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CV1 Flashcards

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1
Q

true ribs
false ribs
floating ribs

A

1-7
8-10
11 and 12

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2
Q

flail chest

A

multiple broken ribs in 2 or more places

thoracic wall moves in during inspiration and out during expiration

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3
Q

xiphoid process level of rib and dermatome

A

7th rib but T6 dermatome

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4
Q

transverse thoracic plane

A

sternal angle-disc bw TV4-5

seperation bw sup and inf mediastinum

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5
Q

sternocostal joint

A

1st one is synchondrosis-impt for respiation
2-7 are plane
dislocations

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6
Q

costochondral

A

synchondrosis

seperation

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7
Q

rib dislocation
rib seperation
rib fracture

A

sternocostal
costochondral
usually angle (and usually middle ribs)

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8
Q

external intercostal

A

*only one that elevates ribs (inspiration)
A:maintain intercostal space during respiration by elevating ribs during inspiration

N: intercostal nn

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9
Q

internal intercostals

A

A:maintain intercostal space during respiration by depressing ribs during expiration

N: intercostal nn

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10
Q

innermost intercostals

A

*lat
A:maintain intercostal space during respiration by depressing ribs during expiration

N: intercostal nn

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11
Q

subcostal

A

*post and spans more than one rib level
A: depress ribs during expiration

N: intercostal nn

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12
Q

transversus thoracis

A

*ant
A: depress ribs during expiration

N: intercostal nn 2-6

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13
Q

endothoracic fascia

A

deep thoracic fascia
top part is sibsons
adheres parietal pleura to thoracic wall

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14
Q

pump handle

A

increase A-P

why the first rib is a synchodrosis

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15
Q

bucket handle

A

increase transverse

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16
Q

musculophrenic and superior epigastric

A

musculophrenic is lateral

superior epigastric is medial

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17
Q

intercostal nn

A

ventral rami of spinal nn

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18
Q

superior mediastinum Ant to post

A

thymus,
brachicephalic vv-formed by int. jugular and subclavian
Aortic arch and branches-starts and ends at TTP
brachiocephalic trunk, L common coratid, L subclav a
SVC-formed by 2 brachiocephalic vv
trachea
esophagus

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19
Q

phrenic n course into thorax

A

passes ant to subclavian a

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20
Q

vagus n course and branches

A

larygeal, cardiac, pulmonary, and esophageal branches

lat border of common carotid and passes post to root of lung and in the post mediastinum on esophagus
left becomes the anterior vagal trunk
right becomes post vagal trunk

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21
Q

recurrent larageal nn

A

branches of vagus n

left-under arch or aorta, lat to lig arteriosum and then goes up

right-around r. subclavian a

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22
Q

post mediastinum

A

portion of inf medistinum

esophagus and decending aorta azygous vv, splancnic nn, thoracic duct

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23
Q

esophagus

A

starts at C6

in sup media its post and left of trachea and then in midline in post media

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24
Q

esophageal constriction

A

C6-pharyngoesophageal
TTP-aortabronchial
T10-diaphragmatic

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25
esophagus innervation
symp-travel with CP splancnic and pain can feel like an MI | PS-vagus
26
azygous v
formed by right ascending lumbar and right subcostal vv. | at T4 goes ant over root of right lung to enter SVC
27
hemiazygous
formed by left ascending lumbar and left subcostal vv | gets 9-11 intercostal vv then cross at T9 to go to azygous
28
accessory hemiazygous
drains 5-8 and crosses at T8 into azygous
29
left 1-4 intercostal vv aka left superior intercostal v
drain directly into left brachicephalic v
30
right superior intercostal v (2-4 intercostal v)
drain into azygous
31
thoracic duct
starts at L2 at the cisterna chyli and travels post to esophagus. At T5 crosses to the left of esophagus and enters the venous angle
32
thoracic splancnic nn
preganglionic sympathetic axons to preaortic (paravertebral ganglia) greatest T5-T9 Lesser T10 and 11 Least T12
33
hiatal hernia
abdominal viscera through esophageal hiatus
34
UR tract LR tract
Upper- nose, pharynx, larynx Lower- trachea, bronchi, lungs
35
trachea
starts at C6 and divides into primary bronchi which the right one is wider shorter and vertical so things get stuck
36
lung pleura
``` serosal membrane (only thing in pleural space) viceral and parital ```
37
lung parital pleura
costal, diaphragmatic, mediastinal, and cervical surfaces
38
mediastinal surface of lung parital pleura
continuous with the visceral, together with visceral pleura forms pulmonary ligamnet
39
pulmonary lig
point of fixation for the lung
40
cervical extension of the lung parital pleura
reinforced by sibsons (suprapleral) of endothoracic fascia
41
pneumothorax
collapsed lung DT puncture of pleura (either one)
42
pluritis of the lung
inflammaed pleura and don't slide over one another pain from parietal pleura which has sensory fibers from phrenic and intercostal nn so refered pain is C345 visceral pleura has sensory that travel with autonomic fibers
43
bare area of heart
rib space 5/6
44
Tension pneumothorax
*parietal DT trauma, emhysema, lung cancer, COPD signs are distended neck veins and hypoTN from low CO caused by loss of integrity of pleura (either one) resulting in air getting in but unable to leave so there is an increase in intrathoracic pressure and you have mediastinal shift to contralateral side and comprimises venous return
45
spontaneous pneumo
*viceral | in tall lanky males
46
right lung
oblique and horizontal fissure=3 lobes sup, middle (4-6 ribs), inf art is ant to bronchus
47
left lung
oblique fissure=2 lobes sup and inf cardiac notch and lingula art is sup to bronchus
48
pulm veins location
usually ant and inf
49
bronchi location
usually post
50
viceral pleura and lung paranchema lymph
bronchopulmonary node -> sup and inf tracheaobronchiol nodes-> bronchomediastinal trunk
51
bronchomediastinal trunk left and right drainage
left into the toracic duct | right into the right lymphatic duct
52
bronchi and bronchioles lymph drainage
pulmonary nodes-> bronchopulmonary nodes-> tracheobronchiole nodes-> bronchomediastinal trunk
53
lung paritel pleura lymph drainage
to thoracic wall aka intercostal nodes
54
which recesses are only occupied during deep inspiration?
costomediastinal and costodiaphragmatic
55
which recess would you find a pleural effusion in xray?
costodiaphragmatic
56
fibrous pericardium where and innervation
anchors heart and prevents overfilling | phrenic
57
serous pericardium where
visceral and parietal layers
58
parietal pericardium where and innervation
underside of fibrous pericardium | phrenic
59
visceral pericardium where and innervation
on the heart itself also called epicardium | cardiac plexus but no pain fibers here
60
pericardial sac
potential space
61
cardiac temponade
when the pericardial sac is filled with fluid and the heart cant fill to capacity
62
transverse pericardial sinus
*where you clamp during bypass and cardiac surgery | behind aorta and pulm trunk but in front of SVC and pulm veins
63
oblique pericardial sinus
blind caul de sac bw pulm veins and IVC
64
pericardial refered pain (pericardidtis)
C345
65
fibrous skeleton of heart
structural support for valves | insulates against impulse propagation from A to V
66
RA structures (6)
sinus venarum, auricle, crista terminalis, fossa ovalus, SA and AV nodes
67
sinus venarum
smooth part of RA where IVC SVC and coronary veins enter
68
auricle
in atria has pectinate muscles
69
crista terminalis
divides sinus venarum and auricle in RA
70
SA and AV locations
SA-subepicardium near SVC | AV-subendocardium near coronary sinus opening
71
RV structures (5 main 10 total)
trabelcula carnae (moderator band), conus arteriousus, tricuspid (chordae tendinae and papilary mm) interventricular septum (membranous and muscular) pulmonary semilunar valve
72
trabeculae carnae
vent mm finer but more in left
73
moderator band (septomarginal)
specialized trabecular carnae in RV m from intervent spetum to ant pap m
74
conus arteriosus
smooth part of RV where the pulm a starts
75
mitral and tricuspid valve and structures
chordae tendinae connect valve to pap mm
76
interventricular septum parts
membranus-short and sup | muscular-long and thick
77
LA structures (3)
gets 4 pulmonary vv, auricle, mitral
78
LV structures (4 main 6 total)
trabecular carnae, aortic vestibule, mitral (CT and pap mm), aortic semilunar valve
79
aortic vestibule
smooth part of LV leading to aorta
80
regurg
valve insufficiency can cause a murmur along with stenosis
81
sites for auscultation
A-2nd ICS on right P-2nd ICS on left T-4th ICS on left M-4th or 5th ICS left MCL
82
CAD
atherosclerosis leads to less blood in heart
83
Ischemia
below MI threshold leads to angina
84
what travels with what
Great CV with LAD Middle CV with PDA Small CV with right marginal a
85
heart lymph drainage
RCA->ant. mediatinal LN->left bronchomediastinal trunk | LCA->inf. tracheobronchiole N->R. bronchomediastinal trunk
86
cardiac plexus
postgang symp (T1-T4) (lung is T2-T6) and pregang PS superficial-under AA deep-on trachea
87
cardiopulmonic splancnic nn
postganglionic sympathetic nerve processes
88
refered pain of MI
pain fibers (GVA) follow sympathetic (GVE) to T1-4
89
plexus has what fibers in it?
symp, PS, and GVA
90
4 parts of the fetal heart from cranial to caudal
bulbis cordis, ventricle, atrium, sinus venosus
91
what comes from the bulbus cordis
truncus arteriosus=pulmonary trunk and aorta conus cordis=RV-conus arteriosus LV=aortic vestibule caudal portion=trabecula carnae of RV
92
what comes from the ventricle
trabecula carnae of LV
93
what comes from the atrium
left and right auricles
94
what comes from the sinus venosus
right horn=sinus venarum of RA | left horn=coronary sinus
95
what makes the interatrial septum
septum secundum
96
what makes the valve of FO
septum primium
97
what makes the AV seperation
endocardial cushions (NC cells)
98
ASD
Can cause a stroke hole in atrial septum DT ostium secundum defect either bc septum primeum regresses too much or septum secundum doesnt form
99
VSD
hole in V septum and L-R shunt
100
what causes L to R shunt (late cyanosis)
VSD, ASD, PDA
101
endocardial cushion defect
ASD
102
pulmonary or aortic stenosis
semilunar valve malformation results in Patent FO and PDA
103
tetralogy of Fallot
``` unequal division of TA by conotruncal ridges PROVE Pulmonary stenosis RVH-(boot shaped heart on CX) Overiding aorta VSD ```
104
Transposition of GV
``` Very bad! conotruncal ridges fail to spiral aorta from RV and pulmonary from LV have to have patent FO and PDA to be compatible with life newborn cyanosis ```
105
persistent TA
conotruncal ridges dont form undivided TA gets blood from both Vs cyanosis of newborn
106
DiGeorge
``` CATCH 22 Cleft palate Abnormal facies Thymic aplasia Cardiac defects HypoCa ```
107
Retroesophageal R subclavian a
right 4th regresses and so forms on the left of Left subclavian and has to bend back to the right behind esophagus and can cause dysphagia
108
PDA
L to R shunt results in increase pulmonary flow and decreased systemic flow
109
Coarctication of aorta
aortic constriction preductal-at birth id collateral circulation didnt happen postductal-early adolescence and huge intercostal aa
110
double aortic arch
right dorsal aorta persists and fuses with left and forms ring around trachea and esophagus and causes dysphagia
111
course of vagus
right-behing ascending aorta | left-in front of arch
112
course of recurrent larengeal nn
right-loops under subclavian | left-under AA and Lig Art
113
umbilical vein
ligamentum teres hepatis
114
ductus venosus
bypass liver to IVC | becomes ligamentum venosum
115
umbilical aa
medial umbilical ligs
116
absent IVC
to azygous
117
Left SVC
r common cardinal degenerates but left persists | blood goes to coronary sinus to RA
118
double SVC
both persists and drain as said before
119
R- L shunt (cyanosis of the newborn)
transposition, TOF, PTA
120
conotruncal ridges unequal division- fail to spiral fail to form
unequal division-TOF fail to spiral-TGV fail to form-PTA
121
pleural effusion
``` Becks triad DDD Distended ext jugular Distant heart sounds Decreased blood pressure ```

CV (1 decks)

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