Chapter 3 (Trunk)

Question 1

___corresponds to the upper part of the trunk and is located between the neck and the abdomen. The ___ is the prominent superficial structure in the anterior aspect. The bones of the ___ include the ___ in the back, the ___ in the side, and the ___ in the front.

Answer 1

• thorax
• breasts
• 12 thoracic vertebrae, ribs in the side, and sternum in the front

Question 2

The ribs articulate with the ___ and the ___ and form the ____, which surrounds the ____ cavity and contains the ___ and ____, as well as the structures in the ____.

Answer 2

• verterbae and sternum
• thoracic cage
• thoracic
• heart and lungs
• mediastinum

Question 3

the thoracic cage has an ___ and ___ opening, referred to as the ____ and ___.

Answer 3

• upper and lower

- thoracic inlet and outlet

Question 4

extends from the body of the T1 vertebra posteriorly, first rib laterally and slopes downward and provides space for some thoracic structures, such as the lungs and pleura

Answer 4

thoracic inlet

Question 5

injuries to the lower part of the neck may be accompanied by damage to the ___ and/or ___

Answer 5

• pleura

- lungs

Question 6

between the T12 posteriorly, ribs 11 and 12 laterally, and costal margin anteriorly.Junction of the costal cartilage of ribs 7-10 creates costal margin and the infrasternal angle

Answer 6

thoracic outlet

Question 7

refers to the lateral edge of the costal margin on each side

Answer 7

infrasternal angle

Question 8

junction of the costal cartilage of ribs 7-10 create the ___

Answer 8

costal margin

Question 9

Ribs 11 and 12 are ___ ribs, with ___ connection to the sternum

Answer 9

• floating

- no

Question 10

There are ___ pairs of ribs in total in the body. The anterior part of the rib is ______ and is known as the _____. Ribs 1-7 are directly connected to the sternum and therefore are known as the ____ ribs. The five lower ribs are known as the ____, which are either indirectly connected to the sternum through the _____, or not at all connected to the sternum are ribs ___. These latter ribs are known as the ____ and lie in the abdominal wall.

Answer 10

• 12
• cartilaginous (hylaine)
• costal cartilage
• true ribs
• false ribs
• costal cartilage of rib 7
• 11 and 12
• floating ribs
• abdominal wall

Question 11

Ribs: following parts are distinguished in the ribs-the ___, ___, body, and ____. There is a ___ in the body of the ribs posteriorly, known as the ____. The head and tubercle have ____ to articulate with ____. The ___ usually articulates with the bodies of the 2 adjacent vertebrae and the _____ between them, while the tubercle articulates with the transverse process of the ____. As previously described, these articulations are referred to as ____ and ____, respectively, and various interconnecting ligaments support the capsule. The head of the 1st, 11th, and 12th ribs articulate only with their ____; these are the only ribs that do not have a ______ near their lower surface, through which the ______ run.

Answer 11

• head, neck, tubercle
• bend
• costal angle
• articular surfaces
• vertebrae
• head
• interverterbral discs
• thoracic vertebrae
• costovertebral, costotranverse
• own vertebrae
• costal sulcus (groove)
• intercostal vessels and nerve

Question 12

Some ribs have important features among them, the following landmarks can be distinguished on the ____, the ___ on its superior surface, as well as ____-one for ___ and lower ____ and one for the passage of the ____. Although the initial ossification of the ribs takes place between the __ and __ month of gestation, their anterior part remains ___. This costal cartilage will ossify with ___ and may cause restrictions in the mobility of the thoracic cage.

Answer 12

• first rib
• scalene tubercle
• two grooves
• subclavian artery
• brachial plexus
• subclavian vein
• 2nd and 4th
• unossified
• age

Question 13

Ribs may ____ in crushing injuries and blows to the ____ cage, and a rare fracture of the ___ may injure the ___, as well as the ____.

Answer 13

• fracture
• thoracic cage
• first rib
• subclavian vessels
• brachial plexus

Question 14

problems with cervical rib: a cervical rib is one of the causes of the _____ syndrome. It is due to a remnant or or development of a costal process on the ____, which may lead to compression of the ___ leading to ____. ____ may also lead to ___ compression, which can cause muscle weakness and pain in the upper limb. A mass may be palpable in the ____.

Answer 14

• thoracic outlet
• C7 vertebrae
• subclavian artery
• ischemic pain
• thoracic outlet syndrome
• lower brachial plexus
• lower neck

Question 15

The ____ is a flat bone located anteriorly in the midline of the chest, consisting of an upper part, the ___; a lower part, the ___; and the ___, located in the middle. The body of the ___ is about 8-9 cm long, and is slightly longer and thinner in ____.

Answer 15

• sternum
• manubrium
• xiphoid process
• sternum
• males

Question 16

There is an angle between the ____ and the body of the sternum-the ____-which is at the level of the ___. The junction is referred to as the ____, and may unit (___) after age 40.

Answer 16

• manubrium
• sternal angle
• T4 vertebra
• manubriosternal joint
• synostosis

Question 17

Important features of the manubrium include the ____ on its superior border, the ___ for articulation with the clavicle, and the ____ for articulation with the 1st and 2nd ribs. There are also several ___ on the lateral borders of the sternal body, for continuous ___articulations with the other ribs. These articulations are supported by various ____.

Answer 17

• jugular (supra sternal) notch
• clavicular notch
• costal notch
• costal notches
• cartilaginous
• sternocostal ligaments

Question 18

The ____ of the sternal body in the midline can be used for ___ and ___ needle biopsy for bone marrow transplants or cytologic analysis. The lower part by be associated with ___ and ___, and its is dangerous to puncture this area. The ossification of the sternum begins in the cartilage during _____, during which several ossification centers appear and will unite later in life. The ____ may ossify during the middle age. ___ is a cut through the bone, a procedure done to access the heart in coronary bypass or open heart surgery

Answer 18

• upper third
• puncture and bone marrow
• congenital fissures or foramen
• months three to six gestation
• xiphoid process
• median sternotomy

Question 19

The thoracic cage moves with ____ by widening the ___ during ___, then returning to normal size during ____. These movements are facilitated by several factors, including the mobility in the ___, movement at the ____ joint, elevation of the sternum by ___ and ____, elasticity of the ____, increased ___ of the thoracic curvature in the vertebral column, and function of the ____.

Answer 19

• respiration
• thorax
• inspiration
• expiration
• costovertebral joints
• manubriosternal joint
• sternocleidomastoid and scalene muscles
• costal cartilages
• kyphosis
• respiratory muscles

Question 20

_____ and muscles of the __ and ___ are involved in the movement of the thoracic cage

Answer 20

• intercostal muscles
• neck
• abdomen

Question 21

Are usually three ____ muscles in the neck and upper parts of the thorax, assisting the respiration and movement of the thoracic cage by ___ the upper ribs

Answer 21

• scalene

- elevating

Question 22

Scalene muscles originate from the ____ of the cervical vertebrae and attach to the ___. The ____ muscle attaches to the ___ tubercle of the first rib, the ___ nerve runs downward on the muscle, and the subclavian vein runs anterior to the insertion point of the muscle in the first rib. The ____ scalene muscle inserts on the first rib behind the insertion point of the ___ scalene and reaches the ___ rib. An opening called the scalene ___ is therefore formed between these two scalene muscles, through which the subclavian artery and brachial plexus pass. Finally, the __ scalene muscle connects to the ___ and/or __ rib. The scalene muscles can also tilt the ____ column, and are innervated by the ___ and the ___.

Answer 22

• transverse process
• upper ribs
• anterior scalene
• anterior scalene
• phrenic
• middle
• anterior
• gap
• posterior
• second and third
• cervical vertebral
• brachial plexus and cervical plexus

Question 23

The ___ muscles are related to the ribs. Some of these muscles are found between the ribs, including the ___, ___, and the ____ muscles. The ___ and ___ muscles also connect to the ribs. By elevating or depressing the ribs, the ___ muscles are involved in respiration, but their function is complex. They are innervated by ___ nerves.

Answer 23

• intercostal
• external, internal, innermost intercostal
• subcostal and transverse thoraces
• intercostal
• intercostal

Question 24

External intercostal muscles are the ___ layer of muscles, originating from the lower border of the ___ and running ___. They connect to the upper border of the lower ___, and are extended from the ___ tubercle of the vertebrae in the back between two ___, to the front to the ___ cartilage. From here, muscle continues as the external intercostal membrane toward the ___. The muscles function during forced ___.

Answer 24

• outermost
• ribs
• obliquely
• rib
• costal
• ribs
• costal
• sternum
• inspiration

Question 25

Internal intercostal muscles are found ___ than the external muscles between two __, and run more ___ compared to the external intercostal fibers. They extend posteriorly from the angle of the ___ toward the __ in the front, and continue backward as the internal intercostal membrane toward the ___. These muscles function both as ___ and ___ muscles.

Answer 25

- deeper - ribs - vertically - rib - sternum - vertebrae - expiratory - inspiratory

Question 26

the innermost intercostal muscles run in the same direction as the ____ and are indeed part of the ___, but are positioned __ and may be missing in some areas. The intercostal ___, ___, and ___ are found between the innermost intercostal muscles and the ___ muscles.

Answer 26

- internal intercostal fibers - internal intercostal fibers - deeper - artery, vein, and nerve - internal intercostal

Question 27

Subcostalis muscles are actually the fibers of the ____ muscles that extend over several segments. These are found close to the ___ angles and function similarly to the ___.

Answer 27

- internal - intercostal - costal - internal intercostal

Question 28

The transverses thoraces muscle originates from the internal surface of the ____ and extends to the ___. These are also ___ muscles.

Answer 28

- xiphoid process - ribs - expiratory

Question 29

Muscles on the outside of the chest wall: These muscles belong to the ___, the ___, and the ___. They include the ___ and ___ and ___, which are discussed with the upper ___ muscles. The ___ and the external and internal abdominal ___ muscles are discussed in the abdominal region. Among the muscles of the back related to the thorax, the ___, ___, and others were discussed among muscles of the back.

Answer 29

- upper limb - abdominal wall - back - pectoralis major and minor - serratus anterior - limb - rectus abdominis - oblique - latissumus dori - trapezius

Question 30

Which muscles elevate the thoracic cage?In addition to the ___, the ____, ___, and the ___ and __ also elevate the ribs.

Answer 30

- scalene muscles - sternocleidomastoid - intercostal muscles - pectoralis major and minor

Question 31

The _____, along with its paired accompanying veins, runs vertically downward on the posterior aspect of the anterior thoracis muscle.

Answer 31

internal thoracic (mammary) artery

Question 32

Internal thoracic (mammary) artery originates from the ____ artery on each side. The artery sends transverse branches- the ____ arteries- that run in the intercostal spaces and, together with the ______ branches, supply the thoracic wall, including the skin of that region, as well as the back.

Answer 32

- subclavian artery - anterior intercostal arteries - posterior intercostal

Question 33

The internal thoracic artery gives off a branch, the _____, in the 6th intercostal space, and continues downward as the ____ in the rectus sheath between the abdominal muscles. The ___ provides the blood supply for intercostal spaces seven, eight, and nine anteriorly on each side.

Answer 33

- musculophrenic artery - superior epigastric artery - musculophrenic artery

Question 34

The superior epigastric artery continues downward as the ____ in the lower abdominal wall and joins the ____.

Answer 34

- inferior epigastric artery | - external iliac artery

Question 35

In condition such as _____, a narrowing in the arch of the aorta may compromise the blood supply to the thoracic, abdominal, and lower limb structures. Therefore, internal thoracic artery and its branches, including the intercostal arteries, may be dilated and supply blood to the thorax, abdomen, and especially the lower limbs

Answer 35

-coarctation of the aorta

Question 36

The ___ originate from the thoracic aorta and run in intercostal spaces three through eleven, and the subcostal artery is also a branch of the thoracic aorta

Answer 36

-posterior intercostal arteries

Question 37

In the thoracic wall, the posterior and anterior intercostal veins are finally drained by the ___ and ___ veins into the ___. The first intercostal veins are drained by the ____ directly, while the second and third posterior intercostal veins unite to form the ____ vein, which drains into the ___ on the right side, and into the left ____ vein on the left side.

Answer 37

- azygos - hemiazygos - superior vena cava - brachiocephalic veins - superior intercostal - azygos - brachiocephalic

Question 38

Intercostal nerves one through ___ run within the ___ in the intercostal spaces, and the subcostal nerve branches off the ___ nerve. Intercostal nerves are the ____ of the spinal nerves and contain motor, sensory, and autonomic fibers. The ___ innervate the intercostal and abdominal muscles as well as the subcostalis and transversus thoracic, while the ___ innervate various dermatomes. The ___ are the postganglionic fibers that originate from the sympathetic chain and reach the intercostal nerves through the grey communication ramus. The ____ fibers originate from the spinal cords intermediate grey column, run a short distance into the intercostal nerves and arrive at the white communicating ramus, reaching the sympathetic ganglia in the thoracic cavity into the abdomen and synapse in preverterbal ganglia.

Answer 38

- eleven - costal groove - T12 - primary ventral rami - motor fibers - sensory fibers - myelinated preganglionic - preganglionic

Question 39

Some conditions for which we may need to access the intercostal spaces? The intercostal nerves can be anesthetized during painful conditions such as fractures of the ___ or ___. The procedure is termed intercostal nerve block and the needle is inserted close to the ___ border of the __ in order to reach the nerves. However, since the ___ and __ pass beneath the ___, extreme care should be taken not to sever them. Another method of accessing the intercostal space is tube ___ and ___, to drain pathologic air/gas or fluid from the pleural cavity. The approach is usually close to the ___ border of the ___ to avoid injury to the intercostal nerve and vessels. All layers from the __ down to the ___ are punctured in this intervention.

Answer 39

- ribs - shingles - lower - rib - intercostal nerve and vesseks - thoracostomy - thoracocentesis - upper - rib - skin - parietal pleura

Question 40

Anterior regions of the Trunk, including the thorax

Answer 40

axillary region, deltoid region, infraclavicular region, and clavipectoral region

Question 41

Skin innervation of the thorax is derived mainly from the ___ nerves from ____. They cover the area at the level of the clavicle down to the level of the ____. The anterior and lateral cutaneous branches of the intercostal nerves innervate the ___ and ___ of the thorax, while the skin of the back, about 2 inches from the midline is innervated by the ___. The boundary between the anterior and posterior branches of the spinal nerves is the ___ in the back. The ___ artery, a branch of the ancillary artery supplies the lateral side, and, medially the perforating branches of the ___ artery, as well as other ___ arteries, all help supply blood to the skin. The veins follow similar naming conventions and drain into regional veins. The ____ plexus around the nipple drains into the anterior intercostal, thoracoepigastric and lateral thoracic veins. Lymphatics of the region are drained by the superficial and deep lymph nodes, and a major portion of the lymphatics here is drained by the ___ lymph nodes. These may be removed if invaded by a metastatic ____

Answer 41

- ventral rami of the thoracic spinal - T2-T6 - xiphoid process - front and sides - dorsal rami of the thoracic nerve - scapular line - lateral thoracic - internal thoracic - intercostal - areolar venous - axillary - breast cancer

Question 42

The ___ in females is the main structure in the anterior region of the thoracic wall. It is a ___ structure that consists of mainly fat and ___ tissues that are supported by ___ tissues. It varies in size, shape and function in different people, depending on age and gender. In males, the breast is a rudimentary structure in spite of showing some changes in puberty. In females, the breast can produce ___ for sustenance of their offspring. The breast in females extends vertically from the ___ to ___ ribs and transversely from the ___ to the mid axillary line. Prominent features seen in the surface of the breast include the ___ and the ___. __ is the presence of more than one nipple on a breast.

Answer 42

- breast - cutaneous - glandular - fibrous - milk - second to sixth - sternum - nipple - areola - polythelia

Question 43

The nipple consists of ____ tissue and ___ muscle covered by a keratinizing stratified squamous epithelium. Milk conducting ducts open into the ___, which is surrounded by the ___, a round area of pigmented skin containing ___ glands giving it a nodular appearance. These glands ___ during pregnancy and their oils secretion helps the suppleness of the nipple during ___. The color of the nipple at puberty and of the areola during pregnancy, may ___ due to increased ___ production and pigmentation. The areola gradually lightens in color after delivery.

Answer 43

- connective - smooth - nipple - areola - enlarge - lactation - darken - melanin

Question 44

The breast is situated in the anterior wall of the ___ in the superficial fascia covering of the ___ and the ___ muscles. It extends into the ___, and downward onto the sheath covering the ___ abdominis. The breast is separated from the pectoralis muscles by the deep fascia and a gap called the____ is located between the breast and deep fascia, which allows some degree of breast movement. The internal structures of the breast are supported by bands of ___ tissue, the ___ ligaments of Cooper, which extend from the ___ to the skin to the deep fascia. The __ in the breast determines its size and contour, while the ___ tissue produces the milk. The ____ glands are exocrine in type and are, in fact, enlarged and modified swear glands. In humans, they are complex tubuloalveolar glands that develop as a down-growth of the epidermis along the milk line. Accessory or ___ breasts are known as polymastia.

Answer 44

- chest - pectoralis major - serratus anterior - axillary - rectus - retro mammary space - fibrous - suspension - dermis - fat - glandular - mammary - supernumerary

Question 45

The alveoli are lined by a milk secreting ____, and are surrounded by the myo epithelial cells that can contract upon ___ secretion. This contraction leads to the ____ into the lumen of the alveoli. The alveoli join to produce ___. There are about ___ milk-secreting lobules in the human breast, each of which is drained by a ____ duct and opens into the ___. The ducts have dilated portion called the ____ where the mile accumulates. The action of a baby sucking the nipple leads to ___ activation and secretion of ___ for release of the milk in a let down process. Milk production is under the anterior ____ secretion.

Answer 45

- cuboidal epithelium - oxytocin - excretion of milk - lobules - 15-20 - lactiferous - nipple - lactiferous - sinus - neurohormonal - oxytocin - pituitary prolactin

Question 46

Under influence of ___ during puberty, the ___ undergo branching and there is an increase in ___ deposition, which leads to ___ enlargement. During pregnancy, true ___ grow when estrogen and progesterone levels increase. Breast involution takes places after ___. When there is a decrease in ___ and growth promoting factors and a cessation of the baby suckling, all alveoli and secretory ducts collapse and undergo ___ and ___.

Answer 46

- estrogen - lactiferous ducts - fat - breast - secretory lobules - lactation - prolactin - apoptosis and autophagy

Question 47

Innervation of the breast: ____ innervate the skin, vessels, and smooth muscles of the breast. Dermatomes of the nipple is approximately at ___.

Answer 47

- intercostal nerves T4-T6 | - T4

Question 48

Blood supply: ____, ___ artery and ___ arteries.

Answer 48

- Internal thoracic, axillary | - intercostal

Question 49

Venous drainage: ___ from the breast is drained to the corresponding veins, which are finally drained by the ___ and ___ veins.

Answer 49

- blood - axillary - azygos

Question 50

Lymphatic drainage: ___ lymph nodes receive the lymphatics of the upper limb and the wall of the trunk as low as the ___. About __ % of the breast lymphatics from the lateral quadrants are drained by ___ nodes. There is a plexus of vessels within the breast under the areola, called the ___, into which the lymphatics of other parts of the breast received. The plexus, in turn, drains into the ___ nodes. There are also some direct pathways from the breast to the ___ nodes, around the ___ or into the __ and not necessarily through the plexus of Sappay.

Answer 50

- axillary - umbilicus - 75 - axillary - subareolar plexus of Sappay - axillary - axillary - clavicle - neck

Question 51

The axillary lymph nodes are organized into 5 major groups ___. The ___ drains major lymphatics of the upper limb. The ___, at the lateral border of the pectoralis minor and major muscles, drain most of the mammary gland. The ___ drains the posterior part of the shoulder, while the ___ drains above groups. The ___ and other groups drain their lymphatics into the ___ group, and some lymphatics of the breast are drained into the ___ group. The ___ group drains to the subclavian lymphatic trunk into the right lymphatic duct in the right side, which then drains into larger veins at the ___ angle. The lymphatics of the left side finally drain the ___ duct. The remaining lymphatics from the medial quadrants of the breast drain by the ___ nodes or other side vessels, and the inferior quadrant lymphatics may reach the ___ lymph node.

Answer 51

- pectoral, lateral, apical, subscapular, central. - lateral group - pectoral/anterior group - subscapular/posterior group - central group - central - apical - central - apical - venous - thoracic - parasternal - abdominal

Question 52

Breast cancer may metastasize to the ___ lymph nodes, and removal of the __nodes may be necessary. Invasion of the __ ligaments by a tumor may cause dimpling of the skin, similar to the appearance of an orange peel. There may be an injury to the ___ nerve during radical mastectomy.

Answer 52

- axillary - lymph - suspensory - long thoracic

Question 53

Can a male have an enlarged breast? Yes, males can also develop an abnormally large breast; this condition is called ____. It may develop during the ___ stage due to the effect of the mothers hormones; it can arise during ___; or it may develop in older people. It may appear as a small lump just under the ___. During growth, this mass can be tender.

Answer 53

- gynecomastia - neonatal - adolescence - areola

Question 54

Gynecomastia is usually ___ to the normal hormonal imbalances between testosterone and estrogen, in favor of ___. This commonly occurs during ___. Gynecomastia may be due to persistent ___ gynecomastia, ___, no detectable abnormality, ___, ___, or the result of testicular and suprarenal cancers. It may be one of the features of male hypogonadism, known as ___. These males have one or more ____.

Answer 54

- secondary - estrogen - puberty - pubertal - drugs - cirrhosis - malnutrition - Klinefelters syndrome - extra X chromosome

Question 55

The ____ is one of the transitional regions between the thorax and the upper limbs, located in the upper chest.

Answer 55

-infraclavicular region

Question 56

The skin of the infraclavicular region is innervated by the ____. Beneath the skin, the ___ is attached to the superficial fascia, covering the pectoralis major and deltoid muscles. The ___ then continues upward through the neck to attach to the inferior border of the mandible and the skin close to the angle of the mouth

Answer 56

- suprascapular nerves of the cervical plexus | - platysma

Question 57

The ___ innervated the platysma

Answer 57

-facial nerve

Question 58

The ___ overlying the pectoralis major muscle is found under the platysma, and the pectoralis minor is deeper than the major in the ___ region. The _____ nerves accompanied by the pectoral vessels and lymphatics can also be found in the infraclavicular region. The ___ muscle is located deep in this region as well, originating from the first rib and connecting to the sulcus for the ___ muscle on the lower surface of the clavicle. It pulls the clavicle toward the sternum and is innervated by the ___.

Answer 58

- pectoral fascia - infraclavicular - medial and lateral pectoral - subclavius - subclavius - nerve to the subclavius

Question 59

Main structure in the region are the ___ artery and the cords of the ___ plexus, as well as the ___ vein situated medial to the artery. These structures continue inferolaterally,

Answer 59

- axillary - brachial - axillary

Question 60

The ___ region is transitional region between the trunk and the upper limb. The main structures in this region are the distal part of the brachial plexus including the cords and their terminal nerves, the ___ artery, vein and lymph nodes.

Answer 60

-axillary

Question 61

The axillary is a pyramid region whose boundaries include the ___ and __ muscles located anteriorly, the ___ located posteriorly, the ___, together with the ___ and short head of the ____, laterally and the thoracic wall with the ___ located medially. Several lymph nodes, which drain the ___ of the upper limb as well as the ___, are arranged in 5 grips that are also found in this region

Answer 61

-pectoralis major and minor -lattisimus dorsi -humerus -coracobrachialis -biceps brachii -serratus anterior lymphatics -breast

Question 62

In the infraclavicular region, the ___ lies superolaterally to the axillary vessels and cephalic to the chest wall. The ___ lies deep to the skin, ___ and clavipectoral fascia, which splits to enclose the pectoralis minor muscle. The ultrasound-guided infraclavicular nerve block include anesthesia for the surgery of the ___, ___ and ___ and post surgical too, also including reimplantation.

Answer 62

- brachial plexus - plexus - pectoralis major - arm, forearm, and hand

Question 63

The axillary is a pyramid region whose boundaries include the ___ and __ muscles located anteriorly, the ___ located posteriorly, the ___, together with the ___ and short head of the ____, laterally and the thoracic wall with the ___ located medially. Several lymph nodes, which drain the ___ of the upper limb as well as the ___, are arranged in 5 grips that are also found in this region

Answer 63

-pectoralis major and minor -lattisimus dorsi -humerus -coracobrachialis -biceps brachii -serratus anterior lymphatics -breast

Question 64

In the infraclavicular region, the ___ lies superolaterally to the axillary vessels and cephalic to the chest wall. The ___ lies deep to the skin, ___ and clavipectoral fascia, which splits to enclose the pectoralis minor muscle. The ultrasound-guided infraclavicular nerve block include anesthesia for the surgery of the ___, ___ and ___ and post surgical too, also including reimplantation.

Answer 64

- brachial plexus - plexus - pectoralis major - arm, forearm, and hand

Question 65

The middle part of the thorax between the two lungs is called the ___, which can be divided into superior and inferior sections by a plane passing though the angle of the ___ to the inferior border of the __. The superior section contains great vessels around the __, including the __ of the __ and its three branches, the ___, ___, and the ___; part of the __, ___ and ___; and ___ and smaller vessels, as well as the ___ duct. The inferior section can be subdivided into three parts in an anteroposterior direction. The anterior mediastinum contains mainly the __, __ and __.

Answer 65

- mediastinum - sternum - T4 vertebra - heart - arch - azygos vein - superior vena cava - r/l brachiocephalic vein - thymus, trachea, and esophagus and phrenic nerves - thoracic - thymus - fat - lymph nodes

Question 66

The thymus consists of ___, and the tissue is populated with the ___ migrating from bone marrow. The thymus weighs about 10g birth and 20-40 g puberty. With age, it ___ and is replaced by adipose tissue, though it still functions and is a site of ___ differentiation. Pathology of the anterior mediastinum includes ___, as well as thymomas due to ___.

Answer 66

- epitheliocytes - T stem cells - decreases in size - T cell differentiation - lymphomas - myasthenia gravis

Question 67

The middle mediastinum contains the ___ and the ___, covered by ___ as well as the great vessels, including the ascending aorta, the autonomic and phrenic nerves. The posterior mediastinum, which lays behind the __ ligament from the T5-T12 vertebrae, contains the ___, ___, ___ and __; the ___ system; and the ___ nerves.

Answer 67

- heart and coronary vessels - pericardium - pulmonary - esophagus, vagus nerves, thoracic aorta, and thoracic duct; azygos venous, sympathetic

Question 68

The lungs are covered by a saclike, ___ membrane called the pleura, a ___ that produces a small quantity of serous fluid. The ___ of the pleura is very close to and actually adheres to the ___, the __ and the ___, and lines one half of the cavity. It is continuous with the __ which is closely adhered to the surface of the ___ and even into the __ of the lungs. Different parts of the parietal layer take different names: the ___ is the area where the parietal layer covers the ribs and costal cartilages, whereas the apex of the lungs is covered by the ___, which is reinforced by the suprapleural membrane. Close to the lateral borders of the heart, the parietal leura is called the ____, while the part covering the diaphragm is known as the ___. At the __ of the lungs, where the bronchi and pulmonary vessels enter or leave the lungs, the mediastinal pleura becomes continuous with the ____.

Answer 68

- double-layered - serous membrane - outer (parietal) layer - thoracic wall - diaphragm - pericardium - inner (visceral) layer - fissures - costal pleura - cervical pleura - mediastinal pleura - diaphragmatic pleura - hilum - visceral pleura

Question 69

Inferior to the hilum, the duplicature of the pleura is called the ___. The posterior mediastium is situated posterior to the ___

Answer 69

-pulmonary ligament

Question 70

The ___ is from the sternoclavicular joints on both sides, which extend anteriorly in the middle of the sternum down to the xiphoid process slightly on the right side, and laterally to the right by reaching rib 8 around the midclavicular line, to rib 10 laterally, and to rib 12 posteriorly. On the left side, it follows the border of the ___, reaching the costal cartilage of the fourth rib, down to the sixth costal cartilage and follows a path similiar to the right side when extended laterally and posteriorly.

Answer 70

- reflection of the pleura | - mediastinum

Question 71

The pleural cavity is the space between the __ and __ pleurae that is filled with a small amount of ___: the pleural fluid serves for lubrication and other purposes. The pleural cavity becomes wider close to the ___ or ___, creating the costodiaphragmatic and costomediastinal recesses.

Answer 71

- parietal - visceral - serous - diaphragm - medastinum

Question 72

Innervation, blood supply, and lymphatic drainage of the pleura: ___ nerves, including the ___ and the ___, innervate the parietal layer. The pain of ___ is due to the ___ innervation of the parietal layer, causing a sharp local pain as well as referred pain in the thoracic wall, or even to the root of the neck. The parietal pleura is supplied by the __ and __ arteries, and venous drainage is accomplished via the corresponding __. The lymphatic pass to the nodes of the internal aspect of the ___ wall.

Answer 72

- local somatic - intercostal and phrenic nerve - phrenic nerve - intercostal and internal thoracic - veins - thoracic

Question 73

The ___ nerves innervated the visceral pleura, which is insensitive to pain caused by ___. The vessels of the lungs supply the blood to the ___ layer, and its lymphatic drainage follows that of the lungs to the nodes in the ___ of the lungs.

Answer 73

- sensory autonomic - inflammation - visceral - hilum

Question 74

Significance of intrapleural press: the pressure of the ___ is very important for the expansion of the thorax and the lungs. The pressure can be measured with a balloon catheter placed in the ___. In a breathing cycle, the intrapleural pressure is ___ at rest, due to the opposing forces of the lungs trying to ___ and the chest wall trying to ___. During ___, the intrapleural pressure drops even further because of an increase in both volume and elastic recoil strength of the lungs. During normal ___, the intrapleural pressure returns to the value at rest, and the cycle repeats.

Answer 74

- pleural cavity - esophagus - negative - collapse - expand - inspiration - expiration

Question 75

What happens if the intrapleural pressure is disturbed. Conditions that disturb the intrapleural pressure may interfere with ___. The most important of these include ____, a condition in which air gets into the pleural cavity due to injury, such as a gunshot wound or puncture by a sharp object such as a knife wound, trauma with fractures of the ribs, inadvertent damage to the pleura during surgery of the kidney from a posterior approach, thoracocentesis, catheterization of the subclavian vein, mechanical ventilation or brachial plexus or sympathetic nerve block. Another possible cause of ___ is ___, which may lead to the rupture of the visceral pleura, thereby allowing air from the lungs into the pleural cavity. ___ pressure leads to the collapse of the lung and interferes with respiration, which can be fatal if not corrected in time.

Answer 75

- respiration - pneuomothorax - pneumothorax - pulmonary disease - positive intrapleural

Question 76

Pneumothoraces can be classified as simple, tension, or open, according to their pathophysiology. In ___, the parietal pleura is punctured, which lets the outside atmospheric air into the pleural cavity during inspiration, resulting in the collapse of the lung. In some pulmonary diseases, ____ typically occurs due to the rupture of a bleb, damaging the visceral pleura and allowing air from the alveoli into the pleural cavity. In ___, air enter the pleural cavity but does not leave it, leading to the collapse of the lung in the affected side. There may also be a mediastinal shift toward the normal side, increasing intrathoracic pressures and leading to dyspnea and/or cyanosis, hyper-resonant percussion tone, and a radiolucent area in a chest X-ray. Tension pneumothorax is a medical emergency, relieved by ___ in the anterior axillary line, in the fourth or fifth intercostal space. The tube is placed posteriorly and superiorly and is connected to a water seal drainage system with suction control

Answer 76

- open (sucking) pneumothorax - spontaneous pneumothorax - tension pneumothorax - tube thoracostomy (chest drain)

Question 77

In the middles between the two lungs, called the ___, the trachea divide into bronchi, bronchial vessels, and pulmonary vessels, and the lymphatics enter or leave the lungs.

Answer 77

-hilum

Question 78

Lungs: The ___ nerve and __ vessels are found anteriorly, while the ___ nerves are found more deeply in the thorax. The left lung is smaller and provides a space for the ___, situated externally between the two lungs. The right lung is a bit wider, though it is shorter due to the ___, which is situated beneath the thoracic diaphragm in the abdominal cavity, pushing the right lung upward.

Answer 78

- phrenic - pericardiophrenic - vagus - heart - liver

Question 79

The lungs have an ___ as well as a base.

Answer 79

apex

Question 80

The apex is behind and about one inch higher than the __ in the root of the neck, due to the oblique inlet of the thorax. Three surfaces can be distinguished on each lung. These include the __ surface, the ___ surface and the ___ surface, where the hilum of the lung is located. The surface of the lung, which is covered by the ___, is mottled with polyhedral-shaped line markings, with smaller lines subdividing them. There are also 3 borders in the lungs: the anterior, posterior and the inferior border.

Answer 80

- clavicle - costal - diaphragmatic - mediastinal - visceral pleura

Question 81

The inferior border of the lungs in an adult is situated at approximately the level of the __ in the __ line, the ___ in ___ line, and at the __ posteriorly in the ___ line. The inferior border of the lungs in children is about ___ higher than in adults.

Answer 81

- 6th rib - midclavicular - 8th rib - midaxillary - 10th rib - scapular - 1 rib

Question 82

There are usually __ in the right lung-the superior, middle and inferior lobes-as well as two fissures: the ___ and __ fissures.

Answer 82

- 3 lobes | - horizontal and oblique

Question 83

There are ___ in the left lung divided by the ___ fissures. On the anterior border of the upper lobe, the ___ appears as an indentation. The ___ is part of the left lung, situated below the cardiac notch. Major impressions of the left lung are also found in the mediastinal surface, including a large ___ impression situated anteriorly and inferior to the hilum. Superior to the __ impression, the area for the ___ is found extending into the groove for the arch of aorta.

Answer 83

- 2 lobes - oblique - cardiac notch - lingual - cardiac - cardiac - ascending aorta

Question 84

The tracheobronchial tree constitutes part of the passagewayds in which ___. The trachea is a 12 cm long and 2 cm wide elastic tube extending from beneath the larynx to its bifurcation into the main bronchi called the ___. Air entering the nasal cavities should pass through the ___, which is a 12 cm long tube at the base of the skull connected to the facial skull, lying over the vertebral column and deep muscles in the anterior aspect of the cervical vertebrae. it is in close relation to the periverteberal fascia, and merges posteriorly into the esophagus at the level of the cricoid cartilage; but anteriorly, it leads to the airway. The pharynx is part of both the ___ and the ___, and is made up of 3 parts: an upper part, called the ___; a middle part, called the __, and a lower part, called the ___.

Answer 84

- air flows - carina - pharynx - respiratory - digestive tracts - nasopharynx - oropharynx - hypopharynx

Question 85

The respiratory system can be divided into an ___ component and a ___ component. The air-conducting system includes the nasal cavity, followed by the ___, ___, ___, and the ___ down to the terminal bronchioles, which only conduct the air and where no ___ occurs. The respiratory component, including the ___, the ___, and the ___, is responsible for the blood-air-gas exchange.

Answer 85

- air conducting - respiratory - pharynx, larynx, trachea, bronchial tree - no gas exchange - respiratory bronchioles - alveolar ducts - alveoli

Question 86

The wall of the trachea and bronchi are well organized and consist of a ____: a muscle later, submucosa, and adventitia. The smaller airways lose such organization, through 4 layers can be distinguished in the trachea in cross section. The ___ consists of a loose connective tissue, including collagen and elastic fibers that surround the C shaped hyaline cartilage, forming the anterior and lateral parts of the trachea. Beneath the cartilage, the submucosa consisting of ___ glands can be distinguished. In a longitudinal view, a dense, ___ connective tissue is located between the cartilages, allowing the elongation of the trachea. A smooth muscle layers of the ___ muscle closes the loop of the trachea posteriorly and converts it into a ___. Constriction of the muscle can narrow the lumen of the trachea by __ and there are approx. ___ such cartilages in the length of the trachea. The smooth muscle of the airways is innervated by ___ and ___ nerves, which control the diameter of the lumen. The __ nerve mediate other function of the airways.

Answer 86

- mucosa - outer layer (adventitia) - seromucous - fibroelastic - trachealis - ring - 25% - 16-20 - sympathetic and parasympathetic - autonomic

Question 87

The inner layer of the trachea consists of a ___ epithelium. The ___ beat toward the mouth, moving dust and small, inhaled particles as well as mucus toward the ___, thus cleaning and protecting the ___. The ciliated cells account for ___ of the mucosal cells. The inner layer also contains other cells that have no kinocilia-these include the ___ cells, small mucous granule cells, diffuse neuroendocrine cells, and the ___ of the epithelium. The ___-the connective tissue layer beneath the basement membrane of the epithelium-has collagen and elastic fibers, separating it from the submucosa

Answer 87

- pseudostratified ciliated columnar - motile cilia - oropharynx - respiratory tract - 30% - mucus producing goblet - basal cells - lamina propria

Question 88

The trachea bifurcates into the right and left main bronchi at the ___, behind the ___angle. A sagittal spur, the __ pointed upward, is located at the bifurcation, which separates the air stream during ____. The right main bronchus is ___, wider and more vertical than left. The left main bronchus is 5 cm ___, though less steep than the right. The main bronchi divide into ___ bronchi, which divide into ___ bronchi on the right lung and 8-10 segmental bronchi in the left lung, corresponding to different bronchopulmonary segments.

Answer 88

- T4 vertebra - sternal - carina - inspiration - shorter - long - lobar - ten segmental

Question 89

The bronchi have structure similar to the ___; however they have irregular ___ plates, and instead of the tracheal is muscle, they have a prominent circular muscle later that separates the ___ from the submucosa. The rest of the airways continue as ___, terminal bronchioles, respiratory bronchioles, alveolar ducts, and the alveoli. With the exception of the bronchioles, these latter structures have an incomplete circular muscle later and lack the ___ or ___.

Answer 89

- trachea - cartilage - lamina propria - bronchioles - submucosa or adventita

Question 90

In the alveolar ducts, the smooth muscle is arranged in __, while the alveoli lack smooth muscle, submucosa or adventitia. The mucosa of the bronchioles contains ___ epithelium with goblet cells, ___ cells, as well as collagen and elastic fibers

Answer 90

- knobs - simple ciliated columnar - clara

Question 91

Terminal and respiratory bronchioles have ___epithelium, while alveolar duct have ___ epithelium. The alveoli are in close contact with the ___. There is a very thin membrane between the capillaries and alveoli called the ___, through which the gas exchange takes place

Answer 91

- simple ciliated cuboidal - simple squamous - capillaries - blood air barrier

Question 92

simple squamous epithelium that cover about 95% of the alveolar surface and take part in the blood-gas barrier for the exchange of oxygen and carbon dioxide. They have tight junctions and do not divide (no mitotic activity)

Answer 92

-Type I pneumocytes.

Question 93

are cuboidal shaped, and are usually found near the inter alveolar septae, where they bulge into the alveolus. They have short microvilli, tight junctions, are able to divide and regenerate. Their main function is to produce surfactant which covers the alveoli and reduces the surface tension, helping alveoli remain open and prevents the from collapsing.

Answer 93

-Type II pneumocytes

Question 94

The lung tissue is separated by a layer of connective tissue into discrete anatomical and functional units called the ___ segments. There are __ bronchopulmonary segments in the right lung and __ segments in the left lung. Each segment contains a ___ bronchus, as well as a branch of __ artery and a bracnh of __ artery that run together. Tributaries of the ___ vein are located in the periphery between the adjacent bronchopulmonary segments. Such separation of the segments allows for surgical removal of a segments without affecting the function of other parts.

Answer 94

- bronchopulmonary - 10 - 8-10 - segmental - pulmonary - bronchial - pulmonary

Question 95

Lung? the superior lobe has three bronchopulmonary segments named according to the position of their segmental bronchus. These include the apical, posterior and anterior segments. The middle lobe includes the lateral and medial segments, and the inferior lobe contains the superior, medial and lateral, anterior and posterior basal bronchopulmonary segments.

Answer 95

-right lung

Question 96

Lung?superior lobe contains the apical, posterior. anterior, superior lingual and inferior lingual bronchopulmonary segments. The inferior lobe of the left lung has segments similar to those of the __ lung, including superior, anterior, medial, posterior and lateral basal bronchopulmonary segments

Answer 96

-left lung

Question 97

One of the main functions of the respiratory system is to exchange ___ between the outside air and the cells in the human body. Fresh air going into the lungs has ___ press and ___ dioxide press, compared to the press of these gaes in our __ that gets into the lungs through the pulmonary trunk and arteries leading to small capillaries. These gases are carried by the ___, and are exchanged according to their pressure differences across the ___ between the alveoli and capillaries of the lung

Answer 97

- oxygen and carbon dioxide - higher oxygen - lower - blood - red blood cells - blood air barrier

Question 98

The lung has static volumes that can be measured by using a ____

Answer 98

spirometer

Question 99

In spirometry, the subject is sitting and breathes into and out of the spirometer, whic leads to the ___ of a bell. The displaced volume is recorded on a ___ paper.

Answer 99

- displacement | - calibrated

Question 100

___ volume is about 0.5 liter and corresponds to the volume of air inspired or expired during each normal breathe

Answer 100

tidal volume

Question 101

The ___ is about 3 liters and corresponds to the volume that one can inspire over and above the tidal volume.

Answer 101

inspiratory reserve volume

Question 102

is 1.2 liters, which is the volume of gas that can be expired following the expiration of the normal tidal volume.

Answer 102

-expiratory reserve volume

Question 103

is 1.2 liters and corresponds to the volume of gas remaining in the lungs following maximum expiration

Answer 103

residual volume

Question 104

capacity is the sum of the ERV and RV

Answer 104

functional residual

Question 105

the ___ or ___ is about 4.7 liters, which does not include the residual volume.

Answer 105

vital capacity or forced vital capacity

Question 106

The ___ includes all of the lung volumes and is about 5.9 liters, which cannot be measured by spirometry due to the residual volume.

Answer 106

total lung capacity

Question 107

___ volume is the air volume expired in the first second of the forced maximum expiration. Its about 80% if the FVC

Answer 107

-forced expiration

Question 108

Pulmonary circulation refers to the movement of __ between the __ and ___. Deoxygenated blood from the right ventricles of the heart is pumped into the ___ trunk and ___ arteries into the smaller branches, eventually finding its way into the ___ capillary plexus surrounding the alveoli in the right and eft lungs. There the blood is ___, then returned to the __ artrium of the heart, typically by means of two ___ veins on each side.

Answer 108

- blood - lungs and heart - pulmonary - pulmonary - pulmonary - oxygenated - pulmonary

Question 109

gas exchange takes place across the __ between the __ and the __ capillary plexus. Oxygen in the blood is carried in two forms: bound to __ or __ in the blood. The O2 bound to hemoglobin is the most important form of ___ transport. __ is a globular protein with 4 subunits, and each subunit has a heme moiety of iron containing porphyrin.

Answer 109

- blood air barrier - alveoli - pulmonary - hemoglobin - dissolved - oxygen - hemoglobin

Question 110

__ is a methemoglobin, which cannot bind to O2. The carbon dioxide produced in the tissues is transported via the venous blood to the lungs in three forms, including HCO3, which transports about 90% of the CO2. The CO2 is also transported via its bond with hemoglobin or dissolved in blood, though this __ rather small amounts

Answer 110

- ferric iron | - tranports

Question 111

The CO2 generated in the tissues diffuses freely into the venous blood and enters the ___. Within the RBC's, the CO2 combines with water to form ___, and the reaction is catalyzed by ____. The ___ then dissociates into __ and H+. The ___ leaves the RBC in the blood in exchange with __ and is transported to the lungs via the ___. In the lungs, the reaction takes places in ___: HCO3 enters the RBCs in exchange with CL. It then recombines with H to form H2CO3, which is then converted to CO2 and H20.

Answer 111

- red blood cells - carbonic acid - carbonic anhydrase - carbonic acid - HCO3 - HCO3 - Cl - blood - reverse

Question 112

The ___ can now diffuse through the ___ to the alveoli. The partial pressure of O2 and CO2 is different in the __ compared to venous blood. In the alveoli, the PO2=-100mm Hg and the PCO2=-40 mm. In the mixed venous blood, the ___ and ___. Since these gases are ___ they diffuse across the thin layers of the blood air barrier between the pulmonary capillary plexus and the alveoli, from higher to lower pressures

Answer 112

- CO2 - blood air barrier - alveoli - PO2=40mm Hg and PCO2=46 mmHg - lipid soluble

Question 113

The lungs have ___ supplies and __ drainage systems in the the human

Answer 113

- two arterial | - two venous

Question 114

The pulmonary trunk, which originates from the right ventricle of the heart, divides into __ and __ pulmonary arteries. These divide further at __, __ and down to the ___ levels, where they drain into the pulmonary __ plexus. This network carries the ___ blood from the heart to the lungs for gas exchange.

Answer 114

- right and left - lobar, segmental, terminal bronchioles - capillary - deoxygenated

Question 115

The ___ arteries originating from the thoracic aorta or from __ arteries give blood to the structures a the hilum of the lung: the ___ of the lungs and __ pleura.

Answer 115

- bronichial - intercostal - parenchyma - visceral

Question 116

The __ bring the oxygenated blood back to the heart. Larger branches of ___ run between the bronchopulmonary segments

Answer 116

-pulmonary veins

Question 117

The bronchial veins drawn into the ___ system; specifically into the __ on the right side and the ___ on the left side.

Answer 117

- azygos venous - azygos - accessory hemiazygos

Question 118

The superficial structures are drained by the ___, ___ and ___ nodes. The deeper structures are drained by ___, as well as the above mentioned lymph nodes in the ___. The superficial lymph plexus lies beneath the ___ pleura, and the deep lymphatic plexus lies in the __ and connective tissue of the ___ tree. The lymph of the lungs and related structures is finally drained into the ____ at the junction between the __ and ___ through the right and left bronchomediastinal trunks. The lower left lobe is usually drained by the __ on the right side.

Answer 118

- bronchopulmonary - tracheobronchial - paratracheal lymph - pulmonary lymph nodes - hilum - submucosa - bronchial - right and left venous angles - internal jugular veins - vessels

Question 119

The nerve supply to the lungs and visceral pleura comes from the ____, which are distributed in the anterior and posterior ___ nerve plxus around the root of the lung. The ___ fibers synapse in the ganglions of the plexus and __ fibers reach the lung and surrounding tissues for the following functions

Answer 119

``` -parasympathetic and sympathetic nerves -pulmonary -vagal preganglionic -postganglionic ```

Question 120

____: the parasympathetic cholinergic fibers extend to the bronchial smooth muscles and cause ____. They activate the muscarininc receptors of the muscle leading to airway constriction. The parasympathetic nerve is a ___ in the lungs due to inhibiting the pulmonary vessels, as well as the ___ to the bronchial glands for mucus secretion

Answer 120

- vagal efferent - bronchoconstriction - vasodilator - secretomotor

Question 121

____: Sensory nerves in the respiratory epithelium, mediating the cough reflex, the baroreceptors, and the chemoreceptors. Also transmits pain from the trachea

Answer 121

-vagal afferent

Question 122

____: these nerves are ___ and activate the beta 2 adrenergic receptors on the bronchial smooth muscles, leading to relaxation and dilation of the airways. The sympathetic nerves are ___ to pulmonary vessels, as well as ___ in the bronchial tree.

Answer 122

- sympathetic efferent - bronchodilator - vasocontrictor - inhibitory to glandular secretion

Question 123

____: pain conducting, fibers from the visceral pleura and bronchi, reaching the spinal cord through the sympathetic nerves

Answer 123

sympathetic afferent

Question 124

The __ is innervated by somatic nerves. and carries the tactile and pain sensations to the central nervous system

Answer 124

-parietal pleura

Question 125

Respiratory diseases can involved the airways, __of the lung, __ vessels, __ and __ and muscles of ___

Answer 125

- parenchyma - pulmonary - pleura - nerves - respiration

Question 126

In ___, less air flows in and out of the airways because the elastic quality of the airways is __. There is an __ in airway resistance, especially in expiration, due to narrowing of the ___. Conditions leading to such narrowing can originate from the ___ of the airways due to increased ___ production, as seen in chronic bronchitis. The narrowing may also originate fin the wall of the airways including the ___, as seen in Asthma. Another ___ condition is the destruction of the ___outside of the airways, which may lead to airway narrowing during ___ due to loss of radial traction, as seen in emphysema. In __ such as ___, the FEV1 ir reduced compared to the FVC.

Answer 126

- COPD - lost - increase - lumen - lumen - mucus - smooth muscle hypertrophy - COPD - lung parenchyma - expiration - asthma - COPD

Question 127

characterized by inflammation and edema of the bronchial wall, hyperplasia of the smooth muscle leading to tightened bronchi and bronchioles, and increased mucus production, which leads to the constriction and narrowing of the lumen

Answer 127

asthma

Question 128

enlargement of distal air spaces and damage to the lung and alveolar tissues. There is a deficiency of alpha-1-antitrypsin enzyme in panacinar ___, leading to destruction of the alveolar walls. The patients are referred to as "pink puffers", due to heavy breathing and pink discoloration. They have difficulty exhaling and present with dyspnea, and may have thin, barrel shaped chest

Answer 128

emphysema

Question 129

inflammation and swelling of the bronchial wall, increased mucus sectretion, hypertrophy of seromucous glands, and scarring of the terminal airways. Patients are referred to as blue boaters, and present with frequent coughing, sputum production and chronic bacterial infection. They may have a muscular, barrel-shaped chest. Disease is related to cigarettes smoking or inhalaing of other chemical irritants.

Answer 129

chronic bronchitis

Question 130

The heart is pear -shaped muscular structures situated in the __ cavity within the ___ and is enclosed in a ___ membrane sac, known as the ___. The hearts is approx. size of a ___ and __ chambers, including two __ in the upper part of the heart separated by an ___ and 2 ___ in the lower part of the heart separated by a ___. The atrium and ventricles are separated by the __ valve on the right, and by the __ valve on the left

Answer 130

- thoracic - middle mediastinum - double layered serous - pericardium - fist - 4 - atria - atrial septum - ventricles - ventricular septum - tricuspid - bicuspid (mitral)

Question 131

There are ___ arteries on the surface of the heart that branch into several smaller arteries and supply blood to the heart. The blood from the heart tissue returns predominantly into the ___ through __ veins, which drain into the ___. The main function of the heart is to supply __ blood to the body by pumping blood into the __, as well as pumping __ blood into the ___ toward the lungs for oxygenation. Cardiac output is the amount of blood pumped into the __ and _- trunk by the heart, which is __ on the left and right sides. Blookd pumped into the vessels exerts a pressure on the arteries and veins, called ___.

Answer 131

- two coronary - right atrium - cardiac - coronary - oxygenated - aorta - deoxygenated - pulmonary trunk - lungs - aorta - pulmonary - equal - blood pressure - arteries - veins

Question 132

The heart and the roots of the great blood vessels connected to the heart are surrounded by a double layer, thin sac of serous membrane called ____, which is covered externally by a dense connective tissue membrane, the ___

Answer 132

- serous pericardium | - fibrous pericardium

Question 133

surrounds the heart and the serous pericardium like a bag from the outside. At the top, it merges with the walls of the great vessels connected to the heart, and is also connected to the pre tracheal fascia. It attaches inferiorly to the central tendon of the thoracic diaphragm, and attaches to the sternum anteriorly

Answer 133

fibrous pericardium

Question 134

____ consists of two layers, the outer membrane called the ___, which closely adheres to the inner surface of the fibrous pericardium; and an inner membrane called the ___, which firmly adheres to the surface of the heart. The two layers are continuous with each other over the great vessel, where the inner later reflects off the heart

Answer 134

- serous pericardium - parietal pericardium - visceral pericardium

Question 135

space between the two layers of serous membrane-contains pericardial fluid produced by the serous membrane. The fluid serves as lubrication between the layers and reduced friction between the pericardial membranes

Answer 135

-pericardial cavity

Question 136

Pericardium keeps the heart in the ___ and ___ the heart against sudden overfilling when blood volume increases

Answer 136

- thoracic cavity | - protects

Question 137

these two spaces can be distinguished when the fibrous and parietal serous pericardium are both opened

Answer 137

pericardial sinuses

Question 138

the oblique sinus, or culdesac, is a U shaped bind recess posterior and inferior to the heart, large enough for a hand to pass through, though it cannot pass around the large vessels because of the firm attachments to the root of the great vessels

Answer 138

-oblique sinus

Question 139

is the space posterior to the ascending aorta and pulmonary trunk and anterior to the superior vena cava

Answer 139

transverse sinus

Question 140

Blood is supplied mainly by the __ and __ arteries from the internal thoracic artery, as well as by indirect branches of the ___. The ___ receives blood from the vessels to the heart as well

Answer 140

- pericardiophrenic - musclophrenic - thoracic aorta - epicardium

Question 141

veins drain into the axygos venous system as well as the pericardiophrenic veins

Answer 141

venous drainage

Question 142

pericardium is innervated by the ___ nerve, as well as the ___ nerve

Answer 142

- sympathetic and parasympathetic | - phrenic

Question 143

an inflammation of the serous pericardium, often due to cardiac or systemic diseases, cancer spreading from a nearby lung tumor, or other conditions that may lead to increased amounts of pericardial fluid. The increased fluids may ___ and __ heart movements, which may lead to ___ and cause severe pain behind and above the ___

Answer 143

- pericarditis - compress and restrict - friction rubbing - sternum

Question 144

___ refers to the removal of excess fluid from the pericardial cavity by entering the 5th or 6th intercostal space on the left side, close to the sternum, through sternal or subxiphoid approaches

Answer 144

-pericardioentesis

Question 145

heart tissue ___ is covered by the ___ from the outside and the ___ a thin layer covering the inner surface of the heart

Answer 145

- myocardium - epicardium - endocardium

Question 146

The ___ of the heart is formed mainly by the right ventricle, which is flanked by the __ and __ surfaces of the heart. The right pulmonary surface is formed by the __ and the left pulmonary surface is formed mainly by the ___. a remnant of fetal growth, the __ can also be seen here, between the pulmonary artery and the arch of aorta. It is occluded after birth and converts to the ___

Answer 146

- anterior (sternocostal) surface - right and left pulmonary - ductus arteriosus - ligamentum arteriosum

Question 147

Other features of anterior view of the heart include the __ situated between the right and left ventricles and the __ between the right atrium and ventricle.

Answer 147

- anterior interventricular sulcus | - coronary sulcus

Question 148

The ___ of the heart is occupied mainly by the left atrium positioned horizontally. receives 4 pulmonary veins and brings oxygenated blood to the heart.

Answer 148

-posterior aspect (base)

Question 149

The ___ of the heart rests on the central tendon of the diaphragm and consists of primarily of the left ventricles. Surface can be seen when the heart is moved from its normal anatomical position.

Answer 149

inferior (diaphragmatic) surface

Question 150

Left ventricle works harder than the right ventricle, the wall of the left ventricle is ___ than the right ventricle. Blood pressure in the aorta is ___ while in the pulmonary artery it is about ____. The muscular layer of the wall consists of internal irregular ridges, called the ___. There are two prominent conical muscles called the ___, one located anteriorly and one posteriorly in the left ventricle. These muscles are connected via ___ to the anterior and posterior cusps of the mitral valve. This connection helps in proper closure of the ___, inhibits regurgitation of blood, and prevents eversion of the valve into the ___. The smooth, non muscular upper part of the left ventricle leads to the ___.

Answer 150

- 2/3 times thicker - 120/80 mmHg - 25/10 mmHg - trabeculae carneae - papillary muscles - tendinous cords (chordae tendineae) - valves - right atrium - aortic valve

Question 151

___ is as thick as the wall of the left ventricle. It lies between the two ventricles and consists of a lower muscular section and an upper membranous section

Answer 151

interventricular septum

Question 152

One of the most common heart defects whose cause is unknown; however, genetic factors may be involved.

Answer 152

-ventricular septal defect

Question 153

There are ___ valves, and ___ valves in the heart. They lie in the valve plane of the heart and arise from the skeleton of the heart. The valves are a duplicator of the endocardium. The mitral and aortic valves are connected to the ___

Answer 153

- two cusped atrioventricular - two semilunar - left ventricle

Question 154

___ is located between the left atrium and left ventricle and consists of two leaflets; one located anterior and the other posterior. These valves are connected to the anterior and posterior papillary muscles by tendinous cords

Answer 154

mitral (bicuspid, left atrioventricular) valve

Question 155

___: this valve lies at the outflow of the left ventricle at the beginning of the aorta, and consists of ___. The cusps of the aortic valve are located in the right, left, and posterior positions. The __ is a nodular thickening in the center of the cusps, and the __ is the edge of the cusp on each side of the nodule. Behind the right and left cusps, the opening for the right and left coronary arteries of the heart receive blood from the ___, the dilated portion of the aorta at the level of the aortic valve that prevents the cusps from sticking to the wall during the closure of the valve.

Answer 155

- aortic valve - three semilunar cusps - nodule - lunule - aortic sinus

Question 156

Blood is pumped into the aorta from the ___. It reaches the head and neck through the right and left common __ arteries, the upper limbs through the right and left ___ arteries, and the thoracic structures through the descending aorta into the __ aorta. Blood travels through the __ aorta to the abdominal structures and to the pelvic structures through the common iliac and ____ arteries. It reaches the lower limbs through the external iliac artery, into the ___ artery and to the arteries further downstream

Answer 156

- left ventricle - carotid - subclavian - thoracic - abdominal - internal iliac - femoral

Question 157

Blood to the smaller arteries and arterioles then enters the __, where the exchange of gases and substances between the blood and tissues take place. The blood then returns through the ___, into smaller and then larger veins, finally reaching the right __ of the heart through two large veins-the ___. Several factors help the return of blood, including the movement of the valves in the veins, the __ at which the veins join the other veins pushing the blood forward, __ of the muscles within which the beins travel moving the blood forward, ___ of the arteries in the vicinity of the veins, and the __ between the abdominal and thoracic cavities. FInally, the muscle pump squeezes the veins running inside the muscles and pushes the blood ___ heart.

Answer 157

- capillaries - venules - atrium - superior and inferior vena cavae - angle - contraction - pulsation - pressure differences - toward the

Question 158

Right atrium receives venous blood from the ___, ___, and the ___. The right atrium has a conical pouch called the __. The interior of the right atrium consists of 2 distant parts. The rough anterior portion consists of a netwok of comblike muscular ridges, the ___, and the smooth posterior portion, the __, where the venae cave open into the right atrium. On the interior aspect of the wall of the right atrium, a vertical line called the ___ can be distinguished, which corresponds to the __, which is found outside on the surface of the right atrium, in front of the venue cavae.

Answer 158

- superior vena cava, inferior vena cava, and coronary sinus - right auricle - pectinate muscle - sinus venarum - crista terminalis - sulcus terminalis

Question 159

There are __ openings in the right atrium: the opening of the ___ in the upper portion, the opening of the ___ in the lower portion, and the opening of the ___. The opening of the IVC is partially covered by a sickle shaped valve, known as the ___. A similar valve can be distinguished at the opening of the coronary sinus, called the ___

Answer 159

- 3 - superior vena cava - inferior vena cava - coronary sinus - valve of Eustachius - valve of Thebesuis

Question 160

The __ is a double layered membrane formed during __ that divides the right and left atria from one another. During development of the heart, a ___grows downward an opening in the lower section, called the ____. Later, second opening called the ___ forms in the center of the ___. The semilunar shaped ___ is formed on the right side of the septum primum, allowing blood through into the left atrium during gestation. This opening is now called the ___. Through this process, a large portion of fetal blood bypass pulmonary circulation since fetal blood is already exchanged with oxygenated blood in the placenta, the connection between the mother and the fetus. After birth, the septum secundum fuses with the septum primum, closing the foramen oval as a result of increases left and pressure. remnant of fetal growth, the ___ can always be distinguished on the atrial septum

Answer 160

- atrial septum - gestation - primary septum - foramen primum - foramen secundum - septum primum - foramen ovale - fossa ovalis

Question 161

Atrial septal defect

Answer 161

p. 165

Question 162

other structures found in the right atrium

Answer 162

p. 165

Question 163

right ventricle

Answer 163

p. 166

Question 164

valves related to the right ventricle

Answer 164

p. 166

Question 165

left atrium

Answer 165

p. 166

Question 166

pathology of the valves

Answer 166

p. 166

Question 167

how may rheumatic fever interfere with cardia function

Answer 167

p. 166

Question 168

conducting system of the heart

Answer 168

p. 167

Question 169

electrocardiography

Answer 169

p. 169

Question 170

abnormal ECG patterns

Answer 170

p. 169

Question 171

What are atrial flutter and atrial fibrillation

Answer 171

p. 169

Question 172

what are ventricular tachycardia and fibrillation? VT

Answer 172

p. 171

Question 173

what are the ECG changes during myocardial ischemia

Answer 173

p. 171

Question 174

which conditions may the S-T segment be elevated

Answer 174

p. 171

Question 175

auscultation

Answer 175

p. 172

Question 176

Blood supply to the heart

Answer 176

p. 173

Question 177

Are there significant anastomotic connections between the coronary arteries

Answer 177

p. 173

Question 178

Venous drainage of the heart

Answer 178

p. 175

Question 179

How is atherosclerotic plaque in the coronary artery detected, and what are the treatment strategies?

Answer 179

p. 175

Question 180

innervation of the heart

Answer 180

p. 177

Question 181

heart (cardiac) cycle

Answer 181

p. 177

Question 182

systole

Answer 182

p. 179

Question 183

diastole

Answer 183

p. 180

Question 184

posterior mediastinum

Answer 184

p. 182

Question 185

esophagus

Answer 185

p. 183

Question 186

azygos venous system

Answer 186

p. 184

Question 187

sympathetic chain

Answer 187

p. 185

Question 188

lymphatic drainage of the thorax

Answer 188

p. 185

Question 189

thoracic diaphragm

Answer 189

p. 189