REVIEW Flashcards
(166 cards)
1
Q
level of suprasternal notch?
A
TV2 TV3
2
Q
sternocostal joint?
A
1st synchondrosis
2-7 synovial
3
Q
costochondral joint?
A
synchondrosis
4
Q
interchondral joint?
A
8-10 costal cartilage above and below
5
Q
costovertebral joint?
A
synovial plane joints
6
Q
ribs 1, 10, 11, 12
A
articulate with that numbered TV
7
Q
costotransverse joint?
A
rib tubercle and transverse process
synovial
8
Q
innervation of levator costarum?
A
C8-T11
9
Q
intercostal nerves?
A
ventral rami
preganglionic sympathetic - white rami 14
postganglionic sympathetic - gray rami 31
10
Q
intercostobrachial cutaneous nerve?
A
lateral cutaneous intercostal number 2
11
Q
dermatome at nipple?
A
T4
12
Q
dermatome at umbilicus?
A
T10
13
Q
expiration muscles?
A
internal intercostal
innermost intercostal
subcostal
transverse thoracic
14
Q
inspiration muscles?
A
external intecostal
15
Q
greater, lesser, least splanchnic nerves?
A
greater - 5-9
lesser - 10-11
least - 12
preganglionic sympathetic!
16
Q
cardiac plexus?
A
parasympathetic - preganglionic
sympathetic - postganglionic (T1-T4)
17
Q
pleuritis
A
phrenic nerve C345
aka pleurisy
18
Q
visceral vs parietal pleura
A
MCL 6-8
MAL 8-10
SL 10-12
19
Q
number of bronchopulmonary segments?
A
left - 8
right - 10
20
Q
number of bronchial arteries?
A
2 left
1 right
21
Q
virchow’s node?
A
supraclavicular node
indicates cancer spread
22
Q
innervation of parietal pleura?
A
mediastinal and diaphragmatic - phrenic
costal - intercostal nerves
23
Q
empyema?
A
pus in thorax
24
Q
horner’s?
A
ptosis
miosis
anhidrosis
25
innervation of lungs?
preganglionic sympathetic T2-T6
primary sympathetic - cardiopulmonary splanchnic nerves -
26
cardiopulmonary splanchnic nerves
postganglionic**
most splanchnic, preganglionic
27
pericardiocentesis?
left of sternum 5 or 6 ICS
28
pericardial pain?
phrenic nerve
C345
shoulder dermatomes
29
pain fibers in visceral pericardium?
no
30
beck's triad?
cardiac tamponade
muffled heart sounds
hypotension
distended neck veins
31
dressler syndrome
post MI pericarditis
32
heart sulci
atrioventricular (coronary)
| anterior and posterior interventricular
33
apex of heart?
5th ICS
34
base of heart?
left atrium
35
borders of heart?
3
right - right atrium
inferior - 2/3 right ventricle, 1/3 left ventricle
left - left ventricle, auricular appendage
36
surfaces of heart?
anterior - 2/3 right ventricle, 1/3 left ventricle
right - right atrium
left - left ventricle, auricular appendage
diaphragm - 2/3 left ventricle, 1/3 right ventricle
37
left trigone?
aortic mitral valve separation
38
right trigone?
aortic, mitral, tricuspid valve separation
39
layers of myocardium?
superficial and deep
40
ratio of myocardium?
1:3:9
41
SA node?
sub-epicardium
42
AV node
sub-endocardium
43
conus arteriosus?
smooth right ventricle
44
aortic vestibule?
smooth left ventricle
45
blood supply to AV and SA node?
right coronary artery
46
blood supply to bundle of his and other conduction system?
left coronary artery
47
lymph?
RCA - left
| LCA - right
48
widow maker?
entire left coronary artery
49
most common coronary artery occlusion?
anterior interventricular artery
50
heart innervation?
T1-T4
postganglionic cardiopulmonary splanchnic
parasympathetic vagus
51
superior vena cava?
1-3 ICS on right side
52
vagus nerve?
preganglionic parasympathetic
53
thoracic duct?
cisterna chyli LV2
54
parasympathetic to heart?
AcH
55
sympathetic to heart?
NE
56
tube thoracostomy?
air - 2-3 ICS
| fluid 4-5 ICS
57
spontaneous pneumothorax?
visceral pleura
58
traumatic pneumothorax?
parietal pleura
59
AN at AV junction?
long pathway
60
N at AV junction?
slows signal
61
left bundle branch?
thin anterior, thick posterior
62
purkinje fibers
lack T tubules
63
order of depolarization?
endocardium - epicardium
| apex - base
64
biomarkers for cardiac damage?
cTnT, cTnI
| CK-MB
65
ECF calcium release?
L -type channels
leads to Ca2+ induced calcium release through RyR
66
relaxation of cardiac AP?
3 Na+/1 Ca2+ antiport - to ECF
| SERCA - to SR
67
phase 0
rapid depolarization
68
phase 1
early rapid depolarization
69
phase 2
plateau
70
phase 3
final rapid depolarization
71
phase 4
resting potential
72
slow type APs?
SA/AV nodes
73
fast type APs?
atrial myocytes, purkinje, ventricular myocytes
74
plateau phase?
Ca2+ vs. K+
75
I-Ca vs. I-Na
calcium smaller
therefore, slower depolarization of SA/AV nodes (slow type)
76
potassium channel blocker?
longer AP
77
hyperkalemia?
depolarizes RMP, slows HR
inactivation of sodium gates, slows conduction
78
effective refractory?
absolute
79
relative refractory?
can get signal
80
afterdepolarizations?
can result in tachycardia
81
funny current?
mainly due to sodium influx during hyperpolarization
non-specific cation channels
82
Q wave
left to right IV septum
83
R'
second upward in EKG
84
tiny box?
0.04s
85
box?
0.2s or 0.5mV
86
PR interval?
normal 3-5 small boxes
shows AV nodal delay
87
ST segment?
myocardial injury
should be isoelectric
88
QT interval?
total ventricle activity
normal 0.44-0.35s
89
long QT syndrome?
more likely to cause torsades de point
can't inactivate sodium (hyperkalemia)
90
anterior leads?
V2 V3 V4
91
left lateral leads?
I aVl V5 V6
92
right ventricular leads?
aVr V1
93
inferior leads?
II III aVf
94
range of MEA?
-30 to +110
95
left ventricular hypertrophy?
V1 and V5 > 35mm
96
primary block?
long PR interval
97
secondary block?
mobitz 1 - PR gradually lengthens
| mobitz 2 - every nth missing
98
tertiary block?
complete, AV disocciation
99
WPW syndrome?
alternate conduction pathway
| wide QRS
100
arteries?
pressure reservoir
101
arterioles?
resistance vessels
drop in BP**
102
capillaries?
exchange
103
veins?
blood reservoir
104
what maintains MAP?
arteries
105
MAP = ?
DBP + 1/3 (SBP - DBP)
*exercise - 1/2
106
gravity?
when standing, BP higher in feet
differences of arterial/venous remains same
107
compliance?
C = change in volume/change in pressure
108
most compliant?
veins
109
wall stress?
T ~ PxR / 2h
LaPlaces Law
110
causes of turbulence?
```
increased velocity (sudden local decrease in diameter)
increased diameter
decreased viscosity (increases velocity)
```
111
cause of change in blood viscosity?
anemia
112
reynold's number
= diameter x velocity x density / viscosity
113
Fick Principle?
CO = VO2 / A-V O2 difference
114
driving force of blood?
pressure gradient
| -change in pressure
115
CO= ?
MAP/TPR
116
how is flow distribution regulated?
resistance
117
in series?
resistance increases overall resistance
118
in parallel?
resistance decreases overall resistance
| -redirects flow
119
poiseuilles law
radius to the 4th** with flow
| inverse, length and velocity
120
vasoconstriction?
alpha1
121
vasodilation?
beta2
122
active hyperemia?
flow keeps up
123
reactive hyperemia?
blood flow increases after occlusion
124
factors affecting diffusion?
```
concentration gradient
permeability
membrane SA
molecular weight
distance
```
125
outward pressure forces?
P-c and Pi-IF
126
inward pressure forces?
P-IF and Pi-c
127
coronary steal?
coronary artery downstream already dilated
vasodilator will cause blood to go to other areas than target
128
PTCA
stent
129
CABG
bypass with vein
130
most blood flow to heart when?
diastole
131
LCA blood flow?
during isovolumetric relaxation
132
RCA blood flow?
more during systole
133
rate pressure product?
RPP = HR x SBP
134
MVO2=?
MVO2 = CBF x (AO2 - VO2)
135
extraction?
near max at rest
exercise requires increase in FLOW
136
adenosine?
decreased O2 leads to increased adenosine
| -vasodilation
137
tachycardia?
less time in diastole - less coronary flow
can be problematic for those with heart conditions
138
ST elevation?
MI
139
cardiopulmonary splanchnic nerves
superior, middle, inferior cervical cardiac nerves
-sympathetic postganglionic
thoracic cardiac nerves
-sympathetic postganglionic
140
vagal cardiac nerves
superior, inferior cervical cardiac branch
-parasympathetic preganglionic
thoracic cardia branch
-parasympathetic preganglionic
141
serratus anterior
long thoracic nerve
142
ductus venosus
allows blood from umbilical vein to bypass fetal liver
143
premature fetus
no surfactant!
| respiratory distress
144
five densities of Xray?
```
air
fat
soft tissue/water
calcification (bone)
metal
```
all allow for contrast
145
consolidation
filling of alveoli with air
146
interstitial
holds up bronchial tree
147
atelectasis
volume loss
148
opacity
area that is more white
attenuates the xray beam and appears more opaque
149
consolidation
exudate or other product of disease that replaces alveolar air
-renders lungs as solid
type of opacity
150
interstitial
connective tissue through the lung
lots of disease processes here**
151
three subdivisions of interstitial?
bronchovascular
parenchymal
subpleural
152
major pathological patterns of interstitial?
reticular
nodular
septal
153
silhouette sign
shadows
154
CXR frontal anatomy?
trachea
right paratracheal stripe - adenopathy**
carina - endotracheal tube placement** 3-7cm above
left mainstem bronchus - more horizontal
155
CXR lateral anatomy?
trachea
right upper lobe bronchus
carina
left mainstem bronchus - horizontal (round circle)
**useful for localization
156
CXR frontal anatomy?
mediastinum
left - 3 moguls
right - SVC, hilum, right atrium**
157
3 moguls
aortic arch
main pulmonary artery
left ventricle**
158
mediastinal lines
junctional lines - where lungs meet up
| azygoesophageal recess - indicator of hiatal hernia
159
CXR lateral anatomy
windows - retrosternal, retrotracheal, retrocardiac
vessels- aorta, left pulmonary artery, inferior vena cava
heart - right ventricle, left atrium
160
3 windows?
retrosternal
retrotracheal
retrocardiac
161
valves
can be seen on CXR
can differentiate on lateral
line from left mainstem bronchus to cardiophrenic angle
above - aortic valve
below - mitral valve
162
CXR frontal anatomy bones?
spine
-cervical, thoracic, lumbar
ribs
-anterior, posterior
clavicles
scapula
humerus
163
CXR lateral anatomy bones?
spine
-cervical, thoracic, lumbar
ribs
sternum
scapula
humerus
164
heart?
always want heart close to film
anterior first
left side first
165
CXR anatomy frontal lungs?
yeah, you can see them.
166
echocardiography
real-time imaging
| ultrasound
