Chapter 1 & 2 Flashcards

Anatomy and Phys review (142 cards)

1
Q

What is the primary function of the bony thorax?
a) To store calcium
b) To provide support for the spine
c) To cover and protect the major organs of the cardiopulmonary system
d) To facilitate digestion

A

Answer: c) To cover and protect the major organs of the cardiopulmonary system

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2
Q

Where is the heart located within the thoracic cavity?
a) In the lungs
b) In the mediastinum
c) In the ribcage
d) In the diaphragm

A

Answer: b) In the mediastinum

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3
Q

Which of the following is NOT a skeletal boundary of the thoracic cavity?
a) Thoracic vertebrae
b) Ribs
c) Sternum
d) Pelvis

A

Answer: d) Pelvis

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4
Q

What is the primary muscle responsible for ventilation during breathing?
a) Intercostal muscles
b) Diaphragm
c) Pectoralis major
d) Latissimus dorsi

A

Answer: b) Diaphragm

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5
Q

Which part of the thoracic cage is located ventrally (in front)?
a) Thoracic vertebrae
b) Ribs
c) Sternum
d) Diaphragm

A

Answer: c) Sternum

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6
Q

The shape of the thoracic cage is _____ at both its superior and inferior aspects.

A

Conical

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7
Q

What are the primary components of the skeletal boundaries of the thoracic cavity?

A

The thoracic vertebrae dorsally, the ribs laterally, and the sternum ventrally.

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8
Q

What are the three major parts of the sternum?

A

Answer: a) Manubrium, body, xiphoid process

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9
Q

What is located at the superior border of the manubrium?

A

Answer: b) Jugular notch

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10
Q

What does the sternal angle (angle of Louis) mark the level of?

A

Answer: a) Bifurcation of the trachea into the main stem bronchi

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11
Q

What is Pectus excavatum?

Which of the following is a potential complication of Pectus excavatum?

What is the purpose of a median sternotomy?

A

Answer: b) A congenital deformity of the chest with a sunken sternum and ribs

Answer: b) Cardiac and pulmonary complications

Answer: b) To provide access to the thoracic cavity for surgery

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12
Q

What action of the sternum is involved in the mechanics of inspiration?
a) Pump-handle action of the sternal body
b) Expansion of the ribcage
c) Rotation of the clavicle
d) Lifting of the xiphoid process

A

Answer: a) Pump-handle action of the sternal body

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13
Q

What is the clinical significance of the sternal angle (angle of Louis)?

A

Answer: The sternal angle marks the level of bifurcation of the trachea into the right and left main stem bronchi and is an important landmark for assessing respiratory function.

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14
Q

The sternal angle (angle of Louis) is level with the second costal cartilage anteriorly and thoracic vertebrae _______ and _______ posteriorly.

A

Answer: T4 and T5

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14
Q

Which ribs are classified as “true ribs”?

A

Answer: b) The first seven ribs

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15
Q

The first rib has a single facet for articulation with the body of the first thoracic vertebra.

True or False

A

True

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16
Q

Where do the false ribs (ribs 8-10) attach?

A

Answer: b) To the rib above by their costal cartilages.

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17
Q

Rib fractures are most commonly caused by direct trauma to the sternal end of the ribs.
True or False

A

False - caused by trauma to the area just anterior to the rib’s angle

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18
Q

The costal groove houses the …….. and runs along the …..

A

intercostal vessels and nerves and runs along the inferior border of the rib.

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19
Q

Why is the first rib less likely to fracture compared to other ribs?

What injury can occur if the first rib fractures?

A

Answer: The first rib is protected by the clavicle, making it less vulnerable to fractures.

Answer: Injury to the brachial plexus of nerves and subclavian vessels can occur with a fractured first rib.

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20
Q

The _____ rib sometimes is shorter than the first rib

A

12th

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21
Q

What is the role of accessory muscles in inspiration?

A

Accessory muscles assist with forced inspiration, typically during exercise or when there is cardiopulmonary distress, by increasing the volume of the thoracic cavity beyond what the diaphragm and internal intercostals can achieve alone.

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22
Q

What happens to intrathoracic pressure during inspiration and how does it affect airflow?

A

During inspiration, the volume of the thoracic cavity increases, causing a decrease in intrathoracic pressure below atmospheric pressure. This pressure difference forces air into the lungs to normalize the pressure.

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23
Q

Which of the following muscles is primarily responsible for active inspiration at rest?

A

Diaphragm

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24
What happens to intrathoracic pressure during inspiration?
Answer: c) It decreases to below atmospheric pressure.
25
Which of the following movements of the ribs and sternum helps increase the thoracic volume during inspiration? a) Lifting of the pelvis b) Bucket-handle and pump-handle movements c) Twisting of the ribs d) Compression of the abdominal wall
Answer: b) Bucket-handle and pump-handle movements
26
During forced inspiration, such as during exercise, which accessory muscles assist with ventilation? (8_
Diaphragm and internal intercostals Sternocleidomastoid, scalenes, serratus anterior Pectoralis major and minor, trapezius
27
What is the primary role of the diaphragm in inspiration?
Answer: a) It increases the volume of the thoracic cavity by contracting and moving downward.
28
The movement of air in and out of the lungs due to pressure differences.
process of ventilation
29
The accessory muscles of inspiration are typically recruited during
Answer: b) Forced inspiration during exercise or cardiopulmonary distress
30
Which of the following is true about the right hemidiaphragm?
Answer: b) It is protected by the liver and is stronger than the left.
31
Which components make up each hemidiaphragm?
Answer: b) Sternal, costal, and lumbar portions that converge into the central tendon
32
What is the function of the central tendon of the diaphragm? a) To provide elasticity during expiration b) To allow the diaphragm to contract and increase the thoracic volume c) To serve as a point of attachment for the diaphragm’s muscular portions d) To help protect the heart during contraction
Answer: c) To serve as a point of attachment for the diaphragm’s muscular portions
33
Which major openings in the diaphragm allow for the passage of critical structures?
Answer: a) The vena caval opening, esophageal opening, and aortic opening
34
What structures pass through the aortic opening of the diaphragm? a) Esophagus, gastric vessels, and inferior vena cava b) Aorta, thoracic duct, and azygos veins c) Phrenic nerve and vagus nerve d) Inferior vena cava, aorta, and pulmonary veins
Answer: b) Aorta, thoracic duct, and azygos veins
35
Which spinal nerves contribute to the phrenic nerve that innervates the diaphragm?
Answer: b) C3 to C5
36
What is the clinical significance of the diaphragm's left hemidiaphragm?
Answer: The left hemidiaphragm is more often subject to rupture and hernia, typically due to weaknesses at the points of embryologic fusion.
37
In patients with chronic obstructive pulmonary disease (COPD), what is the main consequence of compromised ability to expire? a) Increased ability to expand the diaphragm b) Flattening of the diaphragm due to hyperinflated lungs c) Enhanced diaphragm excursion d) Decreased lung volumes due to restricted inspiration
Answer: b) Flattening of the diaphragm due to hyperinflated lungs
38
Why is it important for therapists to reverse hyperinflation in COPD patients?
Answer: b) To restore the normal resting arched position of the diaphragm
39
What happens to the diaphragm when it becomes flat and rigid in COPD patients?
Answer: b) It triggers automatic firing of the accessory muscles for inspiration
40
How does body position affect the resting position of the diaphragm? a) It has no effect on diaphragm position b) It affects lung volumes but not diaphragm movement c) It alters diaphragm position and can change lung volumes d) It only affects diaphragm movement in the supine position
Answer: c) It alters diaphragm position and can change lung volumes
41
What happens to the diaphragm's position in the supine position?
Answer: b) It rises within the thoracic cavity, limiting diaphragm excursion
42
In the side-lying position, what happens to the hemidiaphragms?
Answer: c) The lowermost hemidiaphragm rises higher and has greater excursion
43
The diaphragm normally moves about _______ of an inch during quiet breathing.
Answer: Two-thirds
44
Possible additional factors affecting the normal excursion of the diaphragm during inspiration.
Stomach fullness, obesity with presence of a large pannus, ascites with increased fluid in the peritoneal space from liver disease, and pregnancy
45
For this muscle to facilitate inspiration, the head and neck must be held stable by the neck flexors and extensors
SCM
46
This muscle is a primary accessory muscle and elevates the sternum, increasing the anteroposterior diameter of the chest.
SCM
47
The ________ lie deep to the sternocleidomastoid, but may be palpated in the posterior triangle of the neck
scalene muscles
48
The _____ can only be utilized as an accessory muscle in ventilation, when the rhomboids stabilize the scapula in adduction.
Serratus
49
The _______ is a large muscle group extending from the sacrum to the skull. The
Ercetor spinae
50
The abdominal muscles include the
rectus abdominis, transversus abdominis, and internal and external obliques.
51
The changes in intraabdominal and intrathoracic pressure that occur with forced breathing assist with ..... how does this work?
venous return of blood back to the heart The drop in pressure allows for a filling of the veins, the changing pressure within the abdomen and thorax cause a milking effect to help return blood back to the heart
52
What is the name of the pleura that covers the outer surface of each lung?
Answer: b) Visceral pleura
53
Where do the parietal and visceral pleurae blend together?
Answer: b) At the root of the lung
54
What is the role of the serous fluid in the pleural space?
Answer: c) To reduce friction between the lungs and thoracic wall
55
Infection with resultant inflammatory response within the pleura is termed
pleuritis or pleurisy - best appreciated through the presence of pleural chest pain and an abnormal pleural friction rub on auscultation
56
A pleural effusion refers to this is evidenced by
a buildup of fluid in the pleural space diminished or absent breath sounds in area of effusion and reduced lung volumes
57
Blood in the pleural space
hemothorax
58
whereas air in the pleural space from a collapsed lung is termed
pneumothorax
59
empyema
a bacterial infection with resultant pus in the pleural space
60
Where are the lungs located within the body? a) Above the diaphragm, in the cervical region b) On either side of the thoracic cavity, separated by the mediastinum c) In the abdominal cavity d) Within the pleural space
Answer: b) On either side of the thoracic cavity, separated by the mediastinum
61
What is the substance of the lung called, and what is its characteristic nature?
Answer: b) Parenchyma, porous and spongy
62
Which lung has a larger cardiac impression to accommodate the projection of the apex of the heart?
Answer: b) Left lung
63
The root of the lung, located at the hilus, allows the entry and exit of structures like the ________ and ________.
Answer: Pulmonary arteries and veins
63
64
Which fissure separates the right upper and middle lobes from the right lower lobe?
Answer: b) Oblique fissure
65
The inferior border of the right lower lobe (RLL) extends down to which vertebra during maximal inspiration?
L2
66
Which muscles assist with the movement of the bony framework of the nose?
Answer: b) Procerus, nasalis, and depressor septi
67
What is the primary function of the nasal cavity?
Answer: a) Air conduction, filtration, humidification, and temperature control
68
Which region of the nasal cavity is lined with specialized mucosa for the sense of smell?
Answer: b) Olfactory region
69
Individuals with seasonal allergies who are prone to developing sinus infections are also prone to developing bronchitis if
the infection leaves the sinus cavities and drops down the throat to the bronchioles.
70
The pharynx extends from the base of the skull to the:
Answer: b) Lower border of the cricoid cartilage
71
The pharynx is located posterior to which structure?
Answer: a) Nasal cavity
72
The trachea is ventral to the
esophagus
73
______ paralyzes ciliated epithelial cells
smoking
74
Parasympathetic fibers innervating the lungs are supplied by:
Answer: b) Vagal nuclei via the vagus nerve
75
Which of the following is NOT directly innervated by parasympathetic postganglionic fibers in the lungs?
Answer: d) Cardiac muscle
76
The portion of the heart that strikes the chest wall is the apex of the heart and is termed the
the point of maximum impulse.
77
Which of the following is the outermost layer of the heart wall?
Answer: b) Parietal pericardium
78
The pericardium consists of two layers. The inner layer is also referred to as the:
Answer: b) Epicardium
79
What is the function of the pericardial fluid?
Answer: b) To minimize friction during cardiac contraction
80
In patients with inflammation of the pericardium, the accumulation of fluid in the pericardial space can lead to a condition called ______.
Answer: Cardiac tamponade
81
Which characteristic of myocardial cells allows them to contract in the absence of external stimuli?
Answer: c) Automaticity
82
Which of the following is true regarding myocardial cells?
Answer: c) Mechanical cells (myocytes) have a large number of actin and myosin myofilaments.
83
Injured myocardial cells cannot be replaced, as the myocardium is unable to undergo _______
mitotic activity
84
The innermost layer of the heart is termed the
endocardium
85
Which of the following is true about the right side of the heart?
Answer: b) It receives deoxygenated blood from the body.
86
Which chamber of the heart receives blood from the superior and inferior vena cava and the coronary sinus?
Answer: b) Right atrium
87
Which of the following vessels does NOT empty into the right atrium? a) Superior vena cava b) Inferior vena cava c) Pulmonary veins d) Coronary sinus
Answer: c) Pulmonary veins
88
The effective contraction of the pectinate muscles of the atria accounts for approximately ___% of cardiac output
15% to 20%
89
What is the primary function of the AV node?
Answer: b) To slow down the electrical impulse, allowing time for the ventricles to fill
90
What is the function of the Purkinje fibers in the heart?
Answer: c) To cause mechanical contraction of the ventricles
91
What is the pacing ability of the SA node at rest?
Answer: b) 60–100 beats per minute
92
What are the three conduction pathways that carry impulses from the SA node to the AV node?
Answer: Anterior tract of Bachman, middle tract of Wenckebach, posterior tract of Thorel
93
What is the neurohormone involved in parasympathetic stimulation of the heart?
Answer: c) Acetylcholine
94
Which of the following is a direct effect of sympathetic stimulation on the heart?
Answer: c) Increase in heart rate
95
What is the result of vagal stimulation (parasympathetic) on the heart?
Answer: c) Decreased heart rate and blood pressure
96
Sympathetic stimulation releases which of the following catecholamines that affect the cardiovascular system?
Answer: b) Epinephrine and norepinephrine
97
What is the role of the cardiac plexus in the regulation of heart function?
Answer: The cardiac plexus contains both sympathetic and parasympathetic fibers, regulating the heart rate, strength of contraction, and other cardiac functions.
98
What are the dilations located above the cusps of the aortic valve called? a) Aortic sinuses of Valsalva b) Aortic arches c) Coronary sinuses d) Aortic valves
Answer: a) Aortic sinuses of Valsalva
99
5. Where do the coronary arteries open?
Answer: c) Near the aortic sinuses of Valsalva
100
6. When do the coronary arteries receive their blood supply?
Answer: b) During diastole
101
Which of the following is NOT a branch of the aortic arch? a) Brachiocephalic trunk b) Left common carotid artery c) Left subclavian artery d) Right coronary artery
Answer: d) Right coronary artery
102
1. Where does the left coronary artery originate from?
Answer: b) Left anterolateral aspect of the aorta
103
2. Which of the following are the two major branches of the left coronary artery?
Answer: c) Anterior interventricular (LAD) artery and circumflex artery
104
What is the primary function of the anterior interventricular (LAD) artery? a) Supply blood to the right ventricle b) Supply blood to the lateral aspect of the left ventricle c) Supply blood to the anterior and septal aspects of the left ventricle d) Supply blood to the right atrium
Answer: c) Supply blood to the anterior and septal aspects of the left ventricle
105
9. Which specialized conduction tissues are nourished by the right coronary artery?
Answer: a) SA node and AV node
106
10. What type of infarction is caused by occlusion of the right coronary artery?
Answer: c) Inferior or posterior infarction
107
A saddle embolus is life threatening and involves an
embolus dislodged at the bifurcation of the right and left pulmonary arteries.
108
2. What distinguishes elastic arteries from muscular arteries?
Answer: c) Elastic arteries have a thicker tunica media with more elastic fibers
109
4. What type of arteries are found in medium and small arteries and are responsible for vasoconstriction and vasodilation?
Answer: b) Muscular arteries
110
8. What do arterioles empty into?
Answer: b) Capillary beds
111
What happens in the capillary bed? a) Blood pressure is regulated b) Nutrients and gases are exchanged between blood and tissues c) Blood is oxygenated d) Blood is filtered and returned to the heart
Answer: b) Nutrients and gases are exchanged between blood and tissues
112
Patients with _______ in their veins develop varicosities in their lower extremities
incompetent valves
113
Patients on prolonged bed rest are likely to develop deep vein thrombosis from
a lack of muscle activity, resulting in pooling of blood and clot formation
114
1. What is the most important function of the pulmonary system?
Answer: b) Exchange of oxygen and carbon dioxide between the environment, blood, and tissue
115
2. How many ATP molecules are produced when a cell undergoes aerobic metabolism with oxygen?
Answer: b) 36 ATP
116
4. What does reduced oxygen in tissues due to pulmonary system pathology result in?
Answer: b) Decreased ATP production and reduced exercise tolerance
117
5. What role does the pulmonary system play in regulating blood pH?
Answer: b) It exchanges carbon dioxide, which helps maintain acid-base balance
118
8. What is the ventilatory rate or respiratory rate in an adult at rest?
Answer: b) 10 to 15 breaths/minute
119
13. What gas is exchanged by the pulmonary system to help regulate blood pH?
Answer: c) Carbon dioxide
120
The volume of air that remains in the lungs after a forceful expiratory effort is called
residual volume
121
The additional volume of air that can be let out beyond the normal tidal exhalation is called
expiratory reserve volume
122
14. Why is oxygen necessary for a cell?
Answer: b) To undergo aerobic metabolism and produce ATP
123
Responsible for sensing alterations in blood pH, carbon dioxide, and oxygen levels.
Chemoreceptors
124
The pressure of a given quantity of gas is inversely proportional to its volume
Boyle’s law
125
1. What does the process of respiration primarily involve?
Answer: b) Gas exchange in the lungs
126
2. What are the two major functions of respiration?
Answer: b) To replenish the blood’s oxygen supply and remove carbon dioxide
127
What is the primary mechanism by which gas exchange occurs in the lungs? a) Active transport b) Simple diffusion c) Osmosis d) Facilitated diffusion
Answer: b) Simple diffusion
128
12. Which side of the heart pumps deoxygenated blood to the lungs for gas exchange?
Answer: b) Right side
129
14. What is the main role of pulmonary perfusion in respiration?
Answer: c) To bring blood to the lungs for gas exchange
130
What is the primary benefit of low pressure in the pulmonary circulation? a) It helps to increase blood flow to the systemic circulation b) It allows for higher filtration pressures in the lungs c) It protects the lung from pulmonary edema by reducing filtration pressures d) It increases the ability of the lung to filter oxygen
Answer: c) It protects the lung from pulmonary edema by reducing filtration pressures
131
13. What is diastasis?
Answer: b) The slow-filling phase of the ventricles
131
What is pulmonary edema? a) A condition where the lungs cannot absorb oxygen properly b) A condition where fluid accumulates in the lungs, hindering ventilation and gas exchange c) A condition where the alveoli become dilated d) A condition where the lung fails to expel carbon dioxide
Answer: b) A condition where fluid accumulates in the lungs, hindering ventilation and gas exchange
132
1. What are the two main periods of the cardiac cycle?
Answer: b) Systole and diastole
132
2. What does systole refer to in the cardiac cycle?
Answer: c) The period of ventricular contraction
133
The stroke volume, or volume of blood ejected out of the heart per beat, is affected by three variables:
Preload Contractility Afterload
134
1. What is the primary action of the sympathetic nervous system during exercise in terms of blood flow?
Answer: c) Divert blood to working muscles and away from organs like the kidneys and intestines
135
2. Which type of receptors in systemic blood vessels cause vasoconstriction during exercise?
Answer: a) α-adrenergic receptors
136
What is the effect of norepinephrine released by sympathetic nerve fibers on the blood vessels of the digestive organs and kidneys during exercise? a) Vasodilation to increase blood flow b) No change in blood flow c) Vasoconstriction to divert blood to skeletal muscles d) Increase blood flow to the heart
Answer: c) Vasoconstriction to divert blood to skeletal muscles
137
4. Which receptors are activated by epinephrine in the blood vessels of working muscles during exercise?
Answer: b) β-adrenergic receptors
138
10. What happens to coronary blood flow during exercise?
Answer: c) It increases to meet the increased oxygen demand of the myocardium