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Anatomy > Thoracic Cavity > Flashcards

Thoracic Cavity Flashcards

1
Q

the chest cavity is bounded by the ____ and below by the _____

A

bound by chest wall and inferiorly to diaphragm

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2
Q

superiorly the thoracic cavity extends _____ and inferiorly the thoracic cavity goes to the _____

A

superiorly the thoracic cavity extends upward into the root of the neck about one finger-breadth above the clavicle on each side. Inferiorly the chest cavity goes to the diaphragm

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3
Q

the chest cavity divided by a median partition called the ____ and laterally placed by ____

A

median partition is the mediastinum, laterally placed by the pleurae and lungs

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4
Q

the sternal angle is used to find the position of rib _____ as a reference for counting ribs.

A

rib 2

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5
Q

The sternal angle separates the _____ from the ______ mediastinum. It also marks the position of the superior limit of the ____ and where _____ begins and ends. The sternal angle also has what structure in the area aortic arch and pulmonary arch? it used to old remnant

A

the sternal angle (position of rib 2) separates the superior mediastinum from the inferior mediastinum. It marks the position of the superior limit of the pericardium and also marks where the arch of the aorta begins and ends. the ligamentum arterosium also here

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6
Q

the sternal angle marks the superior limit of the _____ trunk. Also has the connection to the aortic arch called

A

pulmonary trunk, the connection of pulmonary trunk to aortic arch is the ligamentum arterosium

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7
Q

the sternal angle is found at rib __ and creates the ____ plane when it transverses between the IVDs of what vertebrae

A

rib 2, creates the transverse thoracic plane as it goes posteriorly to pierce the IVD between T4 and T5

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8
Q

the sternal angle marks the _____ of the trachea into the _____

A

bifurcation of trachea into left and main bronchi

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9
Q

the sternal angle marks the passage of the ____ from right to left posterior to the esophagus

A

thoracic duct

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10
Q

the sternal angle passes through the site the _____ penetrates the pericardium to enter the heart

A

superior vena cava

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11
Q

the sternal angle has this nerve through it

A

the loop of left recurrent laryngeal nerve around aortic arch

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12
Q

the mediastinum houses all of the organs between

A

the left and right mediastinal pleurae

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13
Q

the extent of anteroposterior mediastinum

A

extends from the sternum anteriorly to the vertebral column posteriorly

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14
Q

the extent of superoinferior mediastinum

A

superiorly from thoracic inlet to diaphragm inferiorly

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15
Q

the demarcation of mediastinum aka the transverse thoracic plane is marked by what

A

mediastinum divided into superior and inferior mediastina by imaginary plane passing from sternal angle anteriorly to the lower border of body of T4 posteriorly

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16
Q

the inferior mediastinum is divided into:

A

anterior, middle, and posterior

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17
Q

is the superior mediastinum divided?

A

no, just inferior mediastinum. Into anterior, middle, and posterior

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18
Q

the superior mediastinum is bounded by?

A

Superior: thoracic inlet

inferior: plane extending from level of sternal angle anteriorly to lower border of T4 vertebra posteriorly (transverse thoracic plane)
anterior: the manubrium sterni
posterior: the first four thoracic vertebrae T1-T4

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19
Q

superficial/anterior contents of superior mediastinum?

A

-thymus

large veins:
- left brachiocephalic vein and right brachiocephalic vein, -superior vena cava

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20
Q

middle contents of superior mediastinum?

A
  • aortic arch and 3 branches
  • phrenic nerve
  • vagus nerve
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21
Q

posterior contents of superior mediastinum?

A

trachea, esophagus, thoracic duct

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22
Q

the inferior mediastinum is bounded by?

A

bounded in front of the body of the sternum and behind by the lower eight thoracic vertebrae T5-T12

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23
Q

the anterior aspect of the inferior mediastinum is located and contains?

A

located: between posterior body of the sternum and attached costal cartilages and goes to the pericardium
contains: fat, remnants of thymus gland, anterior mediastinal lymph nodes

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24
Q

the middle aspect of the inferior mediastinum is located and contains?

A

located: between anterior mediastinum and posterior mediastinum
contains: heart and pericardium, beginning or termination of great vessels, phrenic nerves, pericardiophrenic vessels, lymph nodes

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25
Q

the posterior aspect of the inferior mediastinum is located and contains?

A

located: posterior to heart and pericardium, anterior to vertebrae T5-T12
contains: esophagus, vagus nerve, thoracic aorta, azygos system of veins, thoracic duct, thoracic sympathetic trunk, posterior mediastinal lymph nodes

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26
Q

the pleurae and lungs lie ______ within the ______

A

on either side of the mediastinum within the chest cavity

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27
Q

each pleura has two parts which are:

A

the parietal layer and the visceral layer

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28
Q

the two layers of the pleura are continuous with each other by the means of ?

A

a cuff of pleura

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29
Q

the pleura cuff surrounds ______ and hangs down as a loose fold called _______

A

the cuff surrounds the structures entering and leaving the lung at the hilum of each lung. The pleural cuff hangs down as a loose fold called the pulmonary ligament

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30
Q

the parietal pleura lines _____ and covers ________ it extends into the root of the ________ to line the undersurface of the ________ at the thoracic outlet

A

the parietal pleura lines the thoracic wall, covers the thoracic surface of the diaphragm and the lateral aspect of the mediastinum. It extends into the root of the neck to line the undersurface of the supra-pleural membrane (Sibson’s fascia) at the thoracic outlet/inlet

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31
Q

the visceral layer of pleura covers _____ and extends into?

A

completely covers the surface of the outer surface of the lungs and extends into the depths of the interlobar fissures

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32
Q

the pleural cavity or space are formed by _____. clinicians use the term pleural _____ instead of anatomic term _______. The pleural cavity contains _____ called ______. The fluid permits the two layers to _____ with minimum______

A

the pleural cavity- anatomical term
pleural space- clinical term

is a slitlike space formed by the seperation of the parietal and visceral layers.

Inside the space or cavity is the pleural fluid which is a thin film of tissue fluid

the fluid allows movement between the layers on each other with minimum friction

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33
Q

the parietal pleura is divided into:

A

the region in which it lies or the surface it covers

cervical
costal
diaphragmatic
mediastinal

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34
Q

the cervical parietal pleura extends where? what does it line?

A

the cervical pleura extends up into the neck, it lines the undersurface of the supra-pleural membrane (Sibson’s Fascia). It reaches a level of 1-1.5 inches or 2.5-4 cm above the medial third of the clavicle

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35
Q

the costal parietal pleura lines what structures?

A

it lines the inner surfaces of the:

  • ribs
  • costal cartilages
  • intercostal spaces
  • sides of the verterbral bodies
  • back of the sternum
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36
Q

the diaphragmatic parietal pleura covers?

A

covers the thoracic surface of diaphragm

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37
Q

in quiet respiration, the ____ and ____ pleurae are in apposition to each other below the ________ of the lung. These two pleura ______ during _____ inspiration.

A

the diaphragmatic and costal pleurae are in apposition to each other below the lower border of the lung. These two pleura separate during deep inspiration.

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38
Q

the costophrenic aka costodiaphragmatic recess is?

A

the lower area of the pleural cavity into which the lung expands on inspiration is referred to as the costodiaphragmatic recess

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39
Q

the mediastinal parietal pleura covers:

A

it covers and forms the lateral boundary of the mediastinum. It is reflected as a cuff around the vessels and bronchi at the hilum of the lung. It then continues with the visceral pleura.

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40
Q

each lung lies free except at the ____ , it is attached to the _____ that constitute to lung _____

A

hilum, it is attached to the blood vessels and bronchi that constitute the lung root

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41
Q

during full inspiration, the lungs?

A

the lungs expand and fill the pleural cavities

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42
Q

during quiet inspiration, the lungs _____ occupy the pleural cavities at four sites, which are _____?

A

they do not fully occupy the pleural cavities at four sites,

  • the right and left costodiaphragmatic recesses
  • the right and left costomediastinal recesses
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43
Q

the costodiaphragmatic recesses are ____ and are separated only by ____

A

they are slitlike spaces between the costal and diaphragmatic parietal pleurae, separated only by a capillary later of pleural fluid

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44
Q

during inspiration, the lower margins of the lungs do what?

A

the lower margins of the lungs descend into the recesses

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45
Q

during expiration, the lower margins of the lungs do what?

A

the lower margins of lungs ascend so that the costal and diaphragmatic parietal pleurae come together again

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46
Q

the costomediastinal recesses are situated where? What are they? Separated by what?

A

They are situated along the anterior margins of the pleura. They are slitlike spaces between the costal and the mediastinal parietal pleurae. Separated by a capillary layer of pleural fluid

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47
Q

during inspiration and expiration what do the lungs do in the costomediastinal recesses?

A

the anterior borders of the lungs slide in and out of the recesses

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48
Q

the parietal pleura is sensitive to ?

A

pain, temperature, touch, and pressure

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49
Q

the costal pleura is segmentally supplied by what nerve(s)

A

the intercostal nerves

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50
Q

the mediastinal pleura is supplied by what nerve?

A

the phrenic nerve

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51
Q

the diaphragmatic pleura is supplied by what nerve?

A

the pleura over the domes of diaphragm are supplied by the phrenic nerve.

the periphery of the diaphragmatic pleura is supplied by the lower 6 intercostal nerves (spinal nerves T7-12)

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52
Q

the lungs are describe, located where, color, and shape?

A

a pair of soft, spongy, elastic structure in the thoracic cavity.

The lie on each side of the mediastinum.

In child they are pink but becomes darker with age with the inhalation of dust particles.

the shape: each lung is conical covered with visceral pleura and suspended free in its own pleural cavity

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53
Q

the apex of lung is what shape

A

blunt, but comes to blunt point

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54
Q

the base of lung sits on what

A

the diaphragm

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55
Q

the costal surface of the lung corresponds to_____ the mediastinal surface contains a depression called the ______ which is a passage way for what structures?

A

The costal surface corresponds to the chest.

The mediastinal surface contains a depression called the hilum in the middle. The hilum is a passageway for the bronchi, vessels, and nerves to enter and leave the lung through the hilum

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56
Q

the anterior border of the lung

A

left lung is thin and overlaps the heart, has cardiac notch

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57
Q

the posterior border of the lung

A

is thick, rounded, and lies beside the vertebral column

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58
Q

each lung is divided into ____. Each _____ bronchus, which passes to a lobe of the lung, gives off branches called _____ bronchi.

A

each lung is divided into lobes. Each lobar or secondary bronchus, which passes to a lobe of the lung, gives off branches called segmental or (tertiary) bronchi.

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59
Q

each segmental bronchus passes to a structurally and functionally independent unit of a lung lobe called a ______ which is surrounded by ______. On entering a BPS, each ______ divides repeatedly.

A

segmental bronchus forms the bronchopulmonary segments which is functionally independent and is surrounded by connective tissue

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60
Q

bronchopulmonary segments summarized as what?

A
  • subdivision of a lung lobe
  • pyramid shaped with apex toward the lung root
  • surrounded by connective tissue
  • has a segmental bronchus, a segmental artery, lymph vessels, and autonomic nerves
  • the segmental vein lies in the connective tissue between adjacent bronchopulmonary segments
  • because it is a structural unit, a diseases segement can be removed surgically
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61
Q

the right lung lobes are ___ than the left and are divided by the ______ and _____ fissures? what separates what

A

the right lung is larger and the lobes are divided by the oblique and horizontal fissures. The horizontal fissure is most superior and creates superior and middle lobe. The oblique fissure is oblique in orientation and separates the middle lobe and lower lobe

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62
Q

the superior lobe of R lung has what segments?

A

apical, posterior, and anterior

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63
Q

the middle lobe of R lung has what segments?

A

lateral and medial

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64
Q

the inferior lobe of R lung has what segments?

A

superior (apical), medial basal, anterior basal, lateral basal, and posterior basal

  • note, same as inferior lobe of L lung
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65
Q

the left lung is divided by an _____ fissure into ______ lobes, the ______. There is no _____ fissure in the left lung.

A

left lung divided into 2 lobes by the oblique fissure, the upper and lower lobes. There is no horizontal fissure in the left lung.

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66
Q

the superior or upper lobe of left lung divided into what segments

A

apical, posterior, anterior,

superior lingual, and inferior lingual

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67
Q

the inferior or lower lobe of left lung divided into what segments

A

superior (apical), medial basal, anterior basal, lateral basal, and posterior basal

-note, same as inferior lobe of R lung

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68
Q

the root of the lung is formed by structures that are _____ the lung, which are what structures? the root is surrounded by what?

A

formed by structures entering and leaving.

They are:

1 pulmonary artery, 2 pulmonary veins, 1 main bronchus, bronchial vessels, nerves, and lymphatics

the root of the lung is surrounded by a tubular sheath of pleura which joins the mediastinal parietal pleura to the visceral pleura covering the lungs

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69
Q

blood supply to the bronchi, connective tissues of the lung and visceral pleura supplied by what____ which is a branch of ____

A

supplied by bronchial arteries which are branches of the thoracic aorta

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70
Q

the bronchial vein drain into?

A

into the azygos and hemiazygos vein

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71
Q

___ pulmonary veins leave each lung root to empty into the ____

A

2 pulmonary veins leave each lung root to empty into the left atrium of heart

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72
Q

the right bronchial artery originates from

A

the 3rd posterior intercostal artery or the upper left bronchial artery

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73
Q

the two left bronchial arteries come from?

A

both from the anterior surface of the thoracic aorta.

the superior left bronchial artery; arises at vertebral level T5

the inferior left bronchial artery; arises below the left bronchus

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74
Q

nerve supply to bronchi

A

the pulmonary plexus composed of autonomic nerve fibers of sympathetic and parasympathetic from the vagus nerve

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75
Q

sympathetic efferent fibers produce what effect

A

bronchodialtion and vasoconstriction

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76
Q

parasympathetic efferent fibers produce what effect

A

bronchoconstriction, vasodilation, and increased glandular secretion

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77
Q

afferent supply from _____ and from _____ receptors in the alveolar walls pass to the central nervous system in both ______ and _____ nerves

A

bronchial mucous membrane and from stretch receptors in the alveolar walls pass to the CNS in both sympathetic and parasympathetic nerves

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78
Q

lymph drainage of lungs divided into:

A

superficial and deep

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79
Q

superficial lymph drainage of lungs consists of

A
  • drainage of lung surface
  • lies beneath the visceral pleura and drains over the surface of the lung toward the hilum
  • drain into lymph vessels of the bronchopulmonary nodes
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80
Q

deep lymph drainage of lungs drains what and describe its course

A

the deep drainage drains the bronchial tree, pulmonary vessels, and connective tissues

  • travels along the bronchi and pulmonary vessels toward the hilum of the lung
  • passes through the pulmonary nodes located within the lung substance
  • the lymph then enters the bronchopulmonary nodes in the hilum of the lung
  • finally, into the bronchomediastinal trunk and to the thoracic duct, right lymphatic duct or brachiocephalic veins

note- lymph vessels are not present in alveolar walls

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81
Q

the pericardium is a _____ layered ______ that encloses the _____ and the roots of _______

A

double layered fibrous sac that encloses the heart and the roots of the great vessels

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82
Q

the two main functions of the pericardium?

A

the pericardium is to restrict excessive movements of the heart as a whole and to serve as a lubricated container in which the different parts of the heart can contract

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83
Q

the pericardium is located

A

in the middle mediastinum, about 1-1.5 cm to the right of the sternum, 5-7.5 cm to the left of the median plane at the level of the 5th intercostal space

84
Q

the boundaries of the pericardium, anterior and posterior

A

anterior: body of the the sternum and the 2nd to the 6th costal cartilages
posterior: 5th to 8th thoracic vertebrae

85
Q

the fibrous layer of the pericardium is and what is its function

A

the strong outer layer, composed of tough fibrous tissue. It protects the heart against sudden overfilling

86
Q

serous layer is a transparent membrane with how many layers and what are they?

A

the inner transparent membrane has 2 layers the parietal and visceral layer

87
Q

superiorly the fibrous layer of pericardium is pierced by which structures and becomes fused with?

A

the superior border of the pericardium is pierced by the aorta, pulmonary trunk, and superior vena cava

it becomes fused with the central tendon of the diaphragm

88
Q

interiorly the fibrous layer of pericardium rests on _____ and is fused with_______

A

the inferior border rests on the diaphragm and is fused with the central tendon of the diaphragm

89
Q

anteriorly the fibrous layer is attached to the?

A

the anterior pericardium is attached to the posterior surface of sternum by condensations of connective tissue called the sternopericardial ligaments

90
Q

posteriorly the fibrous pericardium is pierced by which structures? and fuses with the ?

A

pierced by the pulmonary veins and inferior vena cava. it fuses with the tunica adventitia of these vessels (the aorta, the pulmonary trunk, the superior and inferior vena cava, and the pulmonary veins)

91
Q

the parietal layer of the serous layer of the pericardium lines what and becomes what?

A

the parietal layer lines the fibrous pericardium and becomes continuous with the visceral layer around the roots of the great vessels

92
Q

the visceral layer of the serous layer of the pericardium lines what and becomes what?

A

the visceral layer reflected onto the heart or closely applied to the heart is often called the epicardium which is the external layer of the heart wall (epicardium)

93
Q

the two layers of the _____ are continuous with each other at the base of the _____

A

the two laters of the serous membrane of the pericardium are continuous with each other at the base of large vessels

94
Q

the pericardial cavity lies between _______ and contains a thin _______ of which helps in frictionless movement of the heart (about how much?)

A

the pericardial cavity is potential space that lies between parietal and visceral pericardium. It contains a small amount of serous fluid called the pericardial fluid, about 50 mLs

95
Q

the pericardial sinuses develop when?

A

during the folding of embryonic heart

96
Q

the two pericardial sinsues are the _____ and______

A

transverse and oblique sinus

97
Q

the transverse sinus is located where and communicates with what where?

A

the transverse sinus lies posterior to the ascending aorta and pulmonary trunk, anterior to the superior vena cava

it communicates with the main part of the pericardial cavity at its right and left ends

98
Q

the oblique sinus is what and is located where? it is produced by what?

A

the oblique sinus is an inverted U-shaped blind recess that lies posterior to the heart extending posterior to the left atrium, can be entered inferiorly

it is produced by the reflection of pericardium onto the pulmonary veins and inferior vena cava

99
Q

the fibrous pericardium is innervated by

A

the phrenic nerve

100
Q

the parietal pericardium is innervated by

A

the phrenic nerve

101
Q

the visceral pericardium is innervated by

A

sympathetic trunk and parasympathetic fibers of the vagus nerves

102
Q

the arterial supply to the fibrous pericardium is from what arteries

A
  • pericardiophrenic artery
  • musculophrenic artery (branches of internal thoracic)
  • pericardial branches of the bronchial, esophageal, and superior phrenic arteries
103
Q

the parietal layer of the serous pericardium is supplies by what arteries

A
  • pericardiophrenic artery
  • musculophrenic artery (branches of internal thoracic)
  • pericardial branches of the bronchial, esophageal, and superior phrenic arteries
104
Q

the visceral layer of the serous pericardium (epicardium) is supplied by what arteries

A

the coronary arteries

105
Q

the venous drainage of the pericardium is by which veins

A

veins are tributaries of the azygos system

pericardiophrenic veins also drain into the internal thoracic vein

106
Q

pericarditis

A

inflammation of the pericardium which results in build up fluid, pericardial effusion- accumulation of fluid in pericardial space (ie between visceral and parietal pericardium)

107
Q

cardiac tamponade

A

accumulation of fluid in the pericardial space, whether from bleeding, over production of pericardial fluid or other causes results in increased pericardial pressure and eventual progressively reduced ventricular filling, severe compression on the heart from build up of fluid in

slow accumulation of fluid can allow pericardium to stretch, can hold up to a liter of fluid in the space

fast accumulation, as with severe bleeding, allows no time for stretching of the pericardium and can lead to tamponade with as little as 100 mL of fluid

tamponade is a medical emergency, the complications include pulmonary edema, shock, and death unless the fluid is drained

108
Q

friction rub

A

the rubbing/friction of heart against the pericardium creates sound known as heart rub- signs of pericarditis

109
Q

pericardiocentesis

A

a wide bore needle may be inserted through the left 5th and 6th intercostal space near the sternum (area of cardiac notch). Intracardial injections are also given through this area

110
Q

the heart characteristics basic and location

A

the heart is a hollow muscular organ and has a conical or somewhat pyramid shape.

It lies within the pericardium in the mediastinum.

it is connected at its base to the great blood vessels but otherwise lies free within the pericardium. Although, the fibrous pericardium is connected to the diaphragm, the heart rises and falls with every breath

111
Q

the features of heart surface

A

the sternocostal (anterior) surface
diaphragmatic surface (inferior)
base (posterior surface)
apex

112
Q

the sternocostal surface of the heart is formed mainly by what chambers

A

the right atrium and right ventricle separated by the vertical atrioventricular groove

113
Q

the anterior inter-ventricular groove separates

A

the right ventricle from the left ventricle

114
Q

the diaphragmatic surface is formed mainly by what chambers separated by what structure

A

the diaphragmatic surface is formed mainly by the right and left ventricles separated by posterior interventricular groove, and a small part of the right atrium, into which the inferior vena cava opens

115
Q

the base (posterior surface of heart) is formed mainly by what chamber and opens to what structures, what is the shape? which way does it face?

A

the base or posterior surface of the heart is formed mainly by the left atrium, into which open the 4 pulmonary veins. It is quadrilateral in shape. Lies opposite the apex. Faces posteriorly, superiorly, and toward the right shoulder.

116
Q

the apex of the heart is formed by what structure

A

the left ventricle

117
Q

the apex of the heart is directed in which direction

A

directed downward, forward and to the left

inferiorly, anteriorly, and to left

118
Q

the apex of the heart is located?

A

located posterior to the left 5th intercostal space, 7-9 cm from the median plane just medial to the left midclavicular line

position varies slightly with the person’s position and the phase of respiration

119
Q

the apex is the point of what and can be _____ as well as palpated

A

the apex is the point of maximal pulsation of the heart (the apex can be seen as well as palpated)

120
Q

the right border of the heart is formed by

A

the right border is formed by the right atrium

121
Q

the left border of the heart is formed by

A

formed by left auricle above and the left ventricle below

122
Q

the inferior border is formed mainly by

A

the right ventricle and right atrium , also apex of left ventricle

123
Q

the superior border (where great vessels enter or leave the heart) is formed by the

A

formed by right and left auricles and superior part of right and left ventricle

124
Q

the chambers of the heart are divided into how many chambers by what structure

A

the heart is divided into 4 chambers by vertical septa

125
Q

the 4 chambers of the heart and their location

A
  • two atria superiorly, two ventricles inferiorly

- separated from each other by atrioventricular and inter-ventricular grooves

126
Q

_____ are the retrieving chambers

A

atria

127
Q

______ are the pumping chambers

A

ventricles

128
Q

the right atrium lies _____ to the left atrium

A

anterior

129
Q

the right ventricle lies ______ to the left ventricle

A

anterior

130
Q

right side of the heart contains _____ blood and the left side of the heart contains ______ blood

A

deoxygenated on right

oxygenated on left

131
Q

the right atrium has which features

A
  • external auricle
  • anterior coronary veins
  • opening for SVC and IVC
  • opening for coronary sinus (drains coronary veins)
  • fossa ovalis
  • pectinate muscles on atria wall
  • crista terminalis
  • leads into the tricuspid valve
132
Q

the right atrioventricular valve aka the tricuspid valve are made up of how many cusps, and what are they called. This valve is anchored by what surrounding structure.

A

the 3 cusps are

  • anterior (anterosuperior)
  • posterior (inferior)
  • septal

the valve is anchored by a surrounding fibrous ring (annulus)

133
Q

during ventricular systole, what attachments prevents prolapse of the valve leaflets into the right atrium and how does this mechanism work, and what happens if fails?

A

the attachments to the tendinous chords (chordae tendinae) which are attached to papillary muscles prevents prolapse of valve leaflets into the right atrium by arresting the leaflets exactly in contact with one another. If the cusps do not meet precisely during closure, they will leak and allow regurgitation of blood black to the RA.

134
Q

failure to open widely during ventricular diastole is known as what?

A

valve stenosis

135
Q

the right ventricle characteristics

A
  • deoxygenated blood from the RA enter the RV through the tricuspid valve as it relaxes
  • the blood pumped into the lungs passing through the pulmonary semilunar valve via the pulmonary arteries
  • inside the right ventricle there are the chordae tendineae, papillary muscles, and trabeculae carnea
  • ventricular septum borders posteriorly
  • the conus arteriosus- the conical arterial pouch or infundibulum
136
Q

what is the conus arteriosus

A

conical arterial pouch or infundibulum of the heart found in the upper left corner of the ventricle and gives rise to the pulmonary artery, the tendon of the conus arteriosus is a fibrous band that extends superiorly from the right atrioventricular fibrous ring and stretches between the posterior surface of the conus arteriosus and the aorta

137
Q

size and volume vs RV and LV

A

can contain same amount of blood
RV is 3-6 thinner though in muscle wall
so LV is a-lot larger in mass, same volume inside

138
Q

the left atrium characteristics

A
  • now oxygenated blood leaves lungs through the pulmonary arteries and enters left atrium
  • the left atrium has an auricle on external surface
  • external surface has cornonary groove with circumflex artery and great cardiac vein
  • the 4 pulmonary veins open into the upper posterolateral surfaces of the left atrium, two on each side
  • the left atrial aspect of the septum has a characteristically rough appearance bounded by a crescentic appearance, concave upwards, which marks site of foramen ovale
  • the oxygenated blood then will leave through mitral valve
139
Q

which atrium is smaller

A

the left atrium is smaller in volume than the right but has thicker walls (3mm on average)

140
Q

the left ventricle characteristics

A
  • inlet region guarded by mitral valve or bicuspid valve
  • the left AV orifice admits atrial blood during diastole
  • chordae tendinae and papillary muscles
  • trabecular carneae
141
Q

the mitral valve, where located? how many cusps? controlled by?

A

the mitral valve, aka bicuspid valve, aka left AV valve

the mitral valve guards the left ventricle from regurgitation back to left atria

2 cusps, anterior and posterior

controlled by chordae tendineae and papillary muscles

142
Q

unlike the right ventricle, and the orifices of the left ventricle are _____ with ______ continuity between the cusps of the _____ and ______ valves

A

the orifices of the left ventricle are in close contact with each other with a fibrous continuity between the cusps of the mitral and aortic valves

143
Q

the inter-ventricular septum

A

separates right and left ventricle duh

144
Q

the fibrous skeleton of the heart is and what does it do

A

a set of connective tissue rings and extensions that

  • provides a strong framework for attachment of cardiac muscle fibers
  • physically separates atrial and ventricular myocardia and blocks the spread of myocardial excitation across the atrioventricular border (coronary sulcus)
  • supports all 4 heart valves by providing anchoring rings and also forms fibrous ribs in the semilunar valves
145
Q

the fibrous skeleton is comprised of these 3 components and where are they in location

A 
fibrous rings (annulus fibrosi) around valves and extensions into semilunar leaflets
fibrous trigones (trigona fibrosa)-between aortic valve and atrioventricular valves 
membranous portion of inter-ventricular septum (septum membranceum)
146
Q

the conducting system of the heart is an ____ conduction system made up of ______ which lead to contraction of ______ cells without the need of _______ impulses, in a regular continuous way

A 
intrinsic conduction system
made up of specialized epithelial cells
contract heart cells
without nerve impulses 
in a regular continuous way
147
Q

the conducting system of the heart includes these nodes/fibers, in what order

A 
SA node aka pacemaker 
AV node
AV bundle or Bundle of His
Bundle branches (RBB and LBB)
Purkinje Fibers
148
Q

the aortic semilunar valve has how many cusps and what are they

A

3

right coronary cusp, left coronary cusp, posterior cusp (non-coronary cusp)

149
Q

stenosis of aortic semilunar valve causes of _____ blood _____ of the valve and what does what to the left ventricle?

A

turbulence of blood and narrowingwhen listen to heart this sounds like

this causes left ventricle to increase in size to pump harder to push blood through narrowing (left ventricular hypertrophy)

this can lead to stages of heart failure

150
Q

the aortic semilunar valve characterisitis

A
  • aortic sinus: dilations of root of aorta just above leaflets
  • the 3 cusps: (RC, LC, posterior(non-coronary)
  • nodule: a fibrous reinforcement in the edge of each cusp. The three nodules meet in the middle when the valve close
  • lunule: thin memranous edge of cusp
151
Q

stenosis of aortic semilunar valve causes of _____ blood _____ of the valve and what does what to the left ventricle?

A

turbulence of blood and narrowing when listen to heart this sounds like whooshing- murmur

this causes left ventricle to increase in size to pump harder to push blood through narrowing (left ventricular hypertrophy)

this can lead to stages of heart failure

152
Q

the RBB course

A

runs along moderator band and anterior papillary muscle

153
Q

the LBB course

A

LBB runs down septal wall and then fans out on papillary muscles and extends fibers throughout the apical region

154
Q

fibrous tissue in coronary groove blocks conduction from ?

A

from atrium to ventricle

155
Q

the SA node is located

A

in the right atrium (wall of the right atrium in upper part of the sulcus terminalis just to the right of the opening of the SVC)

156
Q

the AV node is located

A

strategically placed on the lower part of the atrial septum just above the attachment of the septal cusp on the tricuspid valve

157
Q

AV node impulse course

A

the cardiac impulse is conducted from it to the ventricles by the atrioventricular bundle (bundle of his). The AV node is stimulated by the excitation wave as it passes through the atrial myocardium

158
Q

_____ infection must be treated because can cause immune reaction that attack valves of

A

streptococcal infection must be treated because can attack heart valves and kidney

159
Q

the AV bundle course and what it turns into

A

the AV bundle descends through the fibrous skeleton of heart and then descends behind the septal cusp of the tricuspid valve to reach inferior border of the membranous part of the ventricular septum. at the upper border it divides into two branches, one for each ventricle
RBB and LBB.

160
Q

the LBB course

A

pierces the septum and passes down its left side beneath the endocardium, it usually divides into two branches (posterior and anterior) which eventually become continuous with Purkinje plexus of left ventricle

161
Q

the impulses from the SA node to AV node travel ____ through a system of inter-nodal conduction, formed by 3 pathways which are?

A

travel rapidly via,

The anterior internodal pathway:
•leaves the anterior end of the sinuatrialnode and passes anterior to the superior vena cavalopening. •It descends on the atrial septum and ends in the atrioventricular node

  • The middle internodal pathway:
  • leaves the posterior end of the sinuatrialnode and passes posterior to the superior vena cavalopening.•It descends on the atria septum to the atrioventricular node.•

The posterior internodal pathway:
•leaves the posterior part of the sinuatrialnode and descends through the crista terminalis and the valve of the inferior vena cava to the atrioventricular node.

162
Q

blood supply to heart via

A

R and L coronary arteries

163
Q

the coronary ostium function to

A

the L coronary and R coronary ostium are above aortic valves, R and L cusps- they allow blood from aorta to supply the heart (L and R coronary arteries)

164
Q

the coronary arteries arise from

A

the ascending aorta immediately above the aortic valves

165
Q

the R coronary artery anastomoses with at what space

A

the circumflex artery which is a branch of the L coronary artery

166
Q

branches of RCA

A
  • SA node branch and atrial branches
  • R conus artery
  • Anterior ventricular branches (2-3), largest is marginal branch
  • R marginal branch (on anterior side)
  • posterior interventricular branch aka posterior descending artery (PDA
167
Q

the L coronary artery is ____ than the R

A

bigger, responsible for supplying most blood supply to heart

168
Q

the L coronary artery branches

A

-anterior interventricular artery aka left anterior descending artery, gives a small conus artery

  • the circumflex artery gives,
  • left marginal branch
  • anterior ventricular branch
  • posterior ventricular branch
  • atrial branches
169
Q

blockage to any of branches of the circumflex arteries, will cause

A

region will suffer ischemia and may lead to tissue damage,

170
Q

blockage of anterior ventricular branch will affect what region of the heart

A

the apex, left ventricle

171
Q

blockage of circumflex artery affect which area

A

outer side and posterior aspect of heart

172
Q

the SA node is supplied by what artery

A

the R coronary artery in most people, sometimes left

173
Q

the AV node is supplied by what artery

A

the R coronary artery

174
Q

the AV bundle aka bundle of His is supplied by what artery

A

R coronary artery

175
Q

the RBB supplied by what artery

A

L coronary artery

176
Q

the LBB supplied by what artery

A

L coronary and R coronary arteries

177
Q

coronary artery anastomoses of terminal branches of R and L arteries, but are not large enough for

A

Though anastomoses do exist between the terminal branches of the right
and left coronary arteries, but these are not large enough to compensate for
any sudden blockage of a large branch.
• A sudden blockage of the larger branches results in myocardial infarction.

178
Q

venous drainage of heart mostly via

A

most of blood drains into the R atrium through the coronary sinus

179
Q

the coronary sinus lies where and is a continuation of what structure? it opens into ?

A
  • Lies in the posterior part of the atrioventricular sulcus
  • Is continuation of the great cardiac vein
  • Opens into the right atrium to the left of the inferior vena cava
180
Q

the tributaries of the coronary sinus are

A
  • great cardiac vein
  • small cardiac vein
  • Middle cardiac vein
  • Posterior vein of the left ventricle
  • Oblique vein of the left atrium
181
Q

anterior cardiac veins drain mainly into the? smallest cardiac veins drain?

A

anterior cardiac veins: drain into R atrium

smallest cardiac vein: mostly to R atrium and ventricle

182
Q

The surface markings of the heart valves are as follows: The tricuspid valve lies behind and where do we place stethoscope?

A

The tricuspid valve lies behind the right half of the sternum opposite the 4th intercostal space.

listen left of sternum at 5th intercostal space (between ribs 5 and 6)

183
Q

the surface markings of the heart valves are as follows:

The mitral valve lies behind? where do we place stethoscope?

A

The mitral valve lies behind the left half of the sternum opposite the 4th costal cartilage.

listen at midclavicular line at 5th intercostal space (between ribs 5 and 6)

184
Q

the surface markings of the heart valves are as follows: The pulmonary valve lies behind? where do we place stethoscope?

A

The pulmonary valve lies behind the medial end of the third left costal cartilage and the adjoining part of the sternum.

listen left of sternum at 2nd intercostal space (between ribs 2 and 3)

185
Q

the surface markings of the heart valves are as follows: The aortic valve lies behind? where do we place stethoscope?

A

The aortic valve lies behind the left half of the sternum opposite the 3rd intercostal space.

listen on right side of sternum at 2nd intercostal space opposite side of pulmonary valve

186
Q

The trachea beginning and ending, whats the point of division called and what does it branch into?

A

• It begins in the neck as a continuation of the larynx at the lower border of the cricoid
cartilage (C6 level)

• Ends at the carina by dividing into right and left principal bronchi

its about 4.5 inch long in adult, 1 inch diameter

187
Q

trachea extent

A

• From 6th cervical vertebra to intervertebral disc between 4th and 5th thoracic vertebra
(level of sternal angle)

188
Q

During expiration the bifurcation rises by about

A

one vertebral level

189
Q

During deep inspiration: the bifurcation may be lowered as far as the

A

the 6th thoracic vertebra

190
Q

The fibroelastic tube is kept patent by the presence of

A

U-shaped bars (rings) of hyaline cartilage embedded in its wall

191
Q

The posterior free ends of the cartilage are connected by

A

smooth muscle, the trachealis muscle.

192
Q

at full exhalation, where carina of trachea at

A

above the IVD disc of T4 and T5 (know it rises above this level, no longer at the IVD disc level)

193
Q

relations of trachea in superior mediastinum: anterior, posterior, right and left sides?

A

The relations of the trachea in the superior mediastinum:

  • Anteriorly: •The sternum, the thymus, the left brachiocephalic vein, the origins of the brachiocephalic and left common carotid arteries, and the arch of the aorta.
  • Posteriorly: •The esophagus and the left recurrent laryngeal nerve.
  • Right side: •The azygos vein, the right vagus nerve, and the pleura.
  • Left side: •The arch of the aorta, the left common carotid and left subclavian arteries, the left vagus and left phrenic nerves, and the pleura.
194
Q

blood supply to trachea

A

The upper two thirds are supplied by the inferior thyroid arteries

the lower third is supplied by the bronchial arteries.

195
Q

sensory nerve supply to trachea

A

The sensory nerve supply is from the vagi and the recurrent laryngeal nerves.

196
Q

autonomic innervation to trachelais muscle

A

Sympathetic nerves supply the trachealis muscle

197
Q

lymph drainage of trachea

A

The pretracheal and paratracheal lymph nodes and the deep cervical nodes.

198
Q

The trachea bifurcates behind

A

The trachea bifurcates behind the arch of the aorta into the right and left principal (primary or main) bronchi

• The alveoli arise from the walls of the sacs as diverticula

199
Q

the bronchi divides giving rise to? that terminate where?

A

The bronchi divide giving rise to several million terminal bronchioles that terminate in one or more respiratory bronchioles.

200
Q

Each respiratory bronchiole divides into _____ ducts that enter the _____ sacs

A

Each respiratory bronchiole divides into 2 to 11 alveolar ducts that enter the alveolar sacs.

201
Q

The alveoli arise from the walls of the sacs as

A

diverticula

202
Q

Principal Bronchi of right vs left; size and orientation? clinical significance of orientation

A

The right principal (main) bronchus is wider, shorter, and
more vertical than the left and is about 1 in. (2.5cm) long.

any foreign objects going into trachea gonna go to R side because is more vertical oriented

The left principal (main) bronchus is narrower, longer, and more horizontal than the right and is about 2 in(5cm) long.

203
Q

Before entering the hilum of the right lung, the principal bronchus gives off ______

A

Before entering the hilum of the right lung, the principal bronchus gives off the superior lobar bronchus.

204
Q

On entering the hilum the R principal bronchus, it divides into what ?

A

a middle and an inferior lobar bronchus.

205
Q

the L main bronchus passes which structure

A

It passes to the left below the arch of the aorta and in front of the esophagus.

206
Q

On entering the hilum of the left lung, the L principal bronchus divides into

A

a superior and an inferior lobar bronchus.

Anatomy (12 decks)

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