Anatomy Flashcards
(123 cards)
1
Q
What are the boundaries of the superior thoracic aperture?
A
Posterior: Body of T1
Lateral: 1st pair of costae
Anterior: manubrium
2
Q
What are boundaries inferior thoracic aperture?
A
Posterior: T12
Lateral: 11th & 12th costae
Anterior: Xiphoid process, costal cartliage 7-10
Inferior: diaphrgam
3
Q
Describe the position of the diaphragm?
Function of
A
Right side - 5th intercostal space
Left side - 6th intercostal space
4
Q
What’s attached to the manubrium?
A
Clavicles. [Sternoclavicular joint]
1st pair of ribs
2nd pair of ribs
body of sternum. [Sternal angle]
5
Q
What’s attached to the body of the sternum?
A
Composed of 4 fused sternebrae
Manubrium
Costal cartliages 2-7
XIphoid process
6
Q
What is the sternal angle’s function?
A
Allows hinge movement anterior and posterior.
Facilitates increased respiration by allowing expansion of thoracic cavity.
7
Q
What is the level of Xiphoid process?
A
T8 Vertebrae
8
Q
Which ribs are true? Why are they called that?
False?
Floating?
A
True ribs costal carliages attached diectly to sternum
8-10 False ribs attached indirectly to the sternum
Floating 11-12
9
Q
How does the rib attach to vertebrae?
For instance, the 7th rib articulates how?
(Costovertebral joints are the facets, costotransverse joints are the transverse process)
A
Attaches to:
inferior costal facet of T6
Superior costal facet of T7
Transverse process of T7
(Named for the vertebrae that sits on top)
10
Q
What is the function of costotransverse joints
A
Rotation of Ribs 1-7
Gliding movement 8-10
Elevation & Depression of ribs during inspiration and expiration
11
Q
What are the 4 muscles of the ribs?
Function?
Innervation?
A
External intercostals
Internal intercostals
Innermost intercostals
Transversus thoracis
Depress Muscles: Internal, innermost, transversus intercostal movies.
Elevates Muscles:
External intercostals
Innervation: ventral primary rami T1-T11
12
Q
What do the intercostsal nerves T7-T11 innervate?
A
Motor: Abdominal wall
Cutaneous: skin in this region
13
Q
Where are the posterior intercostal arteries located? What do they supply?
A
between Internal and innermost intercostal in the intercostal spaces 3-11.
INtercostal, pectoral, serratus anterior muscles.
Breasts intercostal space 3-5
14
Q
What does the supreme thoracic artery branch off?
What does it supply?
A
Branches off axillary
Intercostal spaces 1-2
15
Q
What does the supreme intercostal artery branch off?
What does it supply?
A
Branches off costocervical trunk
Supply intercostal spaces 1-2
16
Q
What does the anterior intercostal artery branch off?
Supply?
A
1-6 intercostal space.
Branch of internal thoracic
Supply skin, intercostal muscles, breasts (3-5), thymus gland
17
Q
What does the internal thoracic artery branch off? What does it split into?
A
Right Subclavian into internal thoracic artery. Branches: > > Musculophrenic artery > Superior epigastric artery
18
Q
What does the musculophrenic artery branch off? Supply?
A
Internal thoracic
Intercostal space 7-9
19
Q
What separates the pleural cavities?
What makes up the pleural cavity?
A
Mediastinum
Deep membrane: Visceral pleura of the parietal membrane
Superficial membrane: Parietal pleura of the parietal membrane
20
Q
Describe the different parts of the parietal pleura
A
Costal pleura: attached to ribs and intercostal spaces
Mediastinal pleura: Mediastinum
Diaphragmatic pleura: Superior sruface of respiratory diaphragm
Cervical: superior part. ABOVE LEVEL OF 1st RIB.
21
Q
Describe the lines of reflection?
A
Vertebral reflection: where costal and mediastinal pleurae = posterior
Sternal reflection: where costal and mediastinal pleurae = anterior
Costal reflection: Costal and diaphragmatic pleurae = Inferiorly
22
Q
What is a recess?
Name them. and locations.
What is the clinical significance?
A
Where 2 layers of parietal pleura are in direct contact.
Right costodiaphragmatic: Right Lateral costal reflectoin
Left costodiaphragmatic:
Left lateral costal reflection
Left Costomediastinal recess: Anteriorly along sternal reflection
Infections can accumulate here
23
Q
In what structure are the lungs located?
A
Pleural sac. under the visceral pleura
24
Q
What provides sensory innervation to the parietal pleura?
What kind of senses?
A
Intercostal nerves: pain & irritation to costal pleura Periphery of diaphragm.
Phrenic Nerve: pain and irritation to mediastinal pleura & Diaphragmatic pleura
25
What are the differences between male and female sternum?
Males bigger. = allows for bigger heart and lung capacity.
| Sternal angle is larger in men = flexible to allow for expansion of ribs
26
What is the clinical significance of the pleural cavity?
PLeural effusion happens here.
27
Name the branches of the costocervical trunk and their branches
Deep cervical artery
Costocervical trunk --> Supreme intercostal arteries --> 1st and 2nd posterior intercostal arteries --> intercostal space 1-2
28
Where do the posterior intercostal arteries come from? Where do they go?
Come from Supreme intercostal arteries, which come from Costocervical trunk
Superior intercostal 1-2
Most come from descending aorta. 3-11.
29
What does the anterior intercostals arise from?
Subclavian --> internal thoracic --> anterior intercostal 1-6
Internal thoracic --> Musculophrenic --> 7-9
30
What structures are included in the lower respiratory tract include?
What is the epithelial tissue of these structures?
Trachea --> Primary Bronchi --> Secondary Bronchi --> Tertiary bronchi --> Bronchioles --> Terminal bronchiole --> Respiratory bronchiole --> Alveoli
Main stem bronchi, bronchial tubes: Ciliated Pseudostratified columnar epithelium
Bronchioles, terminal bronchioles: Simple Columnar Ciliated
Respiratory Bronchioles: Simple Cuboidal Ciliated
Alveoli: Simple squamous epithelium
31
What is the function of the cilia?
Move mucous toward laryngopharynx so it can be swallowed or coughed up.
32
What is the lower respiratory tract composed of?
What is the function of these structures?
20 Hyaline cartliage rings - open posteriorly to allow food to pass easily through esophagus which is posterior.
Smooth muscle -
Mucous glands - Keep epithelium moist
33
What arteries supply the lower respiratory tract? Veins?
Superior and inferior thyroid arteries.
| Superior, middle, inferior thyroid veins
34
Differences between right bronchus and left bronchus?
RIght: Large diameter. More vertical. Shorter length.
Left: smaller diameter. Less vertical. Longer length
35
Differences between right lobar bronchi and left lobar bronchi?
Right: 3 lobes, 3 lobar bronchi
Left: 2 Lobes, 2 lobar bronchi
AKA: secondary
36
Differences between right segmental bronchi and left segmental bronchi?
AKA: tertiary
Right: 10 segments, 10 bronchi
Left: 8 Segments, 8 bronchi
37
What is a clinical significance of the segmental bronchi?
They are physiologically independent, so you can cut off one segment and it doesn't affect the function of the other segments.
38
What arteries supply the bronchi? Veins?
3 Bronchial arteries (NOT in circulatory system - only supply the pulmonary structures. 2 left bronchial and 1 right)
Extra alveolar capillaries
Veins: bronchial veins drain to azygos, which drains to superior vena cava.
39
Which lung has 2 fissures?
What do the 2 fissures divide?
Which one is most superior when looking at it in anatomy?
Oblique: Upper and lower
Horizontal: upper and middle
Horizontal is most superior
40
What superficial structures are unique to the left lung?
| Right lung?
Left: Cardiac notch, lingula, groove for aorta
Right: Groove for azygos vein. Horizontal fissure and middle lobe
41
What is the cupola?
Apex. Area ABOVE 1st ribs. (Know this - tons of questions about this on Michigan)
42
What heart structure do the pulmonary arteries run through? What valve?
Right ventricle; pulmonary semilunar valve.
43
What heart structure do the pulmonary veins run through? What valve?
Left atria; bicuspid valve.
44
The surface area of alveoli is crazy big. What MUST it be equal to to ensure maximum gas exchange?
ALL OF THE COMBINED CAPILLARIES IN ALL THE ORGANS IN THE BODY.
(wow)
45
Where does the sensory information come from for the lungs? What senses are sensed?
Vagus nerve CN X
Stretch receptors - alveoli, smooth muscle
Irritant - respiratory epithelium
Tactile - cough reflex
Baroreceptors - pulmonary arteries
Chemoreceptors - pulmonary veins (detect blood gases)
46
Where do the lung motor neurons come from?
Pulmonary nerve plexus
47
In the pulmonary nerve plexus there are sympathetic and parasympathetic nerve fibers. What do the sympathetic fibers affect? Function?
Where is the synapse for these? What does the mean for location of pre& post ganglia?
Smooth muscle and glands:
inhibit gland secretion, vasodilate bronchial vessels,
constrict bronchial tubes.
The synapse is at the sympathetic trunk ganglia, so you'll see post-ganglionic fibers in the pulmonary.
48
In the pulmonary nerve plexus there are sympathetic and parasympathetic nerve fibers. What do the parasympathetic fibers affect? Function?
Where is the synapse for these? What does the mean for location of pre& post ganglia?
Smooth muscle and glands:
increase Glandular secretion, induce vasoconstriction of bronchila vessels, dilate bronchial tubes.
Synapse on the surface of bronchial tubes & vessels, which means pre-ganglia are from vagus, and post ganglionic are right in the bronchial tube & vessels.
49
Where is the superficial lymphatic plexus? What structures does it drain? Where does it drain to?
Deep to visceral pleura.
Drains visceral pleura and alveoli (AKA parenchyma).
Drains to bronchopulmonary lymph nodes (in hilum)
50
Where is the deep lymphatic plexus? What structures does it drain? Where does it drain to?
Located in bronchi
Drains bronchi.
To pulmonary lymph nodes (hilum) --> goes to bronchopulmonary nodes
51
What are the 4 lymph nodes, their location, and path of drainage?
Pulmonary nodes (Lungs at bifurcation of large bronchi) --> Bronchopulmonary nodes (Hilum) --> Tracheobronchial nodes (Bifurcation of trachea) --> Tracheal nodes (lateral surface of trachea)
52
What are the 2 lymph TRUNKS? What do they drain?
Right bronchomediastinal lymph trunk: drains Right side of trachea to --> Right lymphatic duct
Left bronchomediastinal lymph trunk: drains left side of trachea to --> Thoracic duct.
53
When do we feel pain from visceral organs?
| What other senses do we sense?
Chemical irritation or inflammation. Not when mechanically cut.
Stretch, temp
Remember we get referred pain from these organs.
54
Is sympathetic catabolic or anabolic? What does this mean?
What molecules are at the presynaptic cleft and the post synaptic cleft in sympathetic responses?
What receptors does the sympathetic use?
What is the exception?
Catabolic.
Expends energy --> Fight or flight
Pre-synaptic: ACh
Post-synaptic: Epinephrine/neuroepinephrine
Receptor: Nicotinic (not completely true - we'll learn next exam that it's B1 in cardiac cells, a1 in smooth muscle)
Exception: Sweat glands are controlled by sympathetic, but use muscarinic receptor with ACh as a post-synaptic molecule.
55
Is parasympathetic catabolic or anabolic? What does this mean?
What molecules are at the presynaptic cleft and the post synaptic cleft in parasympathetic responses?
What receptors does the sympathetic use?
What is the exception?
Anabolic
Conserves energy --> Rest and digest, or "normal"
Pre-synaptic: ACh
Post-synaptic: ACh
Receptors: Muscarinic
Exception: Sweat glands are controlled by sympathetic, but use muscarinic receptor with ACh as a post-synaptic molecule.
56
For Sympathetic Division:
Length of pre-synaptic fibers?
Location of fibers from spinal cord to the organs?
Short pre-synaptic fibers
Location: T1-T12
Come from lateral gray horn of spinal cord --> Exit spinal cord at T1-L3 --> (Most) Synapse at Chain ganglia --> long post-synaptic fibers -> visceral organs.
57
For Parasympathetic Division:
Length of pre-synaptic fibers?
Location of fibers from spinal cord to the organs?
Long pre-synaptic fibers
2 Paths:
Brainstem --> Cranial Nerves --> Synapse on head, neck, thorax, abdomen
Cranial Nerve: III, VII, IX, X
Ventral (motor) root of spinal gray matter --> ventral rami --> S2-S4 --> Pelvic Splanchnic Nerves --> Hypogastric plexus --> Synapse on organs of pelvis and lower abdomen
58
What are the 4 sympathetic nerve pathways?
1. Normal:
lateral horn --> White rami communicans --> Synapse on Chain ganglia --> Grey rami communicans --> post synaptic fiber
2. Those hard to reach places
lateral horn --> white rami communicans --> chain ganglia --> moves superior or inferior to another chain ganglia to synapse --> post-synaptic
3. Secondary Ganglia
Lateral horn --> white rami communicans --> Chain ganglia --> PRE synaptic fiber --> Synapse on Collateral ganglia --> POST synaptic fiber --> Target organ
4. Adrenal Medulla
Lateral horn--> white rami communicans --> chain ganglia --> PRE synaptic fiber --> Synapse on Chromaffin cells --> Great quantities of Epinephrine is put into blood.
59
What does the enteric nervous system do?
Neurons in the wall of GI tract from esophagus to anus. Coordinates GI reflexes.
60
Describe location & course of trachea?
Starts as Larynx
Starts C6
Bifurcates at T4 (sternal angle/Nipple line/Transverse thoracic plane/end of superior mediastinum)
3.5-5" long
61
Describe arrangement of the hilum
Right lung?
Left lung?
```
Right:
Anterior pulmonary artery
Posterior bronchi
inferior pulmonary veins
Left:
Superior pulmonary artery
Middle bronchi
Inferior pulmonary veins
```
62
```
What does the sympathetic nervous system do to the:
Eyes
Salivary Glands
Skin
Sweat glands
Heart
Lungs
BV
Adrenal Gland
GI
Genitals
```
```
Eyes: dilate
Salivary Glands: inhibit
Skin: Goosebumbs, errector pili, vasoconstrict peripheral vessels
Sweat glands: activate
Heart: Increase HR and CO. Coronary artery VasoDILATION
Lungs: Dilate airway
BV: Vasoconstrict
Adrenal Gland: Releases epi and NE
GI: Inhibit
Genitals: Shoot [Ejaculate]
```
63
```
What does the sympathetic nervous system do to the:
Eyes
Salivary Glands
Skin
Sweat glands
Heart
Lungs
BV
Adrenal Gland
GI
Genitals
```
```
Eyes: Constrict
Salivary Glands: activate
Skin: Nothing
Sweat glands: nothing
Heart: decrease HR
Lungs: constrict airway (Easy breathing)
BV: Vasodilate
Adrenal Gland: none
GI: promote
Genitals: Point [Erection]
```
64
What tubes are in the superior mediastinum?
Vessels?
Nerves?
Tubes: Trachea, Esophagus
Vessels: Brachiocephalic veins, superior vena cava, Arch of aorta, brachiocephalic trunk, left common carotid, left subclavian
Nerves: Vagus, phrenic, left recurrent laryngeal, cardiac pulmonary plexus
65
What tubes are in the posterior mediastinum?
Vessels?
Nerves?
Tubes: Thoracic duct, thoracic aorta, esophagus
Vessesls: Azygos & Hemiazygos
Nerves: Vagus, Esophogeal plexus, Thoracic sympathetic trunks, thoracic splanchnic nerves
66
At what vertebrae is the suprasternal notch?
Sternal angle?
Bifurcation of trachea?
Beginning of aorta?
Suprasternal: T2 in men, T3 in women.
Trick question!
Sternal angle & Bifurcation of trachea, beginning of aorta all T4
67
Where is the thymus gland located?
Behind manubrium
68
Know the relationship of left and right brachiocephalic vein, arch of aorta, brachiocephalic trunk, right subclavian, common carotids to the manubrium?
Right and left brachiocephalic veins peak from the clavicular notch.
Arch of aorta has already branched, You can see the Brachiocephalic trunk on the right clavicular notch.
Right subclavian - left clavicular notch
common carotid - left clavicular notch
69
Where is the ligamentum arteriosum?
from aorta to pulmonary trunk
70
Where do the phrenic nerves run?
Anterior to root of lung
71
Where to vagus nerves run?
Posterior to root of lung
72
Where is the left recurrent laryngeal nerves?
Comes off vagus from posterior lung, looks around ligamentum arteriosum.
73
Where is the aorta in relation to the vertebrae?
| What does this mean for vessels coming off it?
Left of vertebrae.
| Right posterior intercostal artery are longer because they have to go around the vetebral bodies.
74
Where does the bronchial arteries come off?
Aorta
75
What arteries branch off aorta?
Posterior intercostal arteries, esophageal arteries, bronchial arteries, tracheal arteries, supreme intercostal arteries
76
What does the supreme intercostal vein drain?
| Where does it drain into?
2-4th intercostal space
Brachiocephalic veins on Left
Drains into Azygos on right
77
what drains into the azygos?
Hemiazygos at T9
78
What drains into the Accessory hemiazygos?
Bronchial vein, Posterior intercostal T8- T1.
79
What drains into the hemiazygos
posterior intercostal T9-T12
80
At what vertebral level does the Internal thoracic artery pass through the diaphragm?
Epigastric?
Aorta?
D: T8
E: T10
A: T12
81
Where might food get trapped in the esophagus?
```
Constrictions:
Cricopharynx part
Aortic arch
Left bronchus
diaphragm.
```
82
What is the path of the esophagus?
Esophagus is pushed to the right, but then has to go back over to the left to reach the stomach
83
Where are the vagus nerves located? What is the reason for this?
Twisting during development sends Right vagus nerve to the posterior of the esophagus? and Left vagus to the anterior part
84
Where are the greater splanchnic nerves? Where to they synapse? Are they symathetic or parasympathetic?
T5-T9.
| Synapse on Celiac ganglion. Sympathetic.
85
Where are the lesser splanchnic nerves? Where to they synapse? Are they symathetic or parasympathetic?
T10-T11
Aorticorenal ganglion
Sympathetic.
86
Where are the least splanchnic nerves? Where to they synapse? Are they symathetic or parasympathetic?
T12
Renal plexus
sympathetic.
87
What does the right thoracic duct drain? What does it empty into?
Right upper. Right arm.
| Right subclavian vein
88
What drains into the left thoraic duct? What does it empty into?
Lower abdomen, limbs, pelvis, left side of head, neck, thorax.
Left subclavian vein. (75% of body)
89
Where is the thoracic duct located?
Anterior face of T6-T12.
Posterior to esophagus, between azygos vein and aorta.
Stops at at junction of Internal jugular vein
90
What does enlargment of lymphatic duct cause? Why might the lymph enlarge?
impingement on left recurrent laryngeal nerve - causes hoarseness in speech.
Lung cancer
91
What are the subdivisions of the inferior mediastinum? which one contains the heart?
anterior, middle, postrior
| middle
92
What are the layers of pericardium from superficial to deep?
fibrous pericardium
parietal (serous) pericardium
pericardial cavity
visceral (serious) pericardium (aka epicardium)
93
what supplies blood to the pericardium?
pericardiacophrenic a.
94
what senses pain in the pericardium? what else innervates it?
phrenic n.`
| vagus, sympathetic trunks for vasomotor
95
Where is the transverse sinus? significance?
posterior to ascending aorta and pumonary trunk, anterior to SVC and L atrium.
clamp off for surgery
96
what is the oblique sinus?
posterior to base of heart
97
what is pericardial effusion? sx? cause?
buildup of blood or fluid in the pericardial cavity due to injury, previous MI, surgery, pericarditis etc
sx: decreased cardiac output, weakened pulses, decreased heart sounds, JVD
98
how do you treat pericardial effusion and where do you stick the needle?
pericardiocentesis? (idk how to spell it) 5th intercostal space by sternum
99
describe the position of the heart
2/3 of it is left of midline
100
What makes up the right border of the heart?
SVC, IVC, R atrium
101
what makes if the inferior border of the heart?
R ventricle
102
What makes up the left border of the heart?
L ventricle
103
What makes up superior border of the heart?
atriums
104
What makes up the apex of the heart?
LV
105
what makes up the base of the heart? spinal level?
L atrium, faces T6-T9
106
what makes up the anterior surface of the heart?
R ventricle
107
what makes up the diaphragmatic surface of the heart?
L ventricle
108
what makes up the right pulmonary surface of the heart?
RA
109
what makes up the left pulmonary surface of the heart?
LA
110
What runs in the anterior interventricular groove?
LAD, great cardiac vein
111
what runs in the posterior interventricular groove?
middle cardiac vein, posterior interventricular artery
112
what is contained in the coronary sulcus?
right coronary artery
| coronary sinus
113
what do the RCA and LCA supply?
myocardium and epicardium
114
what does the right marginal branch supply?
right ventricle
115
what does the posterior inteverntricular a supply?
posterior 1/3 of IV septum
116
what does the AIV/LAD supply?
L and right ventricles
117
What are some anastomosis in the heart?
RCA and AIV
Right marginal and IV branches
posterior IV and anterior IV
LCA and RCA
118
what is the most dominant heart type? what does this mean?
right dominant, means the posterior interventricular usually comes off RCA
119
what does the SA nodal usually come off of?
RCA (60%)
120
what are the 3 most common MI blockage sites?
LAD (anterior and septal MI)
RCA (inferior, posterior, or right ventrz
LCX
121
What does the Small Cardiac Vein run with?
Middle Cardiac?
Great Cardiac?
Small Cardiac vein with Right Marginal artery
Middle Cardiac vein with Posterior Interventricular artery
Great Cardiac Vein = ANterior Ventricular
122
What is the most superficial structure that may be lesioned in a tracheotomy?
Brachiocephalic veins
123
What is the function of the cardiac skeleton?
Insulates the atria signals from the ventricles so they all don't contract at the same time.
Also acts as a connection system for the valves. Doesn't allow them to get stretched out.
