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Anatomy Exam 2 > Thorax > Flashcards

Thorax Flashcards

1
Q

what is the anterior median line (midsternal)

A

vertical line through sternum in mid saggital plan

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2
Q

what is a midclavicular line

A

vertical line through midpoints of the clavicles, parallel to medial line apex of the heart

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3
Q

what is anterior axillary line

A

vertical line along anterior axillary fold formed by pec major

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4
Q

what is mid axillary line

A

vertical line through the apex of the axilla

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5
Q

posterior axillary line

A

vertical line through posterior axillary fold which is formed by the latissimus dorsi and teres major

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6
Q

what is posterior median line

A

vertical line through spinous process of vertebrae in mid saggital plane

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7
Q

what are scapular lines

A

vertical lines that pass through inferior angles of the scapula considered dynamic because the scapula move

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8
Q

what makes up the thoracic wall

A

ribs, thoracic vertebrae and sternum

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9
Q

what is the function of the thoracic wall

A

to protect throracic content heart, lung, blood vessels and esophagus

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10
Q

Ribs 1-7 are known as what and why

A

true ribs because they attach directly to the sternum

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11
Q

Rib 8-10 are known as what and why

A

False ribs they attach indirectly to the sternum

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12
Q

ribs 11-12 are known as what and why

A

floating ribs the do not attach to the sternum at all

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13
Q

which ribs are typical

A

3-9

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14
Q

which ribs are atypical

A

1,2 10-12

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15
Q

what do the head of the ribs articulate with

A

the two vertebra

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16
Q

what does the tubercle articulate with

A

with the transverse process

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17
Q

where is the most common place for a rib fracture

A

costal angle

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18
Q

the thoracic vertebrae have costal facets and vertebral bodies on every side except

A

lower 3 thoracic vertebrae

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19
Q

costal facets and transverse process are on every thoracic vertebrae except

A

lower 2-3 thoracic vertebrae

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20
Q

what are the three components of the sternum

A

the manubrium, body and xyphoid process

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21
Q

The manubrium articulates with what

A

clavicle and 1st rib

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22
Q

what does the body of the sternum articulate with

A

the manubrium

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23
Q

why is the sternal angle helpful clinically

A

where the bifurcation of the trachea,
beginning and ending of aortic arch
helps locate 2nd rib

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24
Q

what are the major articulations of the thoracic wall

A

costovertebral joints, costochondral joints, sternocostal, and sternoclavicular

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25
Q

in men the nipple lies where in relation to the rib cage

A

lie at approximately 4th intercostal space between ribs 4&5

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26
Q

where do womens breast fall on the ribs

A

between 2-6

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27
Q

how does lymph drainage occur in the breasts

A

aprox 75% of breast drains into lateral axillary lymphnodes

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28
Q

what is contained in the superior thoracic aperture

A

esophagus, trachea, nerves and blood vessels that supply head and neck

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29
Q

what is the function of the inferior aperture

A

allows esophagus, IVC and aorta to pass inferior

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30
Q

the external intercostals help with what

A

inspiration

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31
Q

what do the internal intercostals do

A

help expiration

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32
Q

What does the Transverse thoracis do and where is it located?

A

expiration (depresses ribs, located along internal ribs, located on the internal anterior thoracic cage

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33
Q

what does the subcoatal muscle do where is it located

A

inspirtation (elevate ribs), located on the internal portion of the ribs, located on the internal posterior thoracic cage

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34
Q

what does the levator costarum do and where is it located

A

inspiration (elevates ribs) attach to the ribs and transverse process (TP) C7-T11, located on external posterior thoracic cage

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35
Q

What is the purpose of serratus posterior superior

A

inspiration (elevates ribs)

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36
Q

What is the purpose of serratus posterior inferior

A

expiration depresses the rips

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37
Q

What nerve innervates the diaphragm

A

innervated by phrenic nerve at the C3-5 level

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38
Q

What is the function of the phrenic nerve

A

provides motor and sensory component of diaphragm

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39
Q

What is the function of the diaphragm

A

major muscle in inspiration

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40
Q

what are the 3 layers of the intercostal spaces

A

external , internal and innermost

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41
Q

What is the neurovascular bundle

A

VAN vein, artery, nerve

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42
Q

Herpes Zoster is very common in what region of the body

A

thoracic region

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43
Q

What muscles are used for inspiration at rest

A

diaphragm

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44
Q

What muscles are used for inspiration during exercise

A

diaphragm and external intercostals

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45
Q

What muscles are being used for inspiration during extreme exercise

A

diaphragm, external intercostals, accessory muscles (SCM&Scalene) pecs can also assist

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46
Q

What type of breathing pattern might you see with a patient who has COPD

A

they will use their diaphragm, external intercostals, accessory muscles,(SCM&Scalene) pecs

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47
Q

What muscles are used at rest for expiration

A

elastic recoil

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48
Q

what muscles are used for expiration during exercise

A

recruit the internal intercostals, abdominal muscles (rectus abdominis, int/ext oblique

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49
Q

What are the two major sources of blood supply to the thorax

A

descending aorta and subclavian arteries

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50
Q

What does the descending aorta supply blood to

A

provides blood to segmental branches known as the posterior intercostal arteries

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51
Q

Where are the posterior intercostal arteries located in the body

A

they travel anteriorly between ribs along with intercostal vein and intercostal nerve

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52
Q

What does the subclavian artery supply blood to

A

provides blood to the R/L internal thoracic arteries

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53
Q

Where are the internal thoracic arteries

A

descend along anterior wall of internal rib cage

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54
Q

Where do the intercostal arteries originate from where do to they go

A

originate from descending internal thoracic artery and they travel between ribs and anastomose with posterior intercostal arteries

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55
Q

What are the 3 main sources of venous return

A

Azygos, Hemiazygos, and accessory hemiazygos

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56
Q

Where is the Azygos Vein located

A

located right posterior internal rib cage, drain into SVC

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57
Q

Where is the Hemiazygos and accessory zygos vein located

A

on the left posterior internal rib cage

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58
Q

what is the function of the hemiazygos vein

A

drain segmental portion of the thorax

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59
Q

what are the 3 compartments of the the thoracic cavity

A

2 pulmonary cavities and mediastinum

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60
Q

what is contained in the pulmonary cavities

A

lungs and pleura

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61
Q

what is contained in the mediastinum

A

heart, great vessels, trachea, esophagus, thymus, and lymph nodes

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62
Q

What is the visceral pleura (pulmonary pleura)

A

invests the lungs

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63
Q

what is the parietal pleura

A

lines the thoracic wall and diaphragm

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64
Q

What is the parietal cavity

A

potential space between the two pleural layers, lubricated by serous pleural fluid which allows the two layers to glide

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65
Q

What is the costodiphragmatic recess

A

pleural recesses than can accumulate fluid with various conditions

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66
Q

How would fluid be removed from the costodiaphragmatic recess

A

thoracocentesis

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67
Q

What is the costomediastinal recess

A

smaller pleural recesses located posterior to the sternum

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68
Q

What is pneumothorax

A

air enters the pleural cavity, partial or complete lung collapse

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69
Q

What is pleural effusion

A

abnormal accumulation of fluid from pathology within the pleural cavity, potential compression of lung

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70
Q

What is hemothorax

A

blood accumulated in the pleural cavity, potential compression of the lung

71
Q

What is pleuritis

A

inflammation of the pulmonary pleura, lung sounds of friction rub

72
Q

what is ventilation

A

mechanics of breathing air being moved into and out of the lungs

73
Q

What happens to the thorax during inspiration

A

there is an increase in volume of the thorax which creates negative pressure in the lungs/ pleural cavity causes air to be sucked in

74
Q

What are static lung volume

A

TLC, TV, IRV etc

75
Q

What are dynamic lung measures

A

FEV and minute ventilation

76
Q

what is FEV1

A

amount of air expired in the 1st second of expiration

77
Q

what is minute ventilation

A

amount of air expired in one minute

78
Q

what is respiration

A

gas exchange that occurs in the lung at the alevolar/capillaries and throughout the body

79
Q

what is a pulse oximeter

A

measures arterial saturation of oxygen

Ideal is between 96-100%

80
Q

what is the hilum

A

site where the lung becomes covered by visceral pleura

81
Q

what is contained in the hilum or root

A

contains primary bronchus, 2 pulmonary veins, 1 pulmonary artery, bronchial vessels, pulmonary nerve plexus, lymph vessels

82
Q

How many lobes are on the right lung

A

3 lobes

83
Q

what are the division of the right lung

A

superior, middle and inferior lobe

84
Q

how many bronchopulmonary segments does the right lung divide into

A

10 segments ( 2 superior lobe, 3 middle lobe, 5 inferior lobe)

85
Q

How many lobes are in the left lung and what are they divided by

A

there are 2 lobes divided by an oblique fissure

86
Q

What are the divisions of the lobes

A

superior, and inferior lobes

87
Q

What is the lingula

A

similar to the middle lobe of the right lung

88
Q

how many bronchopulmonary segments are there in the left lung

A

10 segments ( 5superior lobe, and 5 inferior lobe)

89
Q

Where is the bifurcation of the trachea at

A

sternal angle

90
Q

The bifurcation of the trachea is know as what

A

the carina

91
Q

What is the name of the bronchi that enter the hilum

A

Primary bronchi

92
Q

What is the name of the division of the division after the primary bronchi

A

secondary bronchi

93
Q

How many bronchopulmonary segments are supplied by the segmental bronchi

A

10

94
Q

How many generations are there in bronchial tree

A

20-25 generations

95
Q

What is a pulmonary embolism

A

is the obstruction of a pulmonary arterial blood flow

96
Q

Where may a pulmonary embolism travel from to get to the lungs

A

may travel from the peripheral back to the right side of the heart where it gets pumped through the pulmonary trunk to the pulmonary artery and gradually into smaller diameter vessels

97
Q

What is the mediastinum

A

region between the pleural cavities

98
Q

What is the region made up by the superior mediastinum

A

superior thoracic aperture

99
Q

What is the region made up by the inferior mediastinum

A

diaphragm

100
Q

What is the region made up by the anterior mediastinum

A

sternum and costal cartilages

101
Q

What is the region made up by the posterior mediastinum

A

Thoracic vertebrae

102
Q

A horizontal line is drawn through what anatomical structure to create the superior and inferior mediastinum and what level of the vertebra is this line at.

A

the line is drawn through the sternal angle to the T4-T5 disc space that makes up the border of the superior and inferior mediastunum

103
Q

what are the contents of the anterior mediastinum

A

internal thoracic vessels, fat, few lymph nodes

104
Q

what are the contents of the middle mediastinum

A

pericardium, heart, roots of great vessels

105
Q

what are the contents of the posterior mediastinum

A

esophagus, descending aorta, thoracic duct, lymph nodes

106
Q

What mediastinum is the heart located in

A

middle mediastinum

107
Q

What is the pericardium

A

it is a double walled enclosure or a fiberoserous sac that houses the heart

108
Q

What is the name of the outside sac of the heart

A

fibrous pericardium

109
Q

The fibrous pericardium attaches to what anatomical structures

A

the the diaphragm by the pericardiacophrenic ligament, the sternum by the sternopericardial ligament

110
Q

What is the name of the inside sac of the heart

A

serous pericardium

111
Q

what is the pericardial cavity and what purpose does it serve

A

potential space between parietal and visceral layers, that contains a fluid which allows the heart to move freely within the pericardial sac

112
Q

What is the epicardium

A

visceral serous pericardium

113
Q

what is the myocardium

A

cardiac muscle

114
Q

what is the endocardium

A

thin, smooth endothelial layer that lines the heart valves

115
Q

The fibrous skeleton of the heart covers what

A

four fibrous rings surround the orificies of the heart valves

116
Q

What is the function of the fibrous skeleton

A

provides attachment for myocardium of atria and ventricles
provides attachment for cardiac valves
provide electrical insulation between atria and ventricles

117
Q

The apex of the heart is formed by what

A

the tip of the left ventricle

118
Q

the apex of the heart is located at what rib level

A

between the 5th and 6th just medial to midclavicular line

119
Q

the base of the heart is formed by what

A

the left atrium and a little of the right atrium

120
Q

The right border of the heart is made up of what

A

right atrium, extending between SVC and IVC

121
Q

The left border of the heart is made up of what

A

primarily left ventricle and some left atrium

122
Q

The inferior border is made up of

A

primarily right ventricle and some left ventricle

123
Q

the superior border is made up of what

A

junction where great vessels enter and leave the heart

124
Q

The sternocostal (anterior) surface is made up of what part of the heart

A

mostly right ventricle

125
Q

The right ventricle can be examined along what border? What intercostal space is this

A

left sternal border, 3-5th intercostal space

126
Q

the diaphragmatic surface is made up of what

A

mostly the left ventricle and partially the right

127
Q

the pulmonary surface is made up of

A

mostly left ventricle

128
Q

What are the anatomical contents of the right atrium

A

SVC/IVC openings
Opening of the coronary sinus
Fossa ovalis
Tricuspid valve

129
Q

What are the anatomical contents of the right ventricle

A

Tricuspid valve
papillary muscle/chordae tendineae
pulmonary valve

130
Q

What are the anatomical contents of the Left atrium

A

foramen ovale

4 openings of pulmonary veins

131
Q

What are the anatomical contents of the left ventricle

A

bicuspid valve
papillary muscle/chordae tendineae
aortic valve

132
Q

What is the function of the Superior Vena Cava SVC

A

returns blood back to the right atrium from areas superior to the diaphragm except from heart and lungs

133
Q

What is the function of the inferior vena cava

A

return blood back to the right atrium from areas inferior to the diaphragm

134
Q

What is the function of the pulmonary trunk

A

send un-oxygenated blood from the right ventricle to the lungs

135
Q

what is the function of the right/left pulmonary veins

A

returns oxygentated blood back to the left atrium from the lungs

136
Q

What is the function of the aorta

A

sends blood supply to body from left ventricle.

137
Q

The branches of the aorta include

A

brachiocephalic trunk which gives rise to the right CCA and the right subclavian
Left CCA
Left subclavian artery

138
Q

Where is the tricuspid valve located

A

between the right atrium and ventricle

139
Q

Where do you auscultate to hear the tricuspid

A

along the left sternal border at 5th or 4th intercostal space

140
Q

where is the pulmonary valve located

A

located between the right ventricle and pulmonary trunk

141
Q

where do you auscultate for the pulmonary valve

A

along the left 2nd intercostal space

142
Q

where is the bicuspid valve located

A

between the left atrium and ventricle

143
Q

where do you auscultate for the bicuspid valve

A

left 5th intercostal space just medial to midclavicular line

144
Q

where is the aortic valve located

A

between the left ventricle and the aorta

145
Q

where do you auscultate for the aortic valve

A

along right 2nd intercostal space

146
Q

what happens during atrial filling

A

AV valve opens, semilunar valve closed

blood flows into the atria and the ventricles

147
Q

what happens during atrial systole “kick”

A

AV valve still open: semilunar valve closed
ventricular pressure exceeds atria
atria contract forcing additional blood into ventricles

148
Q

What causes the first heart sounds

A

when AV valves snap shut semilunar valve is still closed

149
Q

In what order do the mitral and tricuspid close

A

left mitral (AV) valve closes then tricuspid

150
Q

What is splitting in the heart

A

is when you can auscultate the left AV (mitral) valve snapping shut before the right (AV) valve

151
Q

True or False

The pressure in the ventricles is not enough to open the bicuspid valve

A

False

ventricle pressure is not enough to open the semilunar valves

152
Q

What causes ventricular ejection

A

AV valves remain closed: semilunar valves open and increased ventricular pressure force open the semilunar valve

153
Q

What is isovolumetric relaxation

A

AV valves remain closed: semilunar valves snap shut (2nd heart sound)

154
Q

During Isovolumetric relaxation what is the order in which aortic and pulmonary valve close

A

the left semilunar valve snaps shut first then the right pulmonary valve

155
Q

What allows blood flow into the coronary arteries

A

back pressure from the aorta

156
Q

Where do the coronary arteries branch from

A

arise from the base of the aorta

157
Q

What does the right coronary supply

A

supplies right atrium and ventricle

158
Q

What do the nodal branches supple

A

SA and AV nodes

159
Q

The marginal branch of the RCA supplies what

A

supplies right ventricle

160
Q

What are the two divisions of the Left coronary artery

A

anterior intervenricular and circumflex artery

161
Q

What does the anterior interventricular artery supply

A

R/L ventricles and majority on interventricular septum

162
Q

what does the circumflex artery supply

A

supplies left atrium and ventricle

163
Q

what does the left marginal branch supply

A

left ventricle

164
Q

What is the purpose of the coronary sinus

A

most cardiac veins drain here

165
Q

where does the coronary drain

A

into right atrium

166
Q

Which veins empty directly into the coronary sinus

A

great, middle, small cardiac vein and oblique vein and left atrium

167
Q

Which veins drain directly into the right atrium

A

anterior cardiac and smallest cardiac vein

168
Q

what is the pathway of conduction of the heart

A

SA node - AV node - AV bundle - L/R bundle branch- purkinje fibers

169
Q

Sympathetic innervation of the heart is done by

A

cervical and thoracic sympathetic trunks

170
Q

what does the sympathetic nerves innervate

A

atria and ventricles

171
Q

what is the function of the sympathetic part of the heart

A

increase HR and contractility

172
Q

what innervates the parasympathetic part of the heart

A

CN 10 ( vagus)

173
Q

what is the function of the parasympathetic

A

decrease HR, contractility

Anatomy Exam 2 (2 decks)

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