spot 2 test Flashcards
(116 cards)
1
Q
Where is the transverse sinus?
A
it is ant to the SVC but post. to the aorta and pulmonary trunk
2
Q
What is the emryological reason for the transverse sinus?
A
embryological folding of the heart tube
3
Q
Where is the oblique sinus?
A
reflection of the pulmonary veins
4
Q
What does the tansverse sinus do?
A
seperate the venous outflow and arterial inflow of the heart
5
Q
where is the fossa ovalis?
A
at the level of the interatrial septum
6
Q
what is the emryological origin of the fossa ovalis?
A
foramen ovalis
7
Q
what is the crista terminalis?
A
the ridge that seperates the pectinate muscle to the smooth muscle
8
Q
Where is the SA node?
A
at the crista terminalis, near the SVC.
9
Q
What are the branches of the right coronary?
A
- ) right coronary
- ) SA nodal branch
- ) marginal branch
- ) posterior interventricluar
10
Q
Where does the coronary artery come out from?
A
the right auricle and the aorta
11
Q
What are the branches of the left coronary artery?
A
- ) left coronary artery
- ) cirrcumflex artery
- ) anteriror interventicular
- ) diagonal branch of the anterior interventricular
12
Q
Where does the left coronary artery come out from?
A
Between the left auricle and the pulmonary trunk
13
Q
What does the right coronary artery supply?
A
- right atrium
- right ventricle
- SA node
- Post. interventicular septum
- part of left ventricle
- AV node
- part of AV septum
14
Q
What does the left coronary arteyr supply?
A
- the left ventricle
- left atrium
- anterior interventricular septum
- AV node (40 %)
- part of reight ventricle
15
Q
Where is the great cardiac vein?
A
in the anterior interventicular sulcus
16
Q
Where is the middle cardiac vein?
A
in the posterior interventicular sulcus
17
Q
Where is the small cardiac vein?
A
The left of the coronary sinus, towards the left appendage
18
Q
What are the layers of the heart?
A
Fibroserous layers:
- ) Fibrous layer - very outside layer
serous: - ) parietal - lines the fibrous
- ) visceral - lines the heart
- ) myocardium
- ) endocardium
19
Q
What is the visceral layer also called?
A
epicardium
20
Q
What does the fibrous pericardium attach to?
A
great vessels, central tendon of the diaphragm, sternum by the sterrnopericardial ligament, parietal layer of serous pericardium
21
Q
where and what is the function of teh pericardial cavity?
A
it is betweent he serous layers and its function is to facilitate the movement of the heart, the gliding or the beating of the heart
22
Q
Where and what is conus arteriorsus?
A
It is the smooth layer of muscle in teh right ventricle
23
Q
What is the orrder if the branches that come of the arch of the aorta?
A
- ) brachiocepahlic (near ascending aorta)
- ) left common carotid
- ) left subclavian
24
Q
what are the branches of the SVC?
A
brachiocephalic veins which become the internal jugular and then the external and then the subclavian which tehn becomes the axillary
25
What closes the mitral valves?
The papillary muscles when they contract close them
26
When are the mitral valves closed?
They are clsoed during ventricular systole or contraction to prevent backflow
27
What does the left circumflex artery anastomse with?
With the right coronary as it wraps around the posterior aspect of the heart.
28
When does the aortic valve open?
When the pressure in the left ventricle is greater rthen the pressure in the aorta, during ventricular systole
29
What is the function of the papillary or chordae tendinae or tricuspid valve during ventricualr systole?
to prevent backflow to the atrium
30
What innervates the trabeculae carnae?
the purkinje fibres
31
Where does the left marginal artery originate from?
from the left circumflex
32
What is the function of the auricle?
To expand during atrial diastole, in which it increases the volume of the atrium, in which blood fills the area.
33
When does the pectinate muscle contract?
during atrial systole to force blood into the right ventricle
34
Where can the AV node?
at the interatrial septum, superior to teh opening of coronary sinus.
35
What is sinus venarum?
smooth muscle in the RA
36
What opening is in the RA?
opening of the coronary sinus
37
When does the trabeculae carnae contract?
it contracts during ventricular systole to push blood to the aorta or pulmonary trunk
38
What is the function of the chordae tendinae?
It is to connect the cusp to the papillary muscle and to so to prevent backflow during ventricular systole.
39
Where does the pharyngeal raphe terminate?
C6
40
The nasal chonchae are prejections of what bones?
Superior - projection of the ethmoid
middle - projection of the ethmoid
inferior -projection of the maxilla
41
what is the nasal septum made up of ?
hard bony part - perpendicular plate of the ethmoid bone and the vomer
cartilagenous part - septal cartilage
42
What does the cartilagenous part consist of?
- lateral process of septal cartilage
- major alar cartilage
- minor alar cartilage
43
what is respiratory mucosa made of?
- pseudostratified columnar ciliated epithelium with goblet cells
44
What is olfactory epthileum made of and where is it ?
- found below the cribriform plate of ethmoid bone.
| - spesialised for the detection of the smell
45
where does the small olfactory nerve rootlets exit?
through the olfactory mucosa and enter the skull to form and olfactory nerve.
46
function of the concha?
to increase the surface area that air can interact with mucosa by breaking air flow into multiple streams.
47
where is the olfactory bulb?
on top of the cribriform plate and then goes through it and through the olfacvtory epithelium to give olfactorry nerves, sort of a bundle down
48
trigeminal nerve branches?
1. ) ophthalmic division (eye and orbit)
2. ) maxillary division
3. ) mandible division
49
What anastomosis occurs in the nasal cavity?
spehnopalatine and anterior ethmoidal which are weak and when it breaks, you get a nose bleed
50
function of the tubal tonsil
has immune system tissue and its job is to sample and react to pathogenic microorganisms
51
where is the palatopharryngeal sphincter?
It is located over the superior constrictor or uvula
52
what is the palatine aponeurosis ?
on the palate bone and it consists of the tendons of the tensor veli palatini muscles
53
what are the arches in the mouth?
palatoglossal arch
| palatopharyngeal arch
54
embryological division of the tongue?
anterior 2/3 - oral part
| post. 1/3 - pharyngeal part (lingual tonsils)
55
what seperates the divisions of the tongue?
foramen cecum and termrinalis sulcus
56
what is the innervation of the tongue?
anterior 2/3:
- taste (special sensation) relayed by the facial nerve (CN7)
- general sensation: mandibular nerve (V3) via lingual nerve
psoterior 1/3:
-general and special by glossopharyngeal (CN 9)
Motor - intrinsic muscles, glossus muscles except palato are innervated by hypoglossal nerve (CN12)
palatoglossus by vagus nerve (CN10)
57
Where is the vellecula?
between the epiglottis and the tongue
58
why is the vallecula well innervated?
so that if food or any crumbs get stuck there you can cough or gag to ensure that the material is ejected.
59
at what level does the oropharynx end?
C3
60
At what level does the laryngopharynx end
C6
61
where does the epiglottis attach to ?
it attaches to the posterior surface of teh hyoid bone
62
where does the thyrohyoid membrane extend from?
from the hyoid bone to the thyroid cartilage
63
where does the quadrangular membrane attach to ?
from the vestibular fold to the lateral epiglottis, has a gap in the middle for air tto pass through.
64
what is the rima vestibuli
the opening between the edges of teh vestibular folds
65
what is the rima glottidis?
the area between the vocal cords
66
what is the epithelium of the vocal folds?
stratified squamous non keratonised which helps it resist abrasion
67
What is the epithelium of the vestibular folds?
ciliated pseudostratified
68
what nerve and artery pass through the thyrohyoid membrane?
-The suprior laryngeal
| superior laryngeal nerve
69
what gives sensation to tehe infraglottic mucosa of the larynx and the supraglottic?
infraglottic - reccurent laryngela nerve
| supraglottic - internal branch of the superior laryngeal nerve
70
what is the arterial supply to the supraglottic larynx ?
superior laryngeal artery
71
what is the arterial supply to the infraglottic larynx?
inferior laryngeal artery
72
what supplies the structures of the larynx?
inferior thyroid artery
73
what supplies the thyroid gland ?
superior thyroid artery
74
where does the thyroid gland sit?
below the cricoid cartilage, must avoid cutting it in surgeries
75
where does the trachea start and end?
C6 --> T4/5 cadaver and T7 living upright
76
why does the trachea contain cartilagenous rings?
to ensure it is open to ensure air flow
77
respiratory epithelium is the same as?
the larynx (except vocal fold), laryngopharynx, nasal sinuses.
78
explain the mucocilliary escalator?
- mucus goes down to the lungs via gravity
- all the cilia beat in the same direction and are coordinated, which causes movement of the mucus to go up away from the air going down.
- protection mechanism
79
what causes the mucocilliary escalator to stop working?
- cystic fibrosis: mucus is thick and vicid
| - kartagener syndrome: cilia are immotile and so mucus drips down to the lungs
80
what is carina?
it is the ridge that seperates the left and right main brronchi and it has lots of nerves under it is sensitive to stimuli. This will make you cough in case food gets stuck here.
81
What bronchi is steeper and what does this cause?
the right is steeper and this makes it easier for food to go down/
82
order of the bronchi?
1.) right main bronchii
2.) right upper lobar
3.) right middle lobar
4.) right tlower lobar
middle and lower has intermediate lobar before it
83
surface anatomy of oblique fissure?
anterior - rib 6 to sternum
| posterior - upper border of rib 5 to medial border of teh scapula
84
what are the borders of the triangle of auscultaion ? bony borders
1. ) lower 1/3 medial border scapula
2. ) inferior tip of the 9th transverse process of the 9th Thoracic vertebrrae
3. ) medial border of the 8th transverse process of the thoracic vertebrae
85
what are the borders of the trinagle of auscualtion? muscular borders
1. ) lateral border of the trapezius muscle
2. )medial border of the scapula
3. ) upper border of the lattisimus dorsi.
86
the phrenic nerve is .... to the lung root?
anterior
87
the vagus nerve is .... to the lung root?
posterior
88
what are the borders of the thorax?
posterior - vertebral column
anterior - sternum
lateral - 12 thoracic ribs
89
what are the borders of the thoracic inlet?
anterior - manubrium of the sternum
posterior - vertebrae T1
medial border - 1st rib
90
what are the openings of the thorax
superior aperture and the inferior aperture
91
what does the pulmonary ligament allow for?
expansion at the root of the lung
92
the costomediastinal recess is more significant on which side?
on the left side
93
where does the costodiaphragmatic recess extend to ?
to the 12th rib and and fluid mostly drains here
94
diffrence between the parietal and pleural epithelium?
parietal more squamous and visceral more cuboidal.
95
airway branching and their generations?
1.) mainstem
2.) lobar
3.) segmental
First 4 generations
Generations 5-11 small bronchi
generations 12-14 bronchioles (no cartilage in the walls and the last generation is called terminal bronchioles)
Generations 19-22 alveolar ducts
Generation 23 - alveolar sac
96
where do the bronchial arteries come from?
- the left superior and inferior from the aorta
| - right from the left superior bronchial
97
why does the right dome of the diaphragm sit higher than the left dome?
because it sits on the liver
98
kinds of hernia that occur at the diaphragm?
- central hernia - incomplete development of esophageal hiatus
- diaphragmatic eventration - can be asymptomatic, failure of muscle wall to migrate into teh diaphragm
- morgagni hernia
- Bochdalek hernia - abs content herniate through and lie in the thorax which can impair the development of lungs (mainly left lung)
99
What supplies the diaphragm on the thoracic surface and where do they come from?
superior phrenic - from aorta
musculophrenic - from the intenral thoracic artery
pericardiophrenic - internal thoracic artery
100
What supplies the diaphragm on the abdominal surface and where do they come from?
inferior phrenic artery - from the aorta
| lower intercostal arteries
101
What is the function of the external intercostal?
elevates the ribs during inspiration
102
What is the function of the internal intercostal?
depresses the rribs in expiration
103
What is the function of the innermost intercostal?
acts with the internal
104
where does the intercostal neurovascular bundle run?
In the costal groove which is under the rib, Intercostal vein, artery and nerve
VAN
105
Where does the collateral branch run?
In the upper surface of the rib below, NAV
106
function of the diaphragm?
contraction, results in flattening which increases thoracic volume and decreases thoracic pressure.
107
how do the ribs move?
pump handle - ribs 1-6
| bucket handle - ribs 7-12
108
Non invasive ventilation assistance kinds and how they work?
- non invasive postive pressure
- negative pressure ventilation
- heliox adjenct therapy
Changing pressure gradient during breathing and so gas is supplied at higher pressure than normal atmospheric during inspiration
109
What is endotracheal tube?
invasive - tube foes past vocal folds and into trachea, cuff inflates to attach which allows breathing
110
What is laryngeal mask airway?
thorugh mouth to larynx and fkuids can be drained
111
What is cricotomy?
emergency:
| establish an airway by cutting through the cricothyroid membrane and put the tube through it
112
What is tracheostomy?
- full surgical facilities
- longitudinal incision across neck
- skin and muscles moves
- thyrroid divided
- trachea exposed (4-5 rings)
- trachea opened for connection to external ventilator
113
what is pneumothorax?
air accumulates in the pleural space
114
What does pneumothorax require?
needle thoracostomy at the 2nd intercostal space, mid clavicular line. Only in emergency a thoracostomy is preferred.
115
Where does the needle thoracostomy occur?
```
in the safe triangle:
anterior - lattisumus dorsi
lateral - pec major
apex - below axilla
inferior - line of the 5th intercostal space or the liner superior to teh horizontal level of the nipple
```
116
What is thoracocentesis and when is it used?
needle to remove fluid or air from the pleural cavity
do it 1-2 intercostal spaces below the upper level of the pleural fluid in midscapular line or 5-10 cm lateral to the spine.
