anatomy thorax Flashcards
(137 cards)
1
Q
What is the function of the lungs?
A
Oxygenates blood by bringing inspired air into contact with O2 poor blood in the pulmonary capillaries.
2
Q
What is the innervation of the intercostal muscles?
A
The intercostal nerves.
3
Q
What does the internal thoracic artery branch into?
A
- Musculophrenic - supplies the diaphragm.2. Superior epigastric arteries - supplies the front of the abdomen.
4
Q
What is the pleural cavity?
A
A potential space between the visceral and parietal pleura.
5
Q
Name 2 functions of the serous fluid within the pleural cavity?
A
- Lubricates the pleurae. 2. Creates a surface tension helping the lungs to expand on inspiration.
6
Q
Name the 4 main structures that are found at the hilum of the lung.
A
- Pulmonary artery x1.2. Bronchus x1.3. Pulmonary vein x2.
7
Q
What branch does the right main bronchus give off outside of the right lung?
A
Superior lobar bronchus.
8
Q
What other smaller vessels are found at the hilum of the lung?
A
- Bronchial arteries.2. Pulmonary plexus of autonomic nerves.3. Lymph nodes.
9
Q
Which lung are inhaled foreign bodies most likely to be found in and why?
A
The right lung. The right main bronchus is shorter and more vertical.
10
Q
How many lobes does the right lung have and what are they called?
A
3 lobes. Superior, middle and inferior.
11
Q
How many lobes does the left lung have and what are they called?
A
2 lobes.Superior and Inferior.
12
Q
What is the fissure in the left lung called?
A
Oblique (lies along 6th rib).
13
Q
What are the fissures in the right lung called?
A
Horizontal (extends from mid-axiallry line anteriorly along the 4th rib) and Oblique (lies along 6th rib).
14
Q
Name the 3 surfaces of the lungs.
A
- Costal.2. Mediastinal.3. Diaphragmatic.
15
Q
Name the 3 borders of the lungs.
A
- Anterior.2. Posterior.3. Inferior.
16
Q
Describe the innervation of the lungs?
A
- Parasympathetic innervation derived from vagus nerve.2. Sympathetic innervation derived from sympathetic trunks. 3. Visceral afferent - conducts pain impulses to sensory ganglion.
17
Q
What is the action of parasympathetic innervation in the lung?
A
Bronchoconstriction and vasodilation of pulmonary vessels.
18
Q
What is the action of sympathetic innervation in the lung?
A
Bronchodilation and vasoconstriction of vessels that are poorly ventilated.
19
Q
What is the surface marking for the apex of the lung?
A
2 finger breadths (3cm) above the medial clavicle in the neck.
20
Q
What are the surface markings for the lower border of the lung?
A
6th rib anteriorly, 8th rib in the mid-axillary line and 10th rib posteriorly.
21
Q
What are the surface markings for the lower border or the pleural cavity?
A
8th rib anteriorly, 10th rib in the mid-axillary line and 12th rib posteriorly.
22
Q
What are the 3 branches of the arch of the aorta?
A
- Brachiocephalic trunk.2. Left common carotid artery.3. Left subclavian artery.
23
Q
What are the branches of the brachiocephalic trunk?
A
Right common carotid (LHS).Right subclavian (RHS).
24
Q
What is the ligamentum arteriosum a remnant of and what was its function in the foetus?
A
Remnant of the ductus arteriosum.It’s function was to shunt blood between the pulmonary trunk and the aorta in order to bypass the non-functioning lungs.
25
What branch does the left vagus nerve give off as it crosses the arch of the aorta?
The left recurrent laryngeal nerve.
26
Briefly describe the anatomical course of the right phrenic nerve.
Lies on large veins (brachiocephalic, SVC etc) and along the right side of the heart. Crosses in front of root of the lung.
27
Briefly describe the anatomical course of the left phrenic nerve.
Crosses the arch of the aorta and descends in front of the root of the lung.
28
What spinal roots is the phrenic nerve derived?
C3, 4 and 5 (cervical plexus).
29
What does the phrenic nerve supply?
Motor innervation to the diaphragm. Sensory innervation to the pleura, peritoneum and pericardium.
30
Briefly describe the anatomical course of the left vagus nerve.
Crosses the aorta and behind the root of the lung. Breaks up into branches on the oesophagus (oesophageal plexus) and leaves the thorax as the anterior gastric nerve.
31
Briefly describe the anatomical course of the right vagus nerve.
Lies on the trachea and crosses behind the root of the lung. Breaks up into branches on the oesophagus and leaves the thorax as the posterior gastric nerve.
32
Does the phrenic nerve enter the diaphragm? If so where?
Yes. It pierces the central tendon of the diaphragm alongside the IVC on the right (T8).
33
Does the vagus nerve enter the diaphragm? If so where?
Yes. Through the oesophageal hiatus (T10).
34
What are the layers of the pericardium?
1. Outer fibrous layer.2. Parietal serous layer.3. Visceral serous layer.
35
What structures form the left border of the heart?
1. Left pulmonary artery.2. Left auricular appendage.3. Left ventricle.
36
What is the surface marking for the apex of the heart?
5th intercostal space in the mid-clavicular line.
37
What forms the right border of the heart?
The right sternal edge.
38
On what aspect of the heart would you find the left atrium?
The posterior aspect. It is closely related to the oesophagus.
39
Where is the RCA found?
In the atrio-ventricular sulcus.
40
Name the 3 main branches of the RCA.
1. Sino-atrial nodal branch.2. Right marginal branch.3. Posterior inter-ventricular branch.
41
In 90% of hearts where does the posterior inter-ventricular artery arise from?
RCA.
42
In 30% of hearts where does the posterior inter-ventricular artery arise from?
The circumflex artery.
43
In 20% of hearts where does the posterior inter-ventricular artery arise from?
The RCA and the circumflex artery.
44
Name the 2 main branches of the LCA.
1. Circumflex.2. Left anterior descending (LAD).
45
In what sulcus does the circumflex artery lie? What other large vessel can be found here?
Left atrio-ventricular sulcus.The coronary sinus can also be found here. IT passes posteriorly and drains into the RA.
46
Where is the SAN located?
The upper aspect of the crista terminalis in the RA.
47
Where is the AVN located?
Inter-atrial septum.
48
Name the artery that supplies:a) The SANb) The AVN
a) Sino-atrial nodal branch of RCA.b) Posterior inter-ventricular branch, usually RCA.
49
At what phase of the cardiac cycle do the coronary arteries fill?
Diastole; when the ventricles are relaxed.
50
What 2 spaces does the crista terminalis divide in the RA?
It divides the smooth walled atrium from the trabeculated auricle - ridges = musculi pecanti.
51
What is the Fossa Ovalis a remnant of?
The Foramen Ovale. In the foetus the foramen ovale shunted blood from the RA to the LA so as to bypass the lungs.
52
In the ventricles, what are the chordae tendinae attached to?
The valves (mitral or tricuspid) and the papillary muscles.
53
How do the mitral and tricuspid valves work?
They open passively when the atria contract and then close afterwards to prevent backflow. The papillary muscles and chordae tendinae work to keep the valves closed during ventricular contraction.
54
How do the atrial and pulmonary valves work?
They open passively when the ventricles contract. Towards the end of systole they close to prevent the back flow of blood. The pressure of blood on the valves keeps them closed.
55
How would you know if the atrial and pulmonary valves were incompetent?
You would get regurgitation of blood into the ventricles. This could be heard as a diastolic murmur.
56
Where can you hear the pulmonary valve?
Left of the sternum, 2nd intercostal space.
57
Where can you hear the aortic valve?
Right of the sternum, 2nd intercostal space.
58
What is the midline connection called of the two lateral thyroid gland lobes?
Isthmus.
59
What tracheal rings does the isthmus of the thyroid gland lie in front of?
2nd, 3rd and 4th.
60
Where do the thyroid arteries arise from?
1. Superior thyroid artery - External carotid artery.2. Inferior thyroid artery - Thyrocervical trunk, a branch of the Subclavian artery.
61
What vessels are contained within the carotid sheath?
1. Carotid artery.2. Jugular vein.3. Vagus nerve.
62
What is the origin of sternocleidomastoid?
The manubrium of the sternum and the clavicle.
63
What is the insertion of sternocleidomastoid?
Mastoid process.
64
What nerve(s) are related to the superior thyroid arteries?
The external laryngeal nerves.
65
What nerve(s) are related to the inferior thyroid arteries?
The recurrent laryngeal nerve crosses the inferior thyroid artery.
66
How many parathyroid glands are there?
4
67
Where are the parathyroid glands located?
Posterior surface of thyroid glands.
68
How are the parathyroid glands developed?
From the pharyngeal pouches.
69
Name 3 functions of the larynx.
1. Phonation.2. Cough reflex.3. Protection of the lower respiratory tract.
70
What is the epithelium of the vocal folds? and why?
Stratified squamous epithelium. This is more robust and can withstand the vibrations and wear and tear.
71
What is the blood supply to the larynx?
Superior and inferior laryngeal arteries (branches of the thyroid arteries).
72
What does the recurrent laryngeal nerve supply?
Motor innervation to intrinsic muscles of the larynx (except cricothyroid).
73
What does the internal branch of the superior laryngeal nerve supply?
Sensory innervation to laryngopharynx and larynx.
74
What does the external branch of the superior laryngeal nerve supply?
Motor innervation to the cricothyroid muscle.
75
Name the 3 unpaired cartilages in the larynx.
1. Epiglottis (elastic cartilage).2. Thyroid (hyaline cartilage). 3. Cricoid (hyaline cartilage).
76
What do the two sheets of thyroid cartilage form in the midline?
The laryngeal prominence (Adam's apple).
77
What do the inferior horns of the thyroid cartilage articulate with?
They form a synovial joint with the cricoid cartilage.
78
What do the superior horns of the thyroid cartilage articulate with?
The hyoid bone.
79
What vertebral level is the inferior border of the larynx at?
C6.
80
Name the 3 paired cartilages in the larynx.
1. Arytenoid.2. Cuneiform.3. Corniculate.
81
What do the arytenoid cartilages articulate with?
The base articulates with the cricoid cartilage and the apex articulates with the corniculate cartilages.
82
Where are cuneiform cartilages located?
Within the ary-epiglottic folds. They strengthen the folds.
83
What is the space between the vocal cords called?
Rima glottidis.
84
What is the superior vestibular folds also known as?
False vocal folds.
85
What are the extrinsic muscles of the pharynx?
The suprahyoids, infrahyoids and stylopharyngeus.
86
What is the function of the extrinsic muscles of the larynx?
They move the larynx superiorly and inferiorly during swallowing.
87
Name the 4 infrahyoid muscles.
1. Omohyoid (scapula to hyoid).2. Sternohyoid (sternum to hyoid). 3. Sternothyroid (sternum to thyroid).4. Thyrohyoid (thyroid to hyoid).
88
What is the function of the intrinsic muscles of the larynx?
They control the shape of the rima glottidis, and the length and tension of the vocal folds.
89
What is the innervation of the intrinsic laryngeal muscles?
Recurrent laryngeal nerve.
90
What intrinsic laryngeal muscle is not innervated by the recurrent laryngeal nerve?
Cricothyroid.
91
What is the innervation of the cricothyroid muscle?
External branch of the superior laryngeal nerve.
92
What is the function of the cricothyroid muscles?
Stretches and tenses the vocal cords. Important for the creation of speech.
93
What is the function of the thyroarytenoid muscles?
Relaxes the vocal ligament, allowing for a softer voice.
94
What is the function of the posterior cricoarytenoid muscles?
Abduction of the vocal cords; the only muscles capable of widening the rima glottidis.
95
What is the function of the lateral cricoarytenoid muscles?
Adduction of the vocal folds; narrow the rima glottidis.
96
What is the function of the transverse arytenoids muscles?
Adduction of the arytenoid cartilages, narrows the laryngeal inlet.
97
What nerve passes through the parotid gland?
The facial nerve - Cn 7.
98
What are the 5 branches of Cn 7.
1. Temporal.2. Zygomatic.3. Buccal.4. Mandibular.5. Cervical.
99
Where does the pharynx extend from and to?
The base of the skull to the cricoid cartilage (C6).
100
What are the 3 sections of the pharynx called?
1. Nasopharynx.2. Oropharynx. 3. Laryngopharynx.
101
What is the function of the pharyngeal constrictor muscles?
They contract sequentially to propel food into the oesophagus.
102
What is the origin of the superior constrictor?
Pterigoid plate and pterygomandibular raphe.
103
What is the origin of the middle constrictor?
Hyoid bone.
104
What is the origin of the inferior constrictor?
Thyroid and cricoid cartilages.
105
What is the innervation of the pharyngeal constrictors?
The pharyngeal branch of the Vagus nerve.
106
What is the function of the longitudinal pharyngeal muscles?
They shorten and widen the pharynx. They also elevate the pharynx during swallowing.
107
What are the 3 longitudinal pharyngeal muscles called?
1. Stylopharyngeus.2. Salpingopharyngeus.3. Palatopharyngeus.
108
What is the origin of the stylopharyngeus and what is its innervation?
Origin: Styloid process of temporal bone.Innervation: Glossopharyngeal, Cn 9.
109
What is Killian's dehiscence?
The weakest part of the pharyngeal wall. Located inferiorly in the midline. It is the commonest site for a pharyngeal diverticulum.
110
What vessels are found in the carotid sheath?
1. Common carotid artery.2. Vagus nerve. 3. Internal jugular vein.
111
Where is the carotid sinus located?
At the bifurcation of the common carotid artery.
112
Where does the glossopharyngeal nerve exit the cranial cavity?
Through the jugular foramen.
113
What nerve supplies sensory and taste innervation to the posterior 1/3 of the tongue.
The glossopharyngeal nerve.
114
What does elevation of the soft palate do?
It closes the orifice between the nasopharynx and oropharynx. This occurse during swallowing to prevent food refluxing into the nose. It also occurs in phonation.
115
What nerve supplies sensory sensation to the anterior 2/3 of the tongue?
The trigeminal nerve, Cn 5.
116
What nerve supplies taste sensation to the anterior 2/3 of the tongue?
The facial nerve, Cn 7.
117
What folds bind the tonsilar fossa?
Palatoglossal (anterior) and Palatopharyngeal (posterior) folds.
118
What is the function of the tonsils?
The tonsils are a consolidation of lymphoid tissue. They prevent infection by stopping germs entering the mouth and nose.
119
Give 4 functions of the nasal cavity.
1. Warms and humidifies air.2. Olfaction.3. Removes and traps pathogens.4. Drains and clears para-nasal sinuses.
120
What is the function of the nasal conchae?
They increase the SA of the nose and they disrupt the fast flow of air. This means the air spends more time in the nasal cavity so it can be humidified.
121
What opens into the inferior meatus?
Nasolacrimal duct.
122
What opens into the middle meatus?
The frontal, maxillary and anterior ethmoid sinuses open at the hiatus semilunaris. The middle ethmoid sinus opens onto the ethmoidal bulla.
123
What opens into the superior meatus?
The posterior ethmoid sinus.
124
Where does the sphenoid sinuses open into the nasal cavity?
At the spheno-ethmoidal recess.
125
Why does the nose have a rich vascular supply?
This means it can change the humidity and temperature of inspired air.
126
What nerve supplies general sensation to the nose?
Branches of the trigeminal nerve.
127
What vertebral level is the tracheal bifurcation?
T4.
128
What is the function of the thoracic duct?
It drains all the lymph from the lower half of the body and bowel back into the blood stream.
129
Where does the thoracic duct drain into?
The confluence between the left jugular vein and left subclavian vein.
130
Where does the azygous vein drain into?
The superior vena cava.
131
What are the names of the three splanchnic nerves?
The greater (T5-9), the lesser (T10-11) and the least (T12).
132
What is the function of the splanchnic nerves?
They provide sympathetic innervation to the foregut, midgut and hindgut.
133
Occlusion of which vessel is most likely to result in a fatal heart attack?
The left main coronary artery.
134
Which artery provides the main blood supply to the left ventricle?
The left anterior descending artery.
135
Which vessel is most likely to become occluded without producing any symptoms?
Right marginal artery.
136
What is stenosis?
Narrowing.
137
Which artery most frequently supplies the AVN?
The right main coronary artery.
