CVPR Week 1: Thorax Overview Flashcards
1
Q
Identify
A
2
Q
Identify
A
3
Q
Identify
A
4
Q
Describe thorax boundaries
A
5
Q
Intercostal muscle location and function
A
6
Q
The intercostal vein, artery, and nerve lie in the _________________ along the ___________ margin of the rib and pass between the ______________ muscles
A
- costal groove
- inferior margin
- intercostal muscles
7
Q
Local anesthesia of intercostal nerves is used in?
A
patients with chest trauma and patient undergoing surgical procedures
8
Q
Identify
A
9
Q
The diaphragm separates the _________ from the ___________.
A
Thorax from the abdomen
10
Q
The major muscle of respiration
A
The diaphragm
11
Q
Identify
A
12
Q
Identify
A
13
Q
Inferior vena cava route through the diaphragm
A
through the central tendon
14
Q
Abdominal aorta route through the diaphragm
A
behind the crura
15
Q
Azygous vein route through the diaphragm
A
behind the crura
16
Q
Vagus nerves route through the diaphragm
A
through the muscular part
17
Q
Esophagus route through the diaphragm
A
through the muscular part
18
Q
Phrenic nerve route through the diaphragm
A
through the central tendon and does not pass
19
Q
Why does the inferior vena cava cross the diaphragm in the way that it does?
A
through the central tendon so that is is not constricted when the diaphragm contracts
20
Q
Why does the esophagusinferior vena cava cross the diaphragm in the way that it does?
A
through the right Crus (muscular part) act as a sphincter to help prevent reflux
21
Q
Why does the aorta cross the diaphragm in the way that it does?
A
behind the diaphragm (between crura) so not constricted when the diaphragm contracts
22
Q
Identify
A
23
Q
Identify
A
24
Q
The thoracic cavity is divided into?
A
The mediastinum and two pleural cavities
25
Pleura description
each lung is encased within a pleural sac formed by a continuous serous membrane called the pleura
26
Identify
27
Identify
28
Identify
29
Thoracentesis description
is the insertion of a needle or catheter into the pleural cavity to remove excess fluid (pleural effusion)
30
Intercostal nerve block Indication
rib contusion or fracture
31
Intercostal nerve block Why
cutaneous anesthesia (pain relief)
32
Intercostal nerve block where?
appropriate rib level as well as 2 ribs above & below
between posterior axillary and midaxillary lines (blocks intercostal nerve before the cutaneous branches)
33
Intercostal nerve block how?
inferior margin of rib
34
Intercostal nerve block what?
infiltration of an anesthetic into the intercostal space (ICS)
35
ICS AKA
Intercostal space
36
Thoracentesis Indictation
pleural effusion
37
Thoracentesis why
Drain fluid
diagnostic (small amount) or therapeutic (large amount)
38
Thoracentesis where?
1-2 ICS below the level of effusion
no lower than the 8th ICS (superior to the 9th rib)
Sitting upright (mid scapular line)
Supine (midaxillary line)
Lateral decubitus (lying on side) posterior axillary line
39
Thoracentesis How
Superior margin of rib
40
Thoracentesis what?
Insertion of a needle or catheter into the pleural cavity
41
Thoracentesis overview
42
Pleura innervation
43
Identify innervation
44
Question 1
E. Parietal pleura
45
Question 2
C. just below the inferior margin of a rib
46
The heart and roots of the great vessels are surrounded by the _____________ and are located in the \_\_\_\_\_\_\_\_\_\_\_\_\_.
* pericardial sac
* middle mediastinum
47
Identify
48
Identify
49
The visceral pericardium reflects back to become __________ at the roots of the \_\_\_\_\_\_\_\_\_\_, forming the \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_.
* parietal pericardium
* great vessels
* pericardial sinuses
50
Identify
51
Identify plane of view
52
How many chambers does the human heart have?
4
53
How many valves does the human heart have?
54
Identify
55
Describe the walls of ventricles
Ventricles have walls with muscular ridges called...
* Trabeculae carneae
* papillary muscles
* Chordae tendineae
56
Describe the walls of atria
Atria have smooth and rigid walls with pectinate muscles
57
Identify
58
Papillary muscles description
The papillary muscles are specialized trabeculae carneae that have a free edge for attachment of the chordae tendineae
59
Papillary muscles function
Together they keep the AV valves closed and prevent them from everting into the atrium upon ventricular contraction
60
Identify
61
Identify the plane of view
62
left atrium pectinate muscles
in the left atrium, pectinate muscles are only found in the auricle
63
Crista Terminalis description
In the right atrium, the crista terminalis separates the muscular part from the smooth part (sinus venarum)
64
Coronary arteries description
the left and right coronary arteries branch off the ascending aorta to supply the heart muscle with blood
65
Cardiac veins description
the cardiac veins drain blood from the heart muscle into the right atrium via the anterior cardiac veins or the coronary sinus
66
% of the right dominant heart
85%
67
% of left dominant heart
15%
68
Right dominant heart description
69
Left dominant heart description
70
Question
71
autonomic innervation of the heart
from the vagus nerves and T1-T4 levels of the sympathetic trunk
72
heart sensory nerves path
travel back to the spinal cord with the sympathetics
73
Referred pain description
occurs when sensory information comes to the spinal cord from one location but is interpreted by the CNS as coming from another location innervated by the same spinal cord level
74
Referred Visceral pain example
* Visceral afferents from the heart enter at the T1-T4 spinal cord segments (with sympathetic axons)
* The pain is "felt" as coming from the chest and medial arm as somatic afferents from dermatomes also enter the spinal cord at that level
75
Referred somatic pain example
The fibrous pericardium is innervated by the phrenic nerves thus pericardial "pain" is referred to the shoulder or neck dermatomes for C3, 4, 5 (also true for the mediastinal parietal pleura and diaphragm)
76
Question
77
Cardiac valves are divided into 2 groups
2 listed
* Semilunar (aortic and pulmonary)
* Atrioventricular valves
78
The cardiac skeleton provides
mechanical stability and attachment for the cardiac muscles and valves
79
Atrioventricular AKA
AV
80
Identify
81
Which valves are atrioventricular?
* Mitral valve
* Tricuspid valve
82
How do semilunar valves function
Backflow closes the cusps of the aortic and pulmonary valves and in the aorta, fills the coronary arteries
83
How are the coronary arteries filled?
the aortic valve's semilunar cusps prevent backflow and fill the coronary arteries
84
How are heart sounds produced
by the closure of the semilunar and AV valves are carried by blood flowing through the valve downstream (auscultation sites)
85
Auscultation position for the aortic valve
right 2nd intercostal space at the sternal margin
86
Auscultation position for the pulmonary valve
left 2nd intercostal space (at sternal margin)
87
Auscultation position for the tricuspid valve
left 5th intercostal space (at the sternal margin)
88
Auscultation position for the mitral valve
left 5th intercostal space (midclavicular line)
89
Identify valves and auscultation locations
90
Question
91
The first part of the conducting portion of the respiratory system?
The nasal cavity
92
Identify
93
Identify
94
Identify
95
Identify
96
Identify
97
Identify
98
Identify
99
Identify
100
Identify
101
Identify
102
Identify
103
Larynx function
the larynx is a valve that closes the lower respiratory tract and an instrument to produce sound (voicebox)
104
Larynx composition
the larynx is composed of cartilages connected by elastic ligaments whose movement affects the tension and position of the vocal ligaments
105
Identify
106
The laryngeal cartilages are moved by?
The laryngeal muscles
107
the only laryngeal muscles that abduct (open) the vocal folds
posterior cricoarytenoids
108
Identify
109
Identify
110
Identify
111
Identify
112
Identify
113
Identify
114
Identify
115
Identify
116
Identify function
117
Identify function
118
Identify function
119
The ___________ provide motor and sensory innervation of the larynx
The vagus nerves
120
The ___________ is motor to the cricothyroid and sensory to the mucosa above the vocal folds
Superior laryngeal branch of the vagus nerve
121
Superior laryngeal branch of the vagus nerve function
motor to the cricothyroid and sensory to the mucosa above the vocal folds
122
The _________ is motor to all muscles except the cricothyroid and sensory to the mucosa below the vocal folds
Recurrent laryngeal branch of the vagus nerve
123
Recurrent laryngeal branch of the vagus nerve function
provides motor to all muscles except the cricothyroid and sensory to the mucosa below the vocal folds
124
Identify
125
Question
126
Trachea structure
* The trachea is a flexible tube composed of C shaped cartilages closed posteriorly by smooth muscle
* The trachea bifurcates into a right and left main (primary) bronchus that divides into lobar (secondary) bronchi that divide into segmental (tertiary bronchi)
127
Identify
128
Blood supply of the tracheobronchial tree
receives its blood supply from the bronchial arteries
129
Identify
130
Question
131
The right main bronchus is ____ and more _________ than the left main bronchus so aspirated material is more likely to be found there
* wider
* more vertical
132
Identify
133
Identify
134
135
Identify
136
Each segmental bronchus and branch of the pulmonary artery supply?
divisions within the lobes called bronchopulmonary segments
137
describe segmentectomy
138
describe lobectomy
139
describe pneumonectomy
140
Identify
141
Autonomic innervation of the tracheobronchial tree
142
Question
143
Overview
