Anatomy

Question 1

What are the structures present at the hilar of lung?

Answer 1

Pulmonary artery, main bronchus, pulmonary veins, pulmonary lymphatics and bronchopulmonary lymph nodes, pulmonary visceral afferents and autonomic motor nerves

Question 2

What is the condition caused by the pericardial cavity filling with blood and the pressure preventing cardiac contraction?

Answer 2

Cardiac Tamponade

Question 3

What is the posterosuperior space within the pericardial cavity called?

Answer 3

Transverse pericardical sinus

Question 4

Where does the apex beat shift to during cardiomegaly?

Answer 4

The left

Question 5

Where is the right coronary artery?

Answer 5

In the coronary groove boundary between the right atrium and right ventricle

Question 6

Where is the branch of the Left Anterior Descending (LAD)?

Answer 6

In anterior interventricular groove between the 2 ventricles

Question 7

What is the coronary sinus?

Answer 7

A short venous conduit (in the atrioventricular groove posteriorly) which receives deoxygenated blood from most of the cardiac veins and drains into the right atrium

Question 8

Where is the left (main stem) coronary artery?

Answer 8

In the atrioventricular groove

Question 9

In the ANS, where do the PRE sympathetic signals travel and emerge?

Answer 9

Travel down spinal cord and emerge via T1-L2/3

Question 10

Where do they parasympathetic signals travel?

Answer 10

Through CN III, VII, IX, X

Question 11

Where do POST sympathetic nerves emerge?

Answer 11

Through cardiopulmonary splanchnic nerves

Question 12

What makes up the cardiac plexus?

Answer 12

Sympathetic, parasympathetic and visceral afferents

Question 13

What is the one parasympathetic cardiopulmonary structure?

Answer 13

Pelvic splanchnic nerves

Question 14

How does the sympathetic system innervate?

Answer 14

Through the sympathetic chain

Question 15

How does the parasympathetic nerves innervate?

Answer 15

Through the walls of the organs

Question 16

What are the pre and post neurotransmitters in the sympathetic system?

Answer 16

pre- Ach……post- Noradrenaline

Question 17

What are the pre and post neurotransmitters in the parasympathetic system?

Answer 17

both Ach

Question 18

Although innervation is bilateral, which side predominates?

Answer 18

Left

Question 19

What is the difference between somatic and visceral pain?

Answer 19

Somatic- sharp, stabbing and localised

Visceral- dull and nauseating and location unknown

Question 20

Name some types of somatic pain

Answer 20

Muscular, joint, shingles, pleurisy, pericarditis

Question 21

What is radiating pain?

Answer 21

It spreads from the chest centre by originating in a somatic structure and passing along the affected dermatome.

Question 22

What is referred pain?

Answer 22

Pain at a single remote site- the somatic and visceral brain signals get “mixed up” and believes that the soma pain is organ pain

Question 23

In what lobe is the postcentral gyrus and is it sensory or motor?

Answer 23

Parietal and is it somatosensory

Question 24

In what lobe is the percentile gyrus and is it somatosensory or motor?

Answer 24

Frontal and somatomotor

Question 25

What is the AP pathways in post central and percentile gyrus'?

Answer 25

From elsewhere to post | From Pre to skeletal muscle

Question 26

Where in the brain does the visceral afferents travel to?

Answer 26

bilaterally to the thalamus and hypothalamus and then diffuse out of the cortex

Question 27

Where are the four most common places for coronary artery occlusion?

Answer 27

LAD, right coronary artery, circumflex branch of LCA, Left (main stem) coronary artery

Question 28

Name an area more vulnerable to ulceration of atheromatous plaque?

Answer 28

Carotid artery disease

Question 29

What is the thoracic inlet?

Answer 29

It is bound by ribs 1, T1 & jugular notch

Question 30

What is the transverse thoracic plane?

Answer 30

between sternal angle and T4/T5 intervertebral disc

Question 31

What are the contents of the anterior mediastinum?

Answer 31

Thymus

Question 32

What happens to the thymus during maturation?

Answer 32

In childhood it produces T lymphocytes and in adulthood it is replaced with adipose tissue

Question 33

What are the contents of the middle mediastinum?

Answer 33

Tracheal bifurcation, oesophagus, heart, pericardium, great vessels, thoracic duct

Question 34

What are the contents of the posterior mediastinum?

Answer 34

Azgous vein, sympathetic trunks, thoracic duct, oesophagus, thoracic aorta, vagal nerves and vagal trunks, trachea and bronchi (superior mediastinum)

Question 35

What is the azygous vein and its associated structures?

Answer 35

In right lung: arches anteriorly, superior to the lung root to drain into the SVC Intercostal veins drain posteriorly into the azygous vein

Question 36

What are the components of the aorta?

Answer 36

abdominal aorta, thoracic aorta, arch of the aorta, ascending aorta

Question 37

Where do the anterior and posterior mediastinal branches drain to?

Answer 37

Anterior thoracic aorta: many places such as bronchial arteries, mediastinal arteries, phrenic arteries Posterior: intercostal arteries (1 for each space)

Question 38

What do the brachiocephalic arteries supply?

Answer 38

arm and neck

Question 39

Where is lymph drained to?

Answer 39

Right and left venous angles

Question 40

Where are the right and left zones for lymph drainage?

Answer 40

Right: Right lung and arm area Left: all over

Question 41

Where is the venous angle?

Answer 41

Between the jugular vein and the subclavian vein

Question 42

How can metastases spread in pulmonary malignancy?

Answer 42

Through the lymphatics

Question 43

Where are the lymph nodes which drain lymph from the lungs?

Answer 43

Around the bifurcation of trachea: trachea-bronchial nodes | Around the main bronchus at the left lung root: bronchopulmonary lymph nodes

Question 44

What can rupture during chest trauma?

Answer 44

The thoracic duct

Question 45

What is the cisterna chyli?

Answer 45

The swollen start of the thoracic duct in the abdomen

Question 46

Where does the right phrenic nerve go?

Answer 46

Through the diaphragm with the ICV to supply the diaphragm from the inferior aspect

Question 47

Where does the left phrenic nerve go?

Answer 47

Pierces through the left dome of the diaphragm to supply it from the inferior aspect

Question 48

Name the aspects of the superior mediastinum anterior to posterior

Answer 48

Brachiocephalic veins, SVC, arch of the aorta, trachea, oesophagus, thoracic duct

Question 49

Name the superior mediastinum from lateral to medial

Answer 49

Phrenic nerves, vagus nerves, laryngeal nerves

Question 50

In what order do the lymph nodes drain?

Answer 50

1. Bronchopulmonary then Trachea-bronchial

Question 51

What are the central veins?

Answer 51

Large veins close to the heart where the pressure in the right atrium is approx the same

Question 52

Where are the central veins?

Answer 52

Internal jugular veins, subclavian, brachiocephalic, superior vena cava, RIGHT ATRIUM, inferior vena cava, iliac veins, femoral veins

Question 53

Where does the right recurrent larygneal nerve go?

Answer 53

Hooks under the right subclavian artery and does NOT enter the chest

Question 54

Where does the left recurrent laryngeal nerve go?

Answer 54

Hooks under the arch of the aorta and DOES enter the chest

Question 55

From medial to lateral, how are the veins positioned

Answer 55

Recurrent laryngeal then vagus then phrenic

Question 56

What happens when the vagus nerves have given off their recurrent laryngeal branches?

Answer 56

They only contain parasympathetic fibres

Question 57

What are the recurrent laryngeal nerves?

Answer 57

Branches of the vagus nerve that supply the pharynx and larynx

Question 58

What does the vagus nerve supply in terms of somatic sensory, motor and parasympathetic?

Answer 58

Somatic: palate, laryngpharynx and larynx Somatic motor: pharynx and larynx Parasympathetic: thoracic and abdominal organs

Question 59

What does the phrenic nerve supply in terms of somatic sensory, motor and parasympathetic?

Answer 59

motor: diaphragm sensory: mediastinal parietal pleura, fibrous pericardium, diaphragmatic parietal pleura, diaphragmatic peritoneum

Question 60

What is happening if a patient presents with "shoulder tip" pain?

Answer 60

eg lung abscess or inflammation of the gallbladder irritates the parietal peritoneum of the diaphragm (phrenic nerve) and the supraclavicular nerve enters the spinal cord at the same level as the phrenic, the brain "refers" the pain

Question 61

Name the arterial and venous supplies to the body wall

Answer 61

Cephalic vein, axillary artery and vein, subclavian artery&vein, internal thoracic artery&vein, anterior and posterior intercostal arteries, Great saphenous vein& and the musculo venous pump, Brachila, radial and ulnar arteries, Inferior epigastric, external iliac& femoral arteries and veins, Anterior and Posterior intercostal veins