Exam I Topics Flashcards
(191 cards)
1
Q
What are the five fetal circulation adaptations?
A
- umbilical vein
- ductus venous
- foramen ovale
- ductus arteriosus
- umbilical artery
2
Q
What causes medial winging of the scapula?
A
Injury of the long thoracic nerve (innervates serratus anterior).
3
Q
What color does air appear as on x-ray?
A
black
4
Q
What color does bone appear as on an x-ray?
A
white
5
Q
What is the mnemonic for reading an x-ray?
A
Airway
Bones
Cardiac silhouette
Diaphragm
Extra-pulmonary
Fields (lungs)
Gastric bubble
Hilum
6
Q
What is a way to determine if a patient has inspired adequately during an x-ray?
A
9-10 ribs are visisble
7
Q
Signs of hypovolemic “burn” shock
A
increased capillary permeability
leakage of intravascular fluids
decreased perfusion
decreased blood pressure
decreased cardiac output
increased heart rate
8
Q
Parkland Formula
A
FR = 4 mL x Kg x TBSA %
1/2 of fluids in first 8 hours
1/2 of fluids in last 16 hours
9
Q
What ribs are true?
A
1-7
10
Q
What ribs are false?
A
8-10 (one piece of cartilage connects them)
11
Q
What ribs are floating?
A
11 and 12 (doesn’t attach to the sternum)
12
Q
How many vertebrae are there?
A
33
13
Q
How many cervical vertebrae are there?
A
7
14
Q
How many thoracic vertebrae are there?
A
12
15
Q
How many lumber vertebrae are there?
A
5
16
Q
How many sacral vertebrae are there?
A
5
17
Q
How many coccyx segments are there?
A
4
18
Q
Why do the vertebrae become larger as you get closer to the sacrum?
A
bears more weight
19
Q
Cervical Lordosis
A
2 degree curve
20
Q
Thoracic Kyphosis
A
1 degree curve
21
Q
Lumbar Lordosis
A
2 degree curve
22
Q
Sacral Kyphosis
A
1 degree curve
23
Q
What is scoliosis?
A
lateral curvature of the spine
most commonly affects girls 12 -15 years old
24
Q
What is lordosis?
A
increase in lumbar curvature
25
What is kyphosis?
increase in thoracic curvature
commonly seen in osteoporosis
26
Where do the spinal nerves exit?
intervertebral foramina
27
C1
Atlas
No vertebral body
28
C2
Axis
29
What does the Atlanto-Occipital Joint allow for?
(C1 Lateral Masses and Occipital Condyle)
Neck Flexion and Extension (nodding)
Lateral Flexion (Sideways tilt)
30
What does the Atlanto-Axial Joint allow for?
(C1 and C2)
Side to Side movement (No)
31
What is the name of the pivot point on C2?
Dens
32
What is a Hangman's fracture?
fracture of C2 (axis)
hyperextension
best seen on lateral view x-ray
33
What region of the back do most sources of pain come from?
Lumbar
34
Ligament that limits extension, is wide, and located on vertebral bodies?
Anterior Longitudinal Ligament
35
Ligament that limits flexion and is located within the vertebral canal?
Posterior Longitudinal Ligament
36
Medial ligament of the neck that substitutes as bone for muscle attachment from C3-C5 spinous process?
Nuchal Ligament
37
Ligament that is located between the lamina and arrest abrupt flexion to prevent injury to the intervertebral discs
Ligament Flavum
38
How long is the spinal cord?
45 cm
39
At what level does the spinal cord end?
L1-L2
40
What is the primary function of the cauda equina?
send and receive messages between the lower limbs and the pelvic organs.
bladder
rectum
internal genitals
41
Outermost layer of the meninges
Duramater
42
Where are spinal blocks given?
Between L3 and L4 or L4 and L5
43
Most inner layer of the meninges that is a vascular membrane that covers the spinal cord
Pia mater
44
Middle layer of the meninges
Arachnoid mater
45
Space that is filled with cerebrospinal fluid
Subarachnoid space
46
What is cerebrospinal fluid formed by?
Choroid plexuses of the brain
47
What holds the spinal cord in place?
Film terminale
48
Subarachnoid space between conus medullaris and the end of the dural sac
Lumbar cistern
49
Location of the brachial plexus
Cervical Enlargement
50
Location of the lumbar and sacral plexus
Lumbar Enlargement
51
End of the spinal cord
Conus Medullaris
52
How many spinal nerves are there?
31
53
SAME DAVE
Sensory - Afferent
Motor - Efferent
Dorsal - Afferent
Ventral - Efferent
54
What do the posterior and anterior roots unite to form?
Spinal Nerves
55
Where do the spinal nerves exit the spine?
intervertebral foramina
56
Where do cervical spinal nerves exit?
Above their corresponding vertebral body
C7 exits between C6 and C7
57
Where do thoracic and lumbar spinal nerves exit?
Below their corresponding vertebral body
L3 exits between L3 and L4
58
Nerve root injury and compression
Radiculopathy (Referred Pain)
59
Jelly-like material that consists of mainly water and allows the vertebral disc to withstand forces of compression and torsion
Nucleus pulposus
60
Ring of ligament fibers that connects the spinal vertebrae and is on the outside of the intervertebral disc
Annulus fibrosus
61
Where do most disk herniations occur?
L4 and L5
L5 and S1
62
Insertion of the Trapezius
Clavicle (lateral third)
Acromion Process
Spine of Scapula
63
Origin of the Trapezius
Nuchal Ligament
Spinous Process of C7-T12
Superior Nuchal Line
External Occipital Protuberance
64
What nerve innervates the Trapezius?
Spinal Accessory (CN XI)
65
What artery supplies blood to the Trapezius?
Transverse Cervical Artery
66
What nerve is affected with lateral winging of the scapula?
Dorsal Scapular Nerve
67
What muscle allows for extension of the neck?
Splenius
68
What muscle allows for extension and lateral flexion of the spine?
Erector Spinae
69
Branches of the Axillary Artery
(HOTEL SPA)
Highest Thoracic Artery
o
Thoracoacromial Artery
e
Lateral Thoracic Artery
Subscapular Artery
Posterior Humeral Circumflex Artery
Anterior Humeral Circumflex Artery
70
What layer of the skin are melanocytes found in?
Epidermis
71
What layer of the skin are keratinocytes found in?
Epidermis
72
What layer of the skin are papillary ridges found in? (Fingerprints)
Epidermis
73
What layer of the skin are hair follicles found in?
Dermis
74
What layer of skin are sweat glands found in?
Dermis
75
These sweat glands regulate heat and are found on the palms, forehead, and neck
Eccrine
76
These sweat glands start to appear after puberty and are found in the groins and arm pits
Apocrine
77
These sweat glands secrete sebum and promotes hair health
Sebaceous
78
What layer of the skin contains capillaries?
Dermis
79
What layer of the skin contains arrector pilli muscles?
Dermis
80
Peach fuzz or light hairs
Vellus hair
81
Dark hair
Terminal hair
82
What layer of skin do the hair and nails belong to?
Dermis
83
Respond to mechanical stimuli such as stroking, stretching, or vibration
Mechanoreceptors
84
Respond to hot or cold temperatures
Thermoreceptors
85
Respond to certain types of chemicals
Chemoreceptors
86
Respond to pain or tissue damaging stimuli
Nociceptors
87
Mechanoreceptors that respond to pressure and low-frequency vibrations
Meissner's corpuscles
88
Detect transient pressure and high-frequency vibrations
Pacinian corpuscles
89
Respond to light pressure
Merkel's disks
90
Detect stretch
Ruffini corpuscles
91
Specific segment of skin supplied by a single spinal nerve
Dermatome
92
What dermatome innervates the nipple
T4
93
What dermatome innervates the belly button
T10
94
What dermatome innervates the genitalia
S2 and S3
95
What dermatome innervates the knee
L4
96
What is the deepest layer of skin called?
Hypodermis or Subcutaneous tissue
97
What layer of skin is adipose tissue found in?
Hypodermis
98
What layer of skin also contains blood vessels?
Hypodermis
99
What layer of skin contains lymph vessels?
Hypodermis
100
What type of tissue attaches the dermis to muscle and bone and regulates heat and provides protection from falls
Subcutaneous Tissue
101
Forms the inter-muscular septa which divide the limbs into compartments
Deep Fascia
102
White cords and fibrous tissue that are made of collagen and attach muscle to bones
Tendons
103
Flat or ribbon shaped tendons
Aponeuroses
104
Laminae found in all regions and are very tough
Fascia
105
Below the skin and connects the skin with deep fascia
Superficial fascia
106
Subcutaneous Injections Examples
Insulin
Heparin
Allergy injections
107
Lines that are followed in an attempt to reduce scarring and promote healing
Tension Lines (Langer's Lines)
108
This layer of the skin contains healing elements such as blood supply and cellular elects that create the extracellular matrix necessary for healing
Dermis
109
When is fluid resuscitation required
Greater than 20% TBSA of a second degree burn
110
Burn that is limited to the epidermal layer. It appears pink and is painful with edema.
First Degree Burn
111
How long does take for first degree burns to heal?
3 - 5 days
No scarring
112
Burn that affects the epidermis and papillary region of the dermis. Blisters and serous fluid. Cherry red and moist appearance. PAINFUL.
Superficial Second Degree Burn
113
How long does it take a Superficial Second Degree Burn to heal?
7 - 28 days
Minimal scarring
114
Burn that affects the epidermis and reticular region of the dermis. Pale or ivory with a moist appearance. PAINFUL.
Deep Second Degree Burn
115
How long does it take a Deep Second Degree Burn to heal?
7 - 28 days
Variable Scarring
116
Burn that extends into subcutaneous tissue. Appears white, yellow, or brown and leathery. Thromboses vessels, loss of elasticity. Possible escharotomy. PAINLESS. Requires grafting.
Third Degree Burn (Full Thickness)
117
Burn that extends to muscle. Black charred appearance. May require amputation. NO PAIN. NO FUNCTION
Fourth Degree Burn
118
Rule of 9s
119
At what level is the Jugular (sternal) Notch found?
T2-T3
120
Level of Sternal Angle
2nd Intercostal Space
T4-T5
121
Level of Xyphoid Process
T8-T9
122
Location of Apical Pulse (Point of Maximal Impulse)
5th Intercostal Space (Left Side)
123
Where is the most common site of breast cancer
Upper lateral quadrant (tail of the breast)
124
Where is breast cancer most likely to metastasize to?
Axillary Lymph Nodes
125
What is the most common site of fracture on a rib?
Costal Angle
126
What is located in the costal groove of a rib?
Veins
Arteries
Nerves
127
Vena Caval Foramen
Inferior Vena Cava
Right Phrenic Nerve
T8
128
Esophageal Hiatus
Esophagus
Esophageal Arteries
Vagus
T10
129
Aortic Hiatus
Aorta
Azygous Vein
Thoracic Duct
T12
130
What nerve innervates the serratus anterior (boxer muscle)
long thoracic nerve
131
What artery supplies the serratus anterior
circumflex scapular artery
132
Portion of the mediastinum that contains:
- Descending Aorta
- Azygous & Hemizygous Veins
- Esophagus
- Thoracic Duct
Posterior Mediastinum
133
Portion of the mediastinum that contains:
- Thymus
- Lymph Nodes
Anterior Mediastinum
134
Portion of the mediastinum that contains:
- Heart
- Pericardium
- Ascending Aorta
- Bronchi
- Trachea
- Vena Cava
- Pulmonary Veins
- Phrenic Nerves
Middle Mediastinum
135
Relationship of Mediastinum anatomy from Superficial to Deep
- Thymus
- Veins
- Arteries
- Nerves
- Trachea
- Esophagus
- Thoracic Duct
136
Invasive method used for staging cancer of the of superior and middle mediastinum
Mediastinoscopy
137
Where does the left recurrent nerve lay?
1cm lateral to the trachea
138
Pleura closest to the organ
Visceral Pleura
139
Pleura that lines the cavity.
Sensitive to pain, temperature, and touch.
Adheres to Mediastinum
Parietal Pleura
140
How many lobes does the right lung have?
3
141
How many lobes does the left lung have
2
142
Tongue-like process off left upper lobe
Lingula
143
Sympathetic innervation that dilates bronchioles and vessels
Cardiac Plexus
144
Parasympathetic innervation that constricts bronchioles
Vagus Nerve
145
Exits to carry presynaptic fibers to the neck, head, and down to the lower abdomen and pelvis
Fight or Flight
Thoracic and Lumbar
146
Post-Synaptic and carry information TO the spinal nerve
Gray Communicans
147
Pre-Synaptic and carry information FROM the Anterior Rami to the sympathetic trunk
White Communicans
148
Where does the parasympathetic nervous system exit?
Cranial nuclei and Sacral
149
Primary nerve of the parasympathetic nervous system
Vagus nerve (CN X)
150
How many pulmonary arteries are there?
2
151
How many pulmonary veins are there?
4
152
Region where pulmonary blood vessels enter and leave
Hilum
153
What are the primary bronchi
Right and Left
154
Where does the right bronchial vein drain into?
azygous vein
155
Where does the left bronchial vein drain into?
hemiazygous vein
156
Vein on the right side of the body that transports deoxygenated blood from the posterior thorax and abdomen into the superior vena cava
Azygous vein
157
Vein on the left side of the body that comes from the left renal vein
Hemiazygous
158
Vein that drains the left superior hemithorax and into the azygous vein
Accessory hemiazygous
159
Where does the hemizygous vein enter the thorax?
Aortic hiatus or diaphragmatic crura
T12
160
Created when a laterally displaced azygous vein creates a deep pleural fissure into the apical segment of the right upper lung
azygous lobe
161
Alveoli that allow for gas exchange. They are made of thin squamous cells and make up 95% of all alveoli
Type I Pnuemocyte
162
Alveoli that make pulmonary surfactant (5% of alveolar cells)
Type II Pneumocyte
163
Emergency medical condition where fluid builds up in the pericardial sac
Cardiac Tamponade
164
Beck's Triad
- Hypotension
- Jugular Venous Distention
- Muffled Heart Sounds
(Cardiac Tamponade)
165
Needle aspiration performed under ultrasound guidance to treat cardiac tamponade. Performed along the left sternal border in the 5th intercostal space
Pericardiocentiusis
166
Where do most clots develop at in the heart?
- Left Atrium
- LAD
167
Oxygen rich blood travels from the placenta to either the liver or to the inferior vena cava
Umbilical Vein
168
Direct connection between the umbilical vein to the inferior vena cava
Ductus Venosus
169
Direct connection between the left atrium and right atrium due to hypoxic pulmonary constriction.
Patent Foramen Ovale
170
Direct connection between the pulmonary artery and the aorta.
Ductus Arteriosus
171
Once blood leaves via the aorta, the majority is diverted back to the placenta. This happens because the resistance in the placenta is so low
Umbilical Artery
172
When a valve does not open fully due to calcium causing narrowing
Stenosis
173
When a valve does not close properly
Regurgitation
174
Superficial vibrations from the eddies (turbulent flow) is felt superficially on the thorax
Thrill
175
Most common of cardiac defects that can lead to possible cardiac failure. (25% are congenital)
Ventricular Septal Defect
176
Incomplete closure of the oval foramen
Atrial Septal Defect
177
What is the largest part of the anterior heart?
Right ventricle
178
Artery that rides in the AV Groove
Left Circumflex Artery
179
What percentage of a coronary artery must be narrowed for heart surgery?
70%
180
Treatments for Myocardial Infarction
- Beta Blockers
- Aspirin
- Statin
- CABG
- Percutaneous Intervention (ballooning or stents)
181
Ventricular Filling
Diastole
182
Ventricular Shortening
Systole
183
Obstruction of blood flow through this major vein is considered a medical emergency. It is often seen in patients with lung cancer
Superior Vena Cava
184
Bifurcation of the trachea
Carina
185
What nerve gives rise to the recurrent laryngeal nerves?
Vagus Nerve (CN X)
186
What nerve innervates the diaphragm?
Phrenic nerve
187
What does the right phrenic nerve pass through at T8
Caval Foramen
188
Drains the right arm and shoulder, as well as the right side of the head (Lymph)
Right Lymphatic Duct
189
Drains the entire left side of the body and from the middle of the abdomen down on the right side (Lymph)
Thoracic Duct
190
Pathologies that cause tracheal deviation AWAY from affected side
- Pneumothorax
- Pleural Effusion
191
Pathologies that cause tracheal deviation TOWARDS affected side
- Lobectomy
- Pleural Fibrosis
