Exam 1 - Thorax Flashcards
(172 cards)
1
Q
what does the ectoderm make?
A
*skin & NS
- adrenal gland, posterior pituitary, brain, SC, nerves
2
Q
what does the mesoderm make?
A
*muscles, bone, reproduction, cardiovascular
- kidneys, spleen, heart & vessels, peritoneum, goands, muscles, skeleton
3
Q
what does the endoderm make?
A
*respiratory, digestive
esophagus, trachea, thyroid, thymus, anterior pituitary, lungs, stomach, liver, pancreas, gall-bladder, duodenum, jejunum, illeum, caecum, appendix, colon, rectum, bladder, prostate
4
Q
where do afferent neurons go? efferent?
A
afferent = body -> CNS
efferent = CNS -> body
5
Q
visceral afferent
A
nonsensory & sensory
- CO2, hunger, nausea, cramps
- broad area pair (stomach ache)
6
Q
somatic afferent
A
touch, taste, burn, kiss (pinpoint sense)
- aware of!
7
Q
efferent visceral
A
maintains homeostasis
- cardiac & smooth muscle, glands
- sympathetic & parasympathetic
8
Q
efferent somatic
A
controlling skeletal muscle
9
Q
what are visceral responses like?
A
internal, slow, diffuse
10
Q
what are somatic responses like?
A
external, fast, precise
11
Q
where in the SC do afferent signals come from?
A
dorsal horn
12
Q
where in the SC do efferent signals come from?
A
visceral efferent = lateral horn (two neurons)
somatic efferent = ventral horn
13
Q
what are the five layers of the epidermis?
A
stratum corneum (outer)
stratum lucidum
stratum granulosum
stratum spinosum
straum basale
*CLGSB (clare lost grace’s softball)
14
Q
describe each layer of the epidermis
A
corneum = anucleate, keratin
lucidum = only in thick skin
granulosum = flattened shape, secrete proteins
spinosum = prickle layer
basale = mitotically active, cuboidal
15
Q
describe the dermis
A
- dense irregular CT
- contains hair follicles, sweat glands, sebaceous glands, small vessels
- melanocytes in hair bulb, contains erector muscles
- SOMATIC AFFERENT nerve endings
16
Q
what are the five types of somatic afferent nerves endings of the dermis? describe them
A
pacinian corpuscles = pressure, high vibration
meissner corpuscles = flutter, low vibration
ruffini corpuscles = stretch, warm
merkel endings = texture (light touch)
krause bulb = cold
17
Q
where are the five different somatic afferent nerve endings of the dermis located at?
A
pacinian = underneath the nerve, low in dermis, light ring
meissner = in the groove of epidermis
ruffini = below grooves, oval shape
merkel = on the hump of groove
krause = bulb shape
18
Q
describe the hypodermis
A
mainly fat tissue
19
Q
describe the pathway of sympathetic nerves in the thorax from the SC (visceral efferent)
A
lateral horn -> ventral root -> white rami communicantes
1. goes through sympathetic trunk
2. goes to visceral organs
3. goes through gray rami communicantes (go through dorsal or ventral ramus)
20
Q
describe the pathway of parasympathetic nerves in the thorax
A
all come from vagus nerve
- comes out of lateral horn
21
Q
what separates the epaxial muscles from the hypaxial muscles?
A
thoracolumnar fascia
22
Q
what is the origin of the trapezius?
A
superior nuchal line
external occipital protuberance
ligamentum nuchae
C7-T12
23
Q
what is the insertion of the trapezius?
A
lateral third of clavicle
acromion
spine of scapula
24
Q
innervation of trapezius
A
CN 11 (accessory nerve)
25
what is the action of the trapezius?
rotate scapula
- upper fibers elevate
- middle fibers retract
- lower fibers depress
26
what is the origin and insertion of the serratus posterior superior?
O: ligamentum nuchae, C7-T3
I: ribs 2-3
27
what is the innervation and action of the serratus posterior superior?
INN: intercostal nerves (T1-4)
A: elevate ribs
28
what is the origin and insertion of the serratus posterior inferior?
O: T11-L2
I: ribs 9-12
29
what is the innervation and action of the serratus posterior inferior?
INN: intercostal nerves (T9-12)
A: depress ribs
30
what are the two splenius muscles? where are they?
neck
- capitis, cervicis
31
what is the origin and insertion of the splenius muscles?
O: nuchal ligament
I: mastoid process (cap), trans. process C1-3 (cerv)
32
what is the innervation and action of the splenius muscles?
INN: dorsal rami
A: extent, lateral bend, and rotate head
33
what are the three erector spinae muscles?
spinalis (closest to center)
longissimus
lliocostalis
34
what is the origin and insertion of the erector spinae spinalis?
O: inferior spinous process
I: superior spinous process
35
what is the origin and insertion of the erector spinae longissimus?
O: inferior medial transverse process
I: superior lateral transverse process
36
what is the orgin and insertion of the erector spinae illocostalis?
O: illiac crest, sacrum, T11-L5
I: ribs
37
what is the innervation and action of the erector spinae muscles?
INN: dorsal rami
A: lateral flex & extending spine
- iliocostals do unilateral spine flex & bilateral rib depression
38
what are the three transversospinalis muscles?
semispinalis (capitas, cervicis, thoracis)
multifius
rotatores
39
what is the origin, insertion, and innervation of the transversospinalis muscles?
O: transverse process (caudally)
I: spinous process (cranially)
INN: dorsal rami
40
describe how to tell the difference between cervical, thoracic, and lumbar vertebrae?
cervical: short body, containn foramen transversarium, and has a short spinous process
thoracic: has two demifacet pairs for ribs, heart shaped body
lumbar: no facets for ribs, large body
41
what in the vertebrae has a primary curvature? secondary curvature?
primary: thoracic, sacrum (bends away from body)
secondary: cervical, lumbar (bends towards body)
42
what is the atlas and axis of the spine?
C1: atlas
C2: axis
43
what ligament runs vertical to the vertebral bodies? what ligament runs vertical to the front of the vertebral bodies?
ant. longitudinal ligaments = runs vertical to vertebrae bodies
- resists hyperextension (bending backwards)
-
post. longitudinal ligaments = runs vertical to the front of vertebraes
- resists hyperflexion and herniation
44
what ligament joins the vertebrae inferior to it (below it) on the laminae?
ligamenta flava
45
what ligament is b/w spinous processes of two vertebrae?
interspinous ligament
46
what ligament runs on the tips of the spinous processes?
supraspinous ligament
47
describe the ligamentum nuchae
cranial continuation of supraspinous ligament
- holds head up to conserve energy
48
scolioosis
lateral bent spine, YOUNG
49
kyphosis
hunchback, weak ligamenta flava, OLD
- occurs in thoracic spine
50
ankylosing spondylistis
inflammation that leads to fusion of vertebrae
- ossification of disks
51
spondylolisthesis
forward slippage of L5 (next to sacrum) and can lead to a break in spinous process
- due to poor evolution, malformed articular processes, or repeated force
52
herniated disk
nucleus pulposus of intervertebral disk bulges out & compresses nerve roots
- effects all downstream targets
53
what are dermatomes?
skin regions receiving somatic afferents from a specific spinal nerve
- has an inferior offset in thorax / abdomen
- twisted in limbs
54
describe the arteries of the spinal cord
1 anterior spinal artery
2 posterior spinal arteries
- has segmental spinal arteries that branch from intercostal arteries
55
describe the veins of the spinal cord
1 anterior spinal vein
1 posterior spinal vein
- all drain into the venous plexus (inside dura matter)
56
what is the mediastinum?
space b/w pleural sacs, behind manubrium
57
what is in the sternal angle?
at the plan of the manubriosternal joint (T4/5 disc)
-superior limit of pericardium
- bifurcation of trachea
- beginning and ending of aortic arch
- entrance of SVA into pericardium
- superior limit of pulmonary trunk
58
what does the tubercle of the ribs articulate with?
transverse processes
59
where are there nonsynovial joints?
intervertebral symphyses
manubriosternal symphyse
first sternocostal joint
60
what are the three muscles in the thoracic wall?
innermost intercostal
internal intercostal (inferoposterior = run toward middle)
external intercostal (inferanterior = run toward back)
61
what are the three vessels between each rib?
intercostal vein (superior)
intercostal artery
intercostal nerve (inferior)
62
what are the muscles called that run inside the rib cage on the posterior surface & cross two intercostal spaces?
subcostalis muscles
63
what are the 4-5 short muscles on the anterior side of the body that attach at the xiphoid process / inferior sternum and connect at the upper costal cartilage?
transversus thoracis muscles
64
what gives rise to the posterior intercostal arteries for ribs 3-12?
descending aorta
65
what gives rise to the posterior intercostal arteries for ribs 1-2?
supreme intercostal artery
- branches off of subclavian artery
66
what gives rise to the anterior intercostal arteries for ribs 1-6?
internal thoracic artery
- branches off of subclavian artery
67
what gives rise to the anterior intercostal arteries for ribs 7-9)
musculophrenic artery
- branches off of internal thoracic artery at T6/7
68
what three vessels branch off the aortic trunk? describe what they branch into
1: left subclavian -> vertebral artery
2. left carotid -> external & internal carotid
3. brachiocephalic branch -> right subclavian, right carotid (external & internal carotid)
69
what gives rise to the posterior intercostal veins for the RIGHT ribs 5-11?
azygous vein
- branches off of lumbar veins from the IVC
70
what gives rise to the posterior intercostal veins for the RIGHT ribs 2-4?
superior intercostal vein
- branches off of the loop of the azygous vein to the SVC (at T4)
71
what gives rise to the posterior intercostal veins for the RIGHT rib 1?
supreme intercostal vein
- branches off of SVC directly
72
what gives rise to the posterior intercostal veins for LEFT ribs 9-11?
hemiazygous
- branches off of lumbar veins from the IVC
73
what gives rise to the posterior intercostal veins for LEFT ribs 5-8?
accessory hemiazygous vein
- branches off of azygous vein at T8
74
what gives rise to the posterior intercostal veins for LEFT ribs 2-4?
superior intercostal vein
- branches directly off of SVC
75
what gives rise to to the posterior intercostal veins for the LEFT rib 1?
supreme intercostal vein
- branches off of SVC directly
76
what two branches does the SVC have? describe what they branch into
brachiocephalic veins
- subclavian & internal jugular veins
*ON BOTH SIDES
77
what is the superior thoracic aperature? what comes out of it?
above rib1 and b/w clavicle & rib1
- esophagus, trachea
- cardotid, subclavian, jugular
78
what is thoracic outlet syndrome?
compression of brachial plexus of nerves by a band of tissue on cervical rib tip
79
what is the inferior thoracic aperature? what are the three openings and what comes out of them?
through the diaphragm
- Caval Opening (T8) = IVC, phrenic nerve (right)
- Esophageal Hiatus (T10) = esophagus, gasrtic vessels (left), lymph channels
- Aortic Hiatus (T12) = aorta, thoracic duct, azygous vein
80
what is the origin and insertion of the diaphragm?
O:right and left crus (L1-3)
I: costal cartilage of ribs 7-12, xiphoid process
81
what is the innervation and action/function of the diaphragm?
INN: phrenic nerve (C3-5)
A: flattens & retracts lower ribs downward, quiet respiration
82
what attaches the mammary glands to the dermis?
suspensory ligaments of Cooper
83
what is peau d'orange?
breast carcinoma causes the suspensory ligament to be pulled tight and create pits in the skin
- leads to breast edema due to the occlusion of lymphatics and inability to drain
84
what are mammary glands?
modified sweat glands that have no capsule or sheath and contain about 15-20 lobes
- each lobe has a lactiferous sinus that leads to a lactiferous duct
85
what is the nerve supply of the breast?
anterior & lateral cutaneous branches of the 4-6 intercostal nerves
86
what are the glands called on the areola?
areolar glands / glands of montgomery
87
what is the axillary tail?
superolateral extenstion of mammary gland that reaches the armpit
- can swell during menstration & feel like a lump
88
what is the blood supply of the breast?
lateral quadrants (outer half)
- lateral mammary arteries
(comes from a branch off of the subclavian artery -> axillary a -> lateral thoracic a)
medial quadrants (inner half)
- medial mammary arteries
(comes from a branch off of the subclavian artery -> internal thoracic a, internal mammary a)
89
describe the lymphatic drainage in the breast
subareolar plexus -> anastomoses with contralateral (opposite) breast
- all quadrants drain to axillary nodes
- some medial quadrants also drain into the parasternal nodes
90
describe why breast cancer is very common and spreads fast
- water diffuses out of the blood and is taken up by the lymph system to drain into the veins
- the breast lymph nodes are close to the subclavian vein
- which can cause the cancerous cells to be spread all throughout the body
91
what is the most common type of breast cancer? where does it form?
ductal cell carcinoma
- in the epithelium of lactiferous ducts
92
describe the three levels of breast cancer
1. lateral to pect. minor
2. behind pect. minor
3. medial to pect. minor
93
what is the upper and lower respiratory tracts?
upper: nasal -> larynx
lower: trachea -> alveolar sacs
94
what is the conducting zone?
nasal -> terminal bronchioles
- cleans, warms, and moistens the air
- known as the dead zone (no gas exchange)
95
what is the respiratory zone?
parenchyma (respiratory bronchioles, alveolar ducts, alevoli)
96
where along the vertebral column is the trachea before it bifurcates?
C6-T4/5
97
which main bronchus is more likely to have an object lodged in it? (L or R)
right
- shorter, wider, and more vertical than left
98
how many primary/main bronchi are there on the left and right sides?
1 on each side
99
how many secondary bronchi are there on the left and right sides?
3R
2L
100
how many tertiary/segmental bronchi are there on the left and right sides?
10R (3 upper, 2 middle, 5 lower)
10L (5 upper, 5 lower)
101
what is the branch called on the right side that contains the upper tertiary bronchi?
eparterial bronchus
102
what is the branch called on the right side that contains the middle and lower tertiary bronchi?
bronchus intermedius
103
what are the branches called on the left side for the uper and lower tertiary bronchi?
upper -> superior
lower -> inferior
104
what occurs during quiet inspiration?
volume increases
- diaphragm contracts and is pulled down & out
105
what occurs during quiet expiration?
volume decreases
- diaphragm relaxes and elastic recoil of lung forces air out
106
what occurs during vigorous inspiration?
- rib1 is stabilized by scalenes
- external intercostal muscles pull ribs up & out
(mediolateral, anterposterior)
107
what occurs during very vigorous inspiration?
-sternocleidomastoid and scalenes elevate thorax
108
what occurs during vigorous expiration?
internal intercostals & abdominal muscles contract
109
what innervates the intercostal muscles?
intercostal nerves
110
what innervates the scalenes?
cervical SC
111
what innervates the sternoclediomastoid?
CN 11 (accessory)
phrenic nerve (C3-4)
112
where on the spinal cord, if it is cut, leaves the individual breathing on a ventiliator?
C3
113
what are bronchopulmonary segments?
area of lungs supplied by tertiary bronchi and it's pulmonary arterial branch
- smallest part of lung that can be surgically removed w/o affecting neighboring regions because they are functionally independent
- 10 segments per lung
114
what blood supplies the parenchyma?
pulmonary artery (intrasegmental -> into each segment)
pulmonary vein (intersegmental -> many segments per)
115
what blood supplies the bronchial part of lungs?
bronchial artery from the descending aorta
116
how many lobes in each lung? what is the fissure b/w the upper and lower lobes in both lungs? what is the fissure called b/w the upper and middle right lobes called?
3R
2L
- upper/lower -> oblique fissure
- upper/middle (R) -> horizontal fissure
117
what is the attachment points of the scalene muscles?
transverse processes & ribs 1,2
118
what is the layer on the outside of the pleural cavity? layer on the lungs? what is the pleural cavity filled with inbetween these two layers?
parietal pleura (against thoracic wall)
visceral pleura (next to lungs)
serous fluid in b/w (allows for surface tension)
119
what is a penumothorax?
air entering the pleural sac causing lungs to collapse inward
- the lungs have sub atmospheric pressure, so when air from the environment enters, it causes the surface tension of the lungs to be destroyed (which is what holds them out)
120
what is a pleural effusion?
collection of fluid in the pleural sac
- hemothorax = blood
- chylothorax = lymph
121
where is the fluid drained from during a pleural tap?
costodiaphragmatic recess (8th/9th intercostal space which is between rib9/10)
122
what is the muscle that is between the pleural cavity and the ribs?
endothoracic fascia
123
what is the innervation of the parietal pleura?
somatic afferent
- phrenic nerve -> diaphragmatic & mediastinal pleura
- intercostal nerves -> costal pleura
124
what is the innervation of the lungs?
visceral efferent
- parasymp -> vagus -> mucous glands in trachea (cholinergic)
- symp -> T1-5 ventral roots
visceral afferent
- nonsensory go to brain thru vagus nerve
- NO SENSORY
125
what type of reflex does the acini activate?
Hering-Breur reflex
- regulates rhythmic ventilation & prevents over inflation / deflation
- uses stretch receptors
126
what type of reflex does the trachea and bronchi activate?
cough reflex
- uses chemoreceptors to sense an irritant
127
what does activation of the sympathetic NS on the trachea and bronchi do?
releases epi to bind to beta2 receptors
- relaxes smooth muscle
- dilates bronchi
128
what does activation of the sympathetic NS on the pulmonary vasculature do?
releases epi to bind to beta2 receptors
- relaxes smooth muscle
- dilates bronchi
129
what does activation of the sympathetic NS on the bronchial arteries?
releases epi to bind to beta2 receptors
- constricts vessel to precent the blood from destroying mucosa lining
130
what innervates the lung parenchyma and visceral pleura?
posterior and anterior plexuses
- found around the carina and main bronchi
- come from the vagus and cardiac nerves
131
what is the most superior part of the pleura called?
cervical pleura
132
what is the most distal part of the pleura called?
costal pleura
133
what is the most inferior part of the pleura called?
diaphragmatic pleura
134
what is the most medial part of the pleura called?
mediastinal pleura
135
what two brain structures regulate breathing?
medulla & pons
136
what center in the pons tells the medulla to stop inspiration?
pnemotaxic center
137
what center in the pons tells the medulla to go check the breathing and contract muscles?
apneustic center
138
what part of the SC deals with inspiration? what about expiration?
inspiration = dorsal respiratory group
expiration = ventral respiratory group
139
where does the pons & medulla get its signals from for breathing?
gets signals from the aorta (CO2, O2)
140
what is the function of the thymus?
primary lymph organ
- gland that screens and allows for a place of T-cell (killer cell) maturation
141
where is the thymus located?
mediastinum, above heart, and in front of carina
142
describe the structure of the thymus? what are the pouches called that they arose from?
2 lobes (R,L)
- each comprised of individual lobules
- each lobule has two layers (medulla, cortex)
- cortex and fenestrated capillaries, medulla has non-fenestrated capillaries
- come from phrengial pouches
143
what is the blood supply of the thymus?
inferior and middle arteries, intercostal arteries
144
describe the blood-thymus barrier
made by epithelial cells to ensure T-cells are mature
- negative screening -> autoreactive cells apoptose
- positive screening -> antigen-binindg cells proliferate
145
describe the shape of the thymus in children vs adults
children = square, larger
adult = triangular, gets smaller and fattier as we age (run out of T-cells to screen)
146
what is the outer layer of the pericardial cavity?
fibrous pericardium (outer)
serous pericardium/parietal layer (inner)
147
what is the inner layer of the pericardial cavity? (closest to the heart)
visceral layer
148
what is the space b/w the parietal layer and visceral layer of the heart called?
pericardial cavity
- filled with serous fluid
149
whats the importance of the fibrous pericardium?
contains phrenic nerves (C3-5) and pericardiacophrenic vessels
150
where is the transverse pericardial sinus?
behind ascending aorta & pulmonary trunk, in front of SVC
151
where is the oblique pericardial sinus?
behind the posterior wall of left atrium
152
what is cardiac tamponade?
compression of the heart due to fluid accumulation w/in pericardium
-caused by kidney malfunction, trauma, inflammation
-makes there be less blood pumped, less blood in the heart, which overall increases bp
- can be solved by drugs or a pericardiocentesis
153
what is the auricle?
pouchlike appendage from embryonic development in the atrium's
154
what is the crista terminalis?
ridge that runs from the IVC to the SVC openings in the right atrium
155
what is the fossa ovalis?
depression in the interatrial septum
- former site of the foramen ovale
156
what is the trabeculae carneae?
irregular ridges of the right venticle myocardium
157
what are papillary muscles?
what attaches the cuspid valves to the heart
158
what are chordae tendineae?
fibrous cords that connect papillary muscles to valve
159
what is the moderator band?
connects anterior papillary muscles to interventricular septum
160
which atrium has a thicker wall, left or right?
left atrium
161
what are the two semilunar valves?
pulmonary and aortic
- not muscular
- blood LEAVES
162
what are the two cuspid valves?
bicuspid (L), tricuspid (R)
- papillary muscles force open
- blood ENTERS
163
what two things are open during fetal development, but eventually close?
foramen ovale
ductus arteriosus
- no need to pump blood to lungs in utero (gets O2 from mom)
164
what are common birth defects of the heart?
narrow pulmonary trunk
enlarged right ventricle
aorta open to both ventricles
hole in ventricular wall
165
what type of membrane is around each valve in the heart and serves as an electrical insulator to open valves separately?
dense fibrous connective tissue
- bound together by trigones
166
what two arteries stem off of the aortic root?
coronary arteries (L, R)
167
describe the three sinuses of the aortic root
three cavities
- left coronary sinus
- right coronary sinus
- non-coronary sinus
168
what branches does the RIGHT coronary artery give rise to?
right marginal artery
posterior inerventricular artery
169
what does the RIGHT coronary artery give blood to?
RA, RV, LV
170
what branches does the LEFT coronary artery give rise to? what do these branches give blood to?
LAD (LA, LV)
circumflex -> left marginal artery (LV, septum)
171
what are atherosclerotic plaques?
common in the RCA and LCA in the tunica intima
- made up of fats, lipids, and debris
172
where are the common occlusion sites for plaques?
1. b/w LAD & circumflex
2. LAD
3. RCA
4. circumflex
5. posterior interventricular artery
