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Thorax
| Question | Answer |
|---|---|
| This marks the junction between the manubrium and the body of the sternum vertebral level t4 | sternal angle of louis |
| Muscle that plays a role in inspiration during exercise or lung disease | external intercostal muscles sternocleidomastoid pec maj m i n scalene muscles |
| muscle that plays a role in expiration during exercise or lung disease | internal intercostal muscles External internal oblique transverse abdominal rectus abdominis |
| what happens during inspiration the pump handle and bucket handle | pump handle ribs 1-6 bucket handle elevation of the lower ribs |
| A branch of the subclavian artery that the cents lateral to the sternum and terminates at intercostal space 6 | internal thoracic artery then divides to superior epigastric and musculophrenic artery |
| The anterior intercostal arteries are branches of the internal thoracic artery they supply what intercostal space | 1 to 6 |
| Anterior intercostals from musculophrenic artery supply | Space 7-9 |
| Posterior intercostals from superior intercostals from the costocervical trink of the subclavian supplies | Intercostal 1-2 |
| Posterior intercostals fro thoracic aorta supplies | 3-11 |
| Anterior intercostals drain into Posterior intercostals drain into | Internal thoracic then brachiocephalic Hemiazygos on the left, azygos on the right then to SVC |
| Nerves that run in the coastal groove | Intercostal nerves T1-T11 |
| Arterial supply of the breast | Medial mammary branches- internal thoracic artery Lateral mammary branches - lateral thoracic Pectoral branches - thoracoacromial artery Perforating branches of the intercostals |
| Venous drainage | Lateral mammary vein and lateral thoracic vein -> axillary vein Medial mammary vein - internal thoracic vein - intercostal vein - azygos vein- SVC |
| Innervation of the breast | Anterior and lateral cutaneous branch of intercostal nerves 4-6 |
| 2 lymph drainage of the breast | Circumareolar Perilobular Interlobular |
| All 3 lymph drainage drain where | Feel subareolar plexus |
| Lymph drainage from the lateral quadrant | Axillary nodes -> infraclavicular and supracavicular nodes-> right subclavian lymph trunk (right breast) or left subclavian ( left breast) |
| Lymph drainage from the medial quadrant | Parasternal nodes -> right bronchomediastinal lymph trunk (right breast) then left (for left breast) |
| Inferior quadrant drainage | Drains into nodes of the upper abdomen |
| CVC insertion thru IJV, central approach | Needle inserted at the apex of the triangle formed by 2 heads of SCM and clavicle at the right side |
| CVC insertion thru subclavian vein, infraclavicular approach | Index finger at sternal notch and thumb at intersection of clavicle and first rib |
| A congenital malformation assoc with inc. BP on upper extremities, diminished and delayed femoral pulse | Postductal coarctation of aorta |
| Result from deceleration in injury where aorta tears distal to left subclavian artery. | Aortic dissection |
| Compression of lower trunk of brachial plexus, subclavian artery | TOS |
| Projection of right dome of diaphragm | Upper border of rib 5 in midclavicular line |
| Projection of central tendon of diaphragm | Posterior to xiphisternal joint |
| In tube thoracostomy the following structures will be penetrated | skin superficial fascia serratus anterior external intercostal internal intercostal innermost intercostal parietal pleura |
| In thoracentesis the needle will penetrate the following | Skin superficial fascia external intercostal muscle internal intercostal innermost intercostal parietal pleura |
| In intercostal nerve block a needle is inserted at the posterior angle of the rib along the lower border of the rib the needle will penetrate the following structures | skin superficial fascia serratus anterior muscle external intercostal internal intercostal |
| The mediastinum is divided into superior and inferior divisions by what | A line from the sternal angle of louis T4 - T5 intervertebral disc |
| Common pathologies found in the superior mediastinum | Aortic arc aneurysm esophageal perforation traumatic rupture of the trachea |
| Anterior mediastinum pathology | Thymoma lymphoma |
| middle mediastinum pathology | Pericardial cyst bronchogenic cyst sarcoidosis |
| Posterior mediastinum pathology | ganglioneuroma neuroblastoma esophageal diverticula or neoplasm |
| The parietal pleura is innervated by what nerve | Phrenic nerve c3 c4 and c5 and intercostal nerves |
| The trachea begins and ends in what vertebral level | C6 to t4 |
| What is the landmark where the trachea bifurcates to the right and left main bronchus | T4 vertebral level or sternal angle |
| Distortions in the position of the carini may be due to | Metastases of bronchogenic carcinoma or enlargement of the left atrium |
| Aspiration of foreign object when a person is sitting or standing most commonly enters and lodges | Into the right lower lobe are bronchus and lodges the posterior basal bps of the right lower lobe 10 |
| When a person is define enters and lodges where | right lower lobar bronchus the superior BPSnumber 6 |
| When a person is lying on the right side enters and lodges where | Right upper lobe are broncos posterior bronchopulmonary segment number 2 |
| When a person is lying on the left side enters and lodges where | Left upper lobe are bronchus and inferior lingular bronchopulmonary segments number five |
| A bronchopulmonary segment contains | segmental bronchus branch of the pulmonary artery branch of the bronchial artery |
| What are the two arterial systems of the lungs | The pulmonary system of arteries and the bronchial system of arteries |
| This structure is anterior to the ascending aorta and travels in a superior posterior direction to the left side for about 5 cm and then bifurcate | Pulmonary trunk which carries deoxygenated blood to the lungs for aeration |
| The structure runs horizontally towards the hilus beneath the ark of the aorta posterior to the ascending aorta and superior vena cava | Right pulmonary artery which is also anterior to the right main bronchus |
| The structure is shorter and narrower than its counterpart and is connected to the arc of the aorta by the ligamentum arteriosum | left pulmonary artery |
| These structures carry oxygenated blood to the parenchyma of the lungs | the bronchial arteries |
| The right bronchial artery is a branch of what | Posterior intercostal artery |
| The two left bronchial arteries are branches of what | the thoracic aorta |
| Dad of long is supplied by to venice system the pulmonary and the bronchial which carry the oxygenated blood from the pulmonary capillary plexus and deoxygenated blood the left atrium | pulmonary veins |
| What is the innervation of the lungs | Anterior pulmonary plexus and posterior pulmonary plexus which contain parasympathetic (vagus)and sympathetic component |
| The parasympathetic preganglionic neuron are located where | Dorsal nucleus of the vagus in nucleus ambiguous of the medalla |
| Postganglionic parasympathetic axons terminate where | To the smooth muscles of the bronchial tree causing bronchoconstriction in syria mucous glands causing increased secretion |
| Sensory parasympathetic cells transmit what sensation in the lungs | touch and stretch |
| Preganglionic sympathetic motor neuronal cell bodies are located where in the lungs | Intermedia lateral cell column of the spinal cord |
| Pain sensation for the sympathetic neuronal cell bodies located in the dorsal root ganglia c7 to c8 and t1 to t4 transmits what | Pain |
| Defined as an incomplete expansion of alveoli in neonates or collapse of alveoli in adults | Atelectasis |
| Hemorrhagic edema within the long at the lectus is 80 sinophil material consisting of proteinaceous fluid and necrotic cells | Neonatal respiratory distress syndrome or hyaline membrane disease |
| It's a secondary surfactant deficiency due to other primary pathologies that damage either alveolar cells or capillary endothelial cells in the lungs | Adult respiratory distress syndrome or diffuse areolar damage |
| Characterized by an increase in airway resistance particularly expiratory airflow | obstructive lung disease |
| Long is hyperlucent and x-ray diaphragm is flat and depressed what type of disease | Obstructive lung disease like emphysema |
| Disease characterized by a decrease in compliance like the the sensibility of the long is restricted the lungs are said to be stiff | restrictive lung disease |
| Radiograph shows reticular pattern of lung opacity due to an abnormal lung interstitium that are interspersed between clear areas or honeycomb lunh h there's a raised diaphragm and a small contracted lung | Restrictive lung disease like pulmonary fibrosis pneumoconiosis and silicosis |
| cystic fibrosis is a mutation in what gene and on what chromosome | Cf transmembrane conductance regulator gene cftr on chromosome 7q 31.2 which functions as a chloride ion channel protein |
| In north america 70% of cystic fibrosis cases are due to a three base deletion that codes for what a mino acid | Phenylalanine at position number 508 |
| P a radiograph shows hyperinflation of both lungs reduce size of the heart due to pulmonary compression cyst formation and atelectasis in both lungs | cystic fibrosis |
| What is the normal amount of pericardial fluid in the pericardial cavity | 20 ml |
| This is a recess of the pericardial cavity located posterior to the aorta and pulmonary trunk and anterior to the superior vena cava | Transverse sinus where a surgeon can pass a finger or ligature from one side of the heart to the other |
| This is a recess of the pericardial cavity that ends in a culde sack surrounded by the pulmonary vein | oblique sinus |
| Layer of the pericardium which is take collagen layer with limited ability to distend acutely | Fibrous pericardium |
| Where does the fibrous pericardium fuse | Superiorly to the tunica adventitia of the great vessels inferiorly to the central tendon of the diaphragm and anteriorly to the sternum |
| What structures descend through the mediastinum lateral to the fibrous pericardium that are in jeopardy during surgery of the heart | Phrenic nerve and pericardium phrenic artery |
| Pericardiocentesis to the sternal approach a needle is inserted in the ic five and six on the left near the sternum the needle then penetrates the following structures | |
| Skin superficial fascia pectoralis major external external intercostal internal intercostal Transverse thoracic muscle fibrous pericardium parietal layer serous pericardium | |
| Or pericardiocentesis in the subsite void approach a needle is inserted at the left infernal angle and gold in a superior and posterior position the needle then penetrates the following | The skin superficial fascia anterior rectus sheath rectus abdominis transverse abdominis fibrous pericardium and the parietal layer of serous pericardium |
| Heart surface the posterior or the base consists mainly off | The related to t6 n t9 |
| the apex | Inferior lateral portion of the left ventricle at intercostal space five along the midclavicular line apex beat |
| Interior surface or the stern a coastal surface | right ventricle |
| Inferior surface or at the diagnostic surface | Left ventricle |
| The pulmonary service or the left surface consists mainly off | Left ventricle |
| The right surface consists mainly off | Right atrium |
| Borders of the heart | The right border ra svc ivc Left border lv la pt aortic arch inferior border right ventricle superior border r a l a svc ascending aorta and pt |
| Provides attachment of valve leaflets and cost and serves as the origin and insertion sites of cardiac myocytes forms and electrical barrier between the atria and ventricles | Fibrous skeleton of the heart |
| The bicuspid valve which is the mitral valve located left atrioventricular where is the auscultation site | cardiac apex left intercostal space 5 |
| The tricuspid valve or the right atrioventricular valve auscultation is where | Over the sternum at intercostal space for four |
| The pulmonary semilunar valve is the outlaw valve of the right ventricle the orifice is directed towards the left shoulder where is the auscultation site | Over the left upper sternal border at the left intercostal space 2 |
| The aortic semilunar valve is the outflow valve of the left ventricle the auscultation site is | Over the right upper sternal border at right intercostal space to two to |
| The first heart sound or thelub sound is caused by the closure of what valve | tricuspid and bicuspid |
| The second heart sound or the dub sound is caused by the closure of what | Pulmonary and aortic valves |
| The coronary arteries feel the heart with arterial blood during what phase | Diastole |
| The coronary sinus is the largest vein draining the heart into the right atrium there is a crescent-shaped valve remnant present which is called | Thebesian valve |
| The great cardiac vein follows what artery | Anterior iv artery |
| the middle cardiac vein follows what are today | Posterior iv artery |
| small cardiac vein | Right marginal artery |
| This is the pacemaker of the heart located at the junction of the svc and the right atrium just beneath the epicardium | sinoatrial node |
| The sinoatrial node fred's impulse to the left atrium via what | Bachmann bundle |
| This structures located on the right side of the av portion of the atrial septum near the ostium of the coronary sinus in the sub endocardial space | Av node which corresponds to the triangle of cough as an important landmark because it contains the av node |
| This travels in the sub endocardial space on the right side of the iv septum and divided into the right and left bundle branch | bundle of his |
| true or false the left bundle branch is thicker than the right | True true |
| The heart is innervated by the superficial cardiac plexus and the deep cardiac plexus where are they located | Inferior to the aorctic arch and anterior to the right pulmonary artery posterior to the aroctic arch and anterior to the tracheal bifurcation respectively |
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katdelaphee
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