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8-10 attach at 7th cost cart |
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typical ribs what how typical
aypical means what |
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Definition
3-9 or 2-10 - may vary two costal attachments at vertebra 1 at transverse process
attach at 1 vertebral costal facet |
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5th rib attaches to which verts superior costal articulating facet? |
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Definition
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pect major has two innervations
pect minor one |
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Definition
lateral/medial pectoral
medial pectoral |
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clavipectoral fascia
medial/sup to CP fascia neurovas bundle of thoracoacromial a/v and lateral pectoral pierce |
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breast located in what fascia |
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Definition
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mammallary crease. where
nipple, males ? |
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Definition
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suspense ligs of cooper attach to what, but not what |
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Definition
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retromam space, bet what? |
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Definition
deep fascia of pect major and breast |
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cause of dimples vs retraction
small dimples? |
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Definition
dimples: invasion of suspens ligs
nipple retraction: of lact ducts
lymphedema |
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Term
how breast ca spread to brain/verts? |
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Definition
ax nodes - posterior intercostal veins - azygos/hemi or - vert. venous plexuses surrounding spinal cord system to verts or brain
azy runs along spine |
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how know if cancer in pect major fram breast? |
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Definition
when pect contracts, boob elevates |
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ax and parasternal nodes drain to what nodes |
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Definition
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what intercostal muscle can you see from costal cart to sternum? |
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Definition
inner intercostal.
external laterally to costal cart then stop |
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external intecost, direction |
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Definition
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which in from axillar v/a? |
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transverus thoracis given rise by what muscle do what |
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Definition
innermost intercost hold down internal thoracic |
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intercostal n between which intercost muscles? |
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Definition
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limits of thoracic cavity mediastinum |
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Definition
diaphragm to ribs
lungs/diaphram |
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Term
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Definition
afferent visceral, afferent motor converge at same levels of spinal cord |
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problems with mediastinum, or any pushing on diaphram results in pain where?
ex. pain in mediastinum/diaphragm ex. pain in stomach/pancreas/spleen/liver/Q |
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Definition
shoulder, neck (PHRENIC)
between shoulder blades (SPLANCHNIC, T5,6)
phrenic nerve motor/sensory to diaphragm but also SENSORY TO MEDIASTINAL PLEURA
if blow up cavity with air for study, shoulders will hurt after |
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parietal pleuras pain, nerve
visceral pleura pain nerves |
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Definition
localized, sensitive (can be referred) somatic
poorly localized, insensitive autonomic
disease wont really hurt until invades parietal layer |
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Definition
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cardiac notch at what rib space |
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Definition
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if at 1st rib what is the space below called? |
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Definition
1st space!
spaces take name of rib ABOVE |
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mid clavicular lungs pleura |
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Definition
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Definition
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scapular (inf angle( lung pleura |
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why only one fissure on left |
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Definition
no room for 3 lobes, heart there |
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pulmonary ligament function what is it |
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Definition
connection between visceral/parietal pleura
at hilum, visceral pleura of lung becomes parietal (think of fist in baloon... has to become parietal at some point |
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leading cause of maternal death |
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bronchus branches a what topographical struct |
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Definition
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bronchus intermedius what side where how diff from left main bronchus |
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Definition
right side. right below right upper lobe bronchus wider and more vertical then left main bronch
[image] |
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Term
if something aspirated, where likely to get stuck |
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Definition
right main bronchus. wider and more vertically in line with trachea |
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bronchial arteries/veins function |
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Definition
feed, drain visceral pleura/tissue of lungs. do not function in gas exchange |
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bronchial branching
right side has how many lobes? left?
about how many segments on each side? |
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Definition
main (prim) -> lobes (secondary) -> segments (tertiary)
Right: 3 Left: 2 (not enough room for 3!)
about 10 on each side |
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Term
bronchus bronchiole avioli
compostion? when does cartilage stop? |
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Definition
bronchus - cart bronchiole - smooth m, elastic fiber avioli - elastic fiber
cart stops at about 1mm diameter |
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Definition
vasodilates systemic vessles (decrease heart rate, BP, stroke v) increase mucous, less exchange constricts bronchiole lumen, slower oxygenation constricts coronoary arts |
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Definition
constrict systemic vessels decrease mucous dilate bronchioles dilate cornary art (increase BF to <3) |
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diaphragm flattens upon inspiration why? |
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Definition
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inspiration: what intercostal muscle contracts why |
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Definition
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expiration what m contracts? why? |
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Definition
inner intercostal
bring ribcage down |
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pneumothorax (open) what? |
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Definition
air getting into pleural cavity, pressure rises and lung collapses |
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pneumothorax (closed) what happens
affect on venous return? |
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Definition
inspiration air into pleural cavity (puncture) causing ipsilateral lung to collapse. mediastinum shifts to opposite side
expiration open wound closes from pressure inside, air cannot get out, mediastinum pushes to other side
increased pressure impairs venous return |
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Definition
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hemothorax hydrothorax pyothorax chylothorax |
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Definition
blood (usual injury to intercostal vess) watery stuff (maybe from effusion into pcavity) pus lymph |
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2 ways stuff could get into pleural space? |
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Definition
opening in parietal pleural
leakage through visceral pleura |
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thoracentisis where? where in this place? |
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Definition
2nd/3rd intercost space
above upper boarder of ribso dont hit intercostal vessels/nerves |
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why does lung collapse when air in PC |
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Definition
surface tension between pleura broken. collapses due to inherent elasticity (recoil) |
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percussion sounds dull resonant flat |
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Definition
dull: fluid resonant: air flat: solid |
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Definition
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heart, how many beats/min
average age |
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Definition
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pericardium layers, layers
outer layer continuous with? |
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Definition
fibrous & serous
serous: parietal and visceral
fibrous layer continuous with central tendon of diaphrahm |
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cardiac tamponade what result - which causes end result how treat? |
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Definition
compression of heart
due to fluid accumulation in pericardium, increased pericard pressure on heart. cant fill up!!
decreased vent filling/StrokeV vents get bigger to compensate (cardiomeglay)
usually shock or death
pericardiocentesis (remove liquid from pericard sac) |
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pericardiocenteisis where put needle in? space? drain? |
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Definition
xiphoid/costal margin, 5th space
cardiac notch allows easy drainage that doesnt affect L lung |
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what could cause heart compression |
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Definition
liquid in peri sac but stab wound (blood), perforated heart wall after Hattack) |
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mediastinum structs anatomically lower when lying or standing |
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Definition
standing. gravity pulls down |
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what sulcus separates A/V |
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Definition
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percussion of heart sounds normally dull where? |
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Definition
4th, 5th, 6th intercost spaces 6 cm to left |
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Definition
only right ventricle where pul art starts |
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Term
tricuspid valve how many papillary m, where |
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Definition
3 papillary muscles attached to cordae tendinae
ant/post/septal |
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ductus arteriosis function becomes what where |
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Definition
bt aorta to pul trunk/artery
shunts blood from pul artery to aorta LIGAMENTUM ARTERIOUS |
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Term
pap muscles contract/relax during systole |
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Definition
contract, close valve so no backflow, respond to pressure |
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interventricular septum what is made of? |
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Definition
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Definition
due to certain types of heart disease, detach and occlude stff |
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septomarginal trabecular also called funtion |
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Definition
moderator band (R vent) part of electrical conduction system |
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Definition
R has more, L has only in auricle. from embryonic atrium |
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what of L atrium is anterior |
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Definition
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RCA branches prx - distal
LCA |
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Definition
AV branch marginal (supplies r boarder) Post IV (right post descending)
ant IV (LAntDescending) circumflex |
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Dominance % R, % left
what means
why is having left dominant dangerous |
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Definition
R, 70 L, 10
SOURCE of posterior descending artery
LCA easily occulded |
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Term
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Definition
corn art bypass graft
internal thoracic artery (divert) or great saphenous vein or radial artery |
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Term
most common sites of embolism resulting in infarct |
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Definition
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ischemic heart diease cause |
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Definition
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typical place of myocardio referred pain |
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Definition
medial aspect of left upper arm |
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CAD / electric system SA/AV nodes supplied by? AV bundle supplied by? |
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Definition
SA/AV -RCA AV bundle -LCA
NOTE: av bundle runs down AV septum |
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Term
heart block damage to what?
bundle block damage to what |
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Definition
damage to AV node vents contract but much slower
AV bundle normal systole in one branch only (asnychronus contraction) |
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Term
Cardiac veins drain where branches? |
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Definition
drain to Csinus
great vein follows LAD middle follows post IV small follows marginal |
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Term
listening to valves: aortic pulmonic tricuspid mitrial |
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Definition
2nd space/sternum right 2nd space/sternum left 5th space/sternum left 5th space/mid-clavicular (apex of heart), where costal cart ends |
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Definition
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apex contracts? (direction)
atria contracts? |
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Definition
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topographic borders of mediastinum ant post
sup mediastinum
inferior mediastinum |
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Definition
sternal angle to xiph-sternal joint
T5-T9
sternal angle to sup thoracic aperature
sternal angle to diaphragm |
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orientation of vessels in mediastinum |
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Definition
Veins - ant arteries - poster nerves - most post |
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embryonic origin of thymus |
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Definition
endoderm 3rd laryngeal pouch |
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blood path when IVC/SVC obstructed? |
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Definition
IVC: through azygos to SVC SVC: drain into abdominal walls then up azygos |
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AAA pain manifests where? other sympts |
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Definition
back dyspnea, AAA may compress trachea/esophagus/Recurrent laryngeal n (difficulty breath/swallow) |
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Term
branches of brachiocephalic vein (L/R)
BCv dumps into |
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Definition
internal jugular v. + subclavian
SVC |
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Term
branches of aortic arch
med to lateral |
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Definition
brachiocephalic trunk (r. common carotid, r sub)
L common carotid L subclavian |
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Bovine Arch % people what |
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Definition
L common carotid comes off brachiocephalic artery L carrot can come off at prox/distal trunk
12%
so now BC artery would have 3 branches, r sub, r carrot, l carrot |
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Bowline Arch what? % people |
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Definition
two brachiocephalic trunks 1.2% |
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Term
L vertebral artery comes off aorta (instead of L subclavian)
%? |
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Definition
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collateral blood with aortic coarctation |
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Definition
less blood to inferior body. due to narrowing of lumen of aorta. prox/dis to ligamentum arteriosis
so blood goes from posterior intercostals moves anterior and inferior. |
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Term
landmark for left recurrent laryngeal nerve? |
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Definition
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Term
Patent Ductus Arteriosis problem after birth? common in? #/1000? female or male? how treat non invasively? |
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Definition
pressure drives blood from aorta through DA to pulmonary trunk/arteries.
more blood to lungs increases pul pressure (-> pul edema)
decreased systemic flow, LV compensates and pumps more (hypertrophy)
more in females, 8/1000 give anti-inflammatorys. |
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Wwhat keeps ductus arterious open? |
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Definition
prostangladins AKA INFLAMMATION |
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Term
inflamm of bronchi or aorta will cause what nerve to get compressed |
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Definition
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Term
left recurr laryngeal n. under what?
right RLn. under what? |
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Definition
aorta/ligamentum arteriosis
R subclavian |
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Term
cardiac plexus originiates from what? supplies what? controls what? where sits? |
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Definition
vagus nerves/sympathetic trunk heart constriction of coronary a, heart rate aortic arch |
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Term
pulmonary plexus originates from? controls sits? |
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Definition
vagus nerves/sympathetic trunk bronchiole constriction pul trunk |
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Term
bifurcation of trachea at vert lvl? (carina) |
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Definition
T4, sternal angle (2nd rib) |
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Term
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Definition
thymus, lymph nodes, fat, connective tissue |
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Term
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Definition
pericardium, heart, root of great vessels, arch of azygos, main bronchi |
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Term
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Definition
largest region, T5-T12, esophagus, aorta, azygos & hemizygos, thoracic duct, vagus nerves, sympathetic trunks, splanchnic nerves |
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Term
esophagus deviates to become anterior to aorta at what vert lvl |
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Definition
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Term
azygos, thoracic duct, aorta right to left |
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Definition
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Term
laceration fo Thoracic duct result |
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Definition
chylothorax - accumulation of chyle in pleura |
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Term
azygos joins SVC at what vert lvl
drains blood from where? |
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Definition
T4 (sternal angle)
post walls of abdomen and thorax |
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Term
hemiazygos arises from where? crosses verts to join azygos where? |
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Definition
post renal vein
T6/7 (post to Tduct/aorta) |
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Term
accessory hemiazygos where crosses over? drains blood from where? |
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Definition
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Term
Splanchnic Nerves innervate what? |
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Definition
supply viscera inferior to diaphragm
Greater, lesser, least (T5-12) medial to sympathetic trunk |
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Term
what vert level, aortic arch |
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Definition
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Term
anterior cardiac vein drains where? |
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Definition
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Term
normal, quiet expiration lying down is acheived by contraction of what? |
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Definition
elastic tissue of lungs/thoracic wall. EXPIRATION IS PASSIVE |
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Term
CIRCUMFLEX BRANCh supplies what? |
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Definition
left atrium, left ventricle |
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Term
posterior intercostal arteries 3-12 supplied by?
what supplies upper 6 intercost arteries? |
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Definition
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Term
thorocentesis where preformed preferrably? |
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Definition
1-2 spaces below the fluid, not below the 9th. mix axillary line |
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Term
apex of heart receives blood form what coronary artery generally? |
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Definition
LAD (goes all the way down) |
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Term
major muscles upon active expiration? |
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Definition
abdominal (not diaphragm) |
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Term
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Definition
diaphragm, external intercostal, levator, |
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Term
what vein passes over root of r lung? |
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Definition
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Term
venous drainage - intercostals |
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Definition
2-4 intercost veins form SUPERIOR IC vein wich drains into (L) brachiocephalic, R (azygos) |
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Term
internal thoracic vein drains into what? |
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Definition
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Term
coronary arteries at max blood flow at? systole/diastole |
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Definition
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Term
LUB DUB what closes during lub? dub? |
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Definition
tricuspid/mitrial
aortic/pulmonary |
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Term
septum primum = character? septum secondum = |
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Definition
SP = thin, membranous SS = musccular thick |
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Term
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Definition
atrium in back, ventricle in front endocardial cushions begin to grow into ridges of tissue on opposite sides (crossing each other) of trucus arteriorsis (superior to vent) making a spiral. forming AORTICOPILMONARY SEPTUM
muscular vent septum grows from floor, partially dividing ventricles. when aorticopulmonary septum and intervent septum meet, aorta and pul trunk are formed. |
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Term
VSD main development cause?
blood goes where? |
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Definition
often associated with irregular partitioning of conotruncal region - failure of ridges to fuse and descend.
blood from left V to right vent and to pulmonary trunk (higher P to lower P) - leading to pul edema |
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Term
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Definition
Dacron patch or reduce flow to pulmonary trunk. |
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Term
tetrology of Fallot most frequent abnormality of conotruncal region what?
4 things associated
presents as? |
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Definition
unequal division of conus, produces 4 alterations:
Intervent septal defect Hypertrophy of Right V Overriding aorta Pulmonary stenosis (small pul trunk)
body cyanosis |
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Term
persistant truncus arteriosis |
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Definition
contruncal ridges fail to fuse, blood from R/L vents move into aorta/pul trunk fused and mix |
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Term
4th pharangeal arch 6th 3rd all become what |
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Definition
4th subbclavian/aorta 6th pulmonary artery (6P) 3rd thymus |
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Term
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Definition
oxy blood (placenta) - umbilical vein - ductus venosus (bypass liver) - IFC - RA - foramen ovale - LA - LV - aorta - body - umbilical artery - placenta
or
RA - RV - PT - DArteriosis - Aorta - body - umbilical artery - placenta |
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