/LV
- anterior interventricular: 2/3 IV septum of LV, anterior wall of LV/RV, connects with posterior interventricular artery at apex
2) right coronary artery gives rise to right marginal artery and posterior interventricular artery, supplies RA/RV
- right marginal: RV
- posterior interventricular artery: posterior 1/3 of IV septum, posterior RV/LV

158
Q

coronary vessels (veins)

A

1) great cardiac vein: drains areas supplied by anterior interventricular artery –> drain into coronary sinus
2) small and middle cardia veins: drains RCA area –> drain into coronary sinus
3) anterior cardiac vein: anterior RV –> drain directly into RA

159
Q

recognizing coronary vessels

A
  • thick wall = aorta
  • thinner wall = pulmonary vein
  • big, dilated vessel near left side = coronary sinus
160
Q

conducting system of heart

A

1) sinoatrial node (pacemaker): automatically depolarize, impulses travel through internodal pathways to…
2) atriovenricular node: impulse slows, atria contract (superior to inferior), fibrous skeleton insulates ventricles from atrial depolarization
3) atrioventricular bundle branches into…
4) L/R bundle branches: conduct impulse through interventricular septum, right bundle transmits to septomarginal trabecula
5) subendocardial plexus: impulse goes upwards from apex, distributed to ventricular myocardium

161
Q

heart innervation

A
  • autonomic nervous system innervates both SA/AV nodes and myocardium via cardiac plexus
  • SNS: increase HR through NE release
  • PNS: decrease HR through Ach release (vagus nerve)
  • cardiac centers in medulla control based on input from baroreceptors and chemoreceptors
162
Q

cardiac cycle

A

1) atrial systole: AV valves open, blood enters ventricles (relaxed)
2) atrial diastole: continues until start of next cycle
3) ventricular systole 1st phase: contraction closes AV valves (“lub”)
4) ventricular systole 2nd phase: ventricular BP rises, SL valves open
5) early ventricular diastole: ventricular BP drops until reverse blood flow closes SL valve (“dub”), passive atrial filling
6) late ventricular diastole: passive ventricular filling, all chambers relaxed

163
Q

aortic valve regurgitation

A
  • aortic valve that does not fully close
  • blood leaks back through during ventricular diastole
  • enlarged LV wall to cope with increased afterload

ANA300 (3 decks)

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