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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
Created by: katdelaphee



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