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What are joint of the thoracic wall?
- costovertebral joints: ribs and vertebrae
- sternocostal
- sternoclavicular
- costochondral
- interchondral
- intervertebral
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how many thoracic spinal nerves are there?
12
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Anterior rami of _____ form the intercostal nerves
T1-T11
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____ anterior rami form subcosal nerves
T12
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Muscles of the thoracic wall:
- external intercostal
- internal intercostal
- inner most intercostals
- serratus posterior superior
- serratus posterior inferior
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Intercostal Muscles:
- Origin: inferior border rib above
- Insertion: superior border rib below
- innervation: intercostal nerves
- Actions- External: elevate ribs in passive and active respiration
- Internal: depress ribs in active expiration
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Serratus Posterior Superior
- Origin: nuchal ligamnet, spinous process of C7-T3
- Insertion: superior border of ribs 2-4
- Innervation: intercostal nerves 2-5
- Action: elevate ribs
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Serratus Posterior Inferior
- Origin: spinous process of T11-L2
- Insertion: inferior borders of ribs 8-12
- Innervation: intercostal nerves 9-12 and T12 nerve
- Action: depress ribs
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Movement of thoracic wall during inspiration:
- -diaphragm moves down, thoracic cage goes up
- -Volume increases and pressure decreases
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Movement of thoracic wall during Expiration:
- -volume decreases and pressure increases
- -pressure in lungs is greater than atmospheric pressure
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What are the muscles used in passive inspiration:
Diaphragm, external intercostal
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What are muscles used in passive expiration?
no muscles used
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What muscles are sued during forced inspiration?
diaphragm, external intercostal, sternocleidomastoid, pectoralis minor and scalenes
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What muscles are used during forced Expiration?
internal intercostal and all abdominal muscles
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What are 3 parts of the thoracic cavity?
- 2 lateral pulmonary cavities
- 1 central mediastinum
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Pulmonary cavity includes:
lungs and pleura
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Mediastinum includes:
heart, great vessels, trachea, esophagus, thymus and lymph nodes
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Visceral Pleura
covers lungs and attaches to surfaces
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Parietal Pleura
lines pulmonary cavities, attaches to thoracic wall, mediastinum and diaphragm
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Lungs
Oxygenate the blood- bring oxygenated air close to deoxygenated venous blood
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Right lobe of lung has ___ lobes and ___ fissures and left lobe of lung has __ lobes and __- fissures
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which structures enter/exit at the hilum?
- main bronchus
- pulmonary weins and arteries
- bronchial vessels
- lymphatic vessels
- nerves
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describe the bronchial tree
- trachea sends primary bronchus to each lung (right and left primary bronchus)
- -primary bronchus branches into bronchial tree
- -each bronchus divdies into secondary bronchi( 2 on left 3 on right)
- -each branch then divides into tertiary bronchi that supply broncho pulmonary segments
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Bronchioles and alveoli
tertiary-->Terminal bronchioles-->Respitory bronchioles-->Alveoli which is basic unit of gas exchange
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Explain the alveolar-capillary gas exchange
carbon dioxide moves from red blood cell through alveolar capillary membrane to the alveolus and oxygen travels from alveolus through alveolar capillary membrane to red blood cell
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Briefly explain pulmonary artery
- each lung is supplied by pulmonary artery
- only de-oxygenated artery in body
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briefly explain pulmonary vein
- each lung is drained by 2 pulmonary vein
- all 4 pulmonary veins drain into left atrium
- only oxygenated vein in body
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what are some structures in the superior mediastinum
superior vena cava, brachiocephalic veins, artch of aorta, trachea, esophagus, vagus nerves and phrenic nerves
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The heart pumps __ L of blood every minute
5
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What is the location of the heart
- lies in the middle mediastinum
- two thirds lies left of midline
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what are the 3 major sulci in the heart?
- coronary sulcus
- anterior interventricular sulcus
- posterior interventricular sulcus
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Coronary Sulcus:
separates atria from ventricles
-
Anterior interventricular sulcus:
external boundary b/w right and left ventricles
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Posterior interventricular sulcus:
external boundary b/w ventricles on posterior surface
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what does the pericardium do?
surrounds and protects the heart
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The two main layers of percardium are:
- 1. Fibrous pericardium
- 2.Serous pericardium
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Fibrous pericardium:
- Superficial layer
- tough
- protection
- anchors heart in place
-
Serous pericardium:
- deeper layer
- thinner then fibrous
- parietal layer: fuse to fibrous pericardium
- visceral layer: attaches to heart
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Pericardial cavity
- contain pericardial fluid which reduces friction
- (b/w two layers of serous)
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3 layers of heart wall:
- epicardium
- endocardium
- myocardium
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Epicardium
- external layer
- composed of CT
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Myocardium
- middle layer
- 95% of heart wall
-
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Right atrium recieves deoxygenated blood from three veins:
- superior vena cava
- inferior vena cava
- coronary sinus
-
the structures in the right atrium include
right auricle, anterior wall, posterior wall, inter atrial septum, fossa ovalis, tricuspid valve
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Right auricle
small pouch allows increased volume
-
Anterior wall
internal muscular ridges called pectinate muscles
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Posterior wall
IVC, SVC and coronary sinus enter
-
Fossa ovalis
oval depression in septum
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Inter atrial septum
seperate the atria
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Tricuspid valve
blood lows from right atrium into right ventricle through tricuspid valve
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What type of cardiac muscle lines right ventricle?
trabeculae carneae
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Name of the septum that seperates the ventricles:
interventricular
-
Chordinae tendineae
attached to tricuspid valve which is then attached to papillary msucles
-
the valve that blood passes through in the right ventricle on its way to lungs:
pulmonary semilunar valve and then blood goes to pulmonary trunk which divides into right and left pulmonary arteries which supply right and left lungs
-
blood flows from left atrium into left ventricle through _____ also called left atrioventricular valve
bicuspid valve
-
which is the thickest part of the heart
left ventricle
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Valves of the heart:
- Av valves (b/w atria and ventricles)-prevent blood from returning to atria once gone to ventricles
- semi-lunar (b/w ventricles and arteries)-prevent blood pumped from the heart from returning
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Left coronary artery divides into:
anterior interventricular branch (or left descending artery) and circumflex branch
-
right coronary artery divides into the:
posterior interventricular branch and marginal branch
-
the circuit for blood to reach heart tissue:
- blood drains from myocardium into coronary sinus by way of veins
- -great cardiac vein
- -middle cardiac vein
- -small cardiac vein
- -anterior cardiac veins
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Vessels of the superior mediastinum include:
- Brachicephalic veins
- superior vena cava
- arch of aorta
- brachicephalic trunk
-
Brachiocephalic veins
drains head and arm blood into SVC
-
superior vena cava
returns blood from all structures superior to diaphragm except heart and lungs
-
arch of aorta branches into
- brachiocephalic trunk (right)
- left common carotid artery
- left subclavian artery
-
brachiocephalic trunk divides into
- right common carotid artery
- right subclavian artery
-
what are the nerves in superior mediastinum?
-
Vagus:
- goes to heart
- come from medulla and goes down posterolateral to common carotid arteries
- enters mediastinum posterior to sternoclavicular joints and brachicephalic veins
-
Phrenic
- goes to diaphragm
- -enters mediastinum b/w subclavian vein and brachiocephalic vein
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The branches of thoracic aorta includes:
- posterior intercostal arteries
- bronchial
- mediastinal
- esophageal
- pericardial
- superior phrenic
- celiac trunk
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Azygos vein is on the ___ side and the hemiazygos vein is on the ___ side
right, left
-
What do the azygos veins drain into?
superior vena cava
-
What do the aygos veins drain?
back, thoraco-abdominal walls and mediastinal viscera
-
components of the cardiac conduction system are:
- Sa node
- AV node
- atrioventricular bundle
- right and left bundle branches
- purkinje fibres
- electrocardiogram
-
The atria___ while the ventricles__ in the cardiac cycle
contract, relax
-
systole
muscle is contracting
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diastole
muscle is relaxing
-
3 major phases of the cardiac cycle:
- diastole-chambers relaxed while ventricles fill with blood
- atria systole- atria contract to complete filling of ventricles
- ventricle systole-blood get pumped out of heart
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Ascultation
listening to sounds with stethoscope
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