Anatomy of systems

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Articular processes are joined by what type of joint
Synovial, paired superior and inferior processes
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What vertebral processes allow for attachment
Spinous and transverse processes
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How many cervical vertebrae
7
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How many thoracic vertebrae
12
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How many lumbar vertebrae
5
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How many sacral vertebrae
5
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Specialisation of cervical vertebrae
They have foramina in their transverse processes for vertebral arteries - foramen transversarium. C1 is atlas, C2 is axis
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Atlas?
C1, has no body, has occipital condyles that join with the base of the skull
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Axis?
C2. Has the dens, allowing rotation of the neck Dens is held in place by the transverse ligament across the canal of the atlas
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Specilisation of thoracic vertebrae
Have additional articulations on transverse process for rib attachment.
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Three main roles of the vertebral column
Main axial support, protections, flexibility
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In development of the spine what is the primary curve called
Kyphotic
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Where are secondary curves found in the vertebral column
Cervical and Lumbar regions
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Functions of the laminae
Protect contents of vertebral column. Transmission of force from processes to body
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Specialisation of lumbar vertebrae
Spinal cord ends at L1, L1's vertebral canal is more circular, L5s is triangular
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The wing on the sacrum is known as
Ala
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What are the two parts of the sacroiliac joint
Synovial lined part and interosseous sacroiliac ligamant
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4 movements of the vertebral column
Flexion, rotation, lateral flexion and extension
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what are the 3 elements of an intervertebral disc
End plate, nucleus pulpous and annulous fibrosus
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intervertabral joints are what type of joint
secondary cartilaginous
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Grade 1 disc?
Age 15-40
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Grade 2 disc?
Age 35-70, nucleus pulpous becomes more fibrous
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Grade 3?
Moderate degenerative, annulous bulges into nucleus. end plate damage
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Nucleus pulpous?
70% water. Type 1 collagen.
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Annulus fibrosus
ordered lamellae (10-20) collagen type 1. strength
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Vertebral end plate
Hyaline cartillage, surround nucleus. Permeable barrier between nucleus and bone
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Anterior longitudinal ligament?
From the occipital bone to upper part of the sacrum. Anterior aspect of vertebral column
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Posterior longitudinal ligament?
Inside the vertebral canal, posterior side. axis to sacrum.
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Ligamentum flavum
Connects lamina of adjacent vertebrae. Mainly elastic tissue
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Superficial posterior trunk muscles
Trapezius, latissimus dorsi, serratus posterior
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Deep trunk muscles. Layers of erector spinae
Ilio-costalis, Longissimus, spinalis
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Deep to erector spinae are?
Semi-spinalis, multifidus, rotatores
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Tranverso-spinalis span from?
the transverse and spinous processes
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Lateral trunk muscles?
quadratus lumborum and psoas major
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Chest wall layers - superficial to deep
Skin, superficial fascia, psoas major, psoas minor, ribs, external intercostal, Internal, neurovascular bundle, innermost, parietal pleura, visceral pleura, lung
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3 parts of the sternum?
Manubrium, body, xiphisternum (xiphoid process)
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angle between the manubrium and the body?
Angle of louis /sterno-angle
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How many true ribs are there and what makes them true
7, directly connected to the sternum
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How many false ribs and which of them are free floating
5, 11 and 12 are freefloating
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The sternocostal joints are what type of joint (excluding rib 1)
synovial
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What type of joint is between rib 1 and the sternum
Primary cartilagenous
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What joint is between ribs 8-10
chondrochondral joints (synovial)
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What neck muscles support the rib cage
Sternoclaidomastoid and the scalenes
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Sternoclaidomastoid attaches to where?
The mastoid process to the sternum and clavicle
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Scalenes attach to where
Scalenus anterior, medius and posterior attach to the first and second ribs (second only by posterior)
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The shape of babies ribcage can be defined as
Bell-shaped due to their straight ribs
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What is the clinal significance of the bell-shaped rib cage
Prevents costal breathing and therefore dependent on the diaphragm
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Head of a rib there is?
Superior demi-facet, interarticular crest and inferior demi-facet
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The facets of the rib attach to?
Their vertebrae and the one above
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The tubercle of the rib has
A articular facet (articulates with thoracic vertibrae processes)
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Where is the subcostal grove and what does it hold?
Posterior surface of the anterior facing part of the rib. neurovascular bundle
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What ribs are atypical?
Ribs 1, 2 (sometimes 10) 11 and 12
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Why is rib 1 atypical?
Tubercle for scalenus anterior, single facet on head, and grooves for subclavian vessels
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Two types of chest movement?
Pump handle and bucket handle
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Neurovascular bundle goes in what order?
Vein, artery, nerve
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What arteries run either side of the sternum?
Interior thoracic
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Interior thoracic arteries give rise to
Anterior Internal intercostal arteries
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Posterior intercostal arteries arise from?
The thoracic aorta
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Posterior intercostal veins drain into?
the azygous vein (on the right)
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The left posterior intercostal veins drain)
Upper hald drain into the accesory hemiazygous, lower to the hemiazygous vein which connect to the azygous vein
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What nodes drain into the posterior thorax and bronchomediastinal trunk
Internal thoracic, branchiocephalic and bronchomediastinal
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The thoracic duct has what nodes drain into it?
posterior intercostal and posterior mediastinal
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The top of the chest is supplied by?
C4
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T4 and T10 are important landmark levels as
T4 - ******* T-10 umbilicus
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Major arteries of head and neck
common carotid
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Major arteries of upper limbs
Subclavian
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Major arteries of trunk
Aorta
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Major arteries of lower limb and pelvis
Common iliac
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Major veins H and N
Internal jugular
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Veins for upper and lower limb
Subclavian
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Veins for trunk
ivc
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Veins for lower limb and pelvis
Common iliac
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Layers of the heart superficial to deep
Fibrous pericardium, serous parietal pericardium, serous visceral pericardium, loose CT, myocardium, inner lining of enodcardium
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Visceral pericardium and loose CT collectively known as
Epicardium
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Pericardium is innervated by
The phrenic nerve, sensory nerves to the pericardium
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The crux of the heart can be found
on the posterior view
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The rough inner surface of the RA is known as
Musculi pectinati
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What feature of the RA tucks onto the top of the aorta
The right auricle
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Between the RA and LA is a embryonic remenant known as
The fossa ovalis
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What is the infundibulum
smooth part of the RV wall before the pulmonary valve, can lead to ventrical septal defects
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Cordae tendinae attaches to what?
the atrioventricular valves to the papillary muscles in the ventricle
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Role of the papillary muscles
They contract in the opposite direction to the ventricles keeping the valve shut
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How many pulmonary veins enter into the left atrium
4
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Blocking of the mitral valve is known as
Mitral stenosis
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What is the importance of the right side of the heart being under high pressure in fetal circulation
Forces blood to flow from the RA to the LA through the foramen ovale, bypassing the lungs
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Despite the high pressure of the right side of the heart, 20% still enters the pulmonary trunk. What is in place to counteract this
Ductus arteriousus connects the pulmonary trunk to the aorta
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What causes the foramen ovale and the ductus arteriousus to shut
When the new born takes its first breath (ductus arteriosus due to CO2 pressure change from lung and foramen due to pressure shift)
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What is the importance of gap junctions between myocytes>
Makes the membranes leaky, when an AP arrives allows the cells to contract simultaneously
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What two parts of the interventricular septum are there?
Membranous and muscular portions
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The cardiac skeleton is found?
Inbetween the atria and the ventricles, prevents conduction
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SAN is located where
On the crista terminalis of the RA
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AVN is located
Posterior of the right atrium
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AVN is connected to
Bundle of His
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What is a tube of myocutes surrounded in fibrous CT
Bundle of His
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At which point does the bundle of His seperate into Left and Right branches
The interventricular septum
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What is the difference between the right and left branches of the bundle of His
Right is fully insulated whereas the left is leaky polarising the septum
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What is the importance of the papillary muscles lying close to end of the insulation of the bundle of His
Allows them to contract and shut the AV valves before ventricular contraction
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Septomarginal bundle supports what branch of the bundle of His towards the purkinje fibres
Right
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What nerve inhibts the SAN node
Vagus, otherwise atria would beat 100 times a min
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Where do the three leads of a cardiac pace maker go
Right atrium, Right ventricla and coronary sinus
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What arteries arise from the right coronal artery
Sinoatrial, Right marginal atrioventricular, post. interventricular
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What arteries arise from the left coronary artery
The circumflex artery, left marginal, ant. interventricular
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What is at the cusp of heart valves to ensure complete closure
Nodules
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On a normal X-ray how many posterior and how many anterior ribs should you see?
9 post, 6 ant.
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As air appears black on an X-ray, what can you use to see the airways
A bronchogram
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What forms the upper boundary of the thoracic cavity and what is it comprised of
The thoracic inlet, comprised of the first rib, T1 and manibrium
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What covers the thoracic inlet
Suprapleural membrane, creates a dome
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What is the thoracic inlet comprised off
Costal cartillages (7-12), xiphoid process and T12
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What seals the thoracic outlet
Diaphragm
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What perverates the thoracic inlet
Oesophague, trachea, int. jugular, common carotid artery and subclavian vessels
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What punctures the diaphragm
The oesophagus and the IVC
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A small space between the chest wall and diaphragm
Phrenic angle (costodiaphragmatic recess) - between the 8th and 11th ics
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The cervical, apical and costal pleura are innervated by what
Intercostal nerves
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The phrenic nerve supplies what pleura
The medistinal and diaphragmatic pleura
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What nerve runs down either side of the sternum
Phrenic nerve
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What ligaments are formed between the diaphragm and the vertebral column, QL and psoas major
Arcuate ligaments
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What two openings are in the diaphragm
Caval and oesophogeal (bounded by the right crus)
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The diaphragm is supplied by what nerve
Phrenic (C3-5)
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What are the intrinsic muscles of the chest wall?
External and internal intercostals, sternoclaidomastoid and scalenes. Subcostal muscles and transversus thoracis
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External intercostal come
Forwards and downwards
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Internal intercostal come
Backwards and downwards
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The sternoclaidomastoid attaches to the inlet, what are it's actions and innervation
Extends head and flexes neck, turns hurd, inspiratory muscle. CNXI
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Scalene attaches to the inlet, what are it's actions and innervation
Lateral flexion of neck, flexion of neck, inspiratory muscle. cervical plexus. Holds first rib steady
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Muscles involved in quiet inspiration
Diaphragm, scalenes and intercostals (prevent bellowing)
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Muscles involved in forced inspiration
Scalenes and sternocleidomastoid, intercostals (rib movement), pectoralis and serratus anterior, erector spinae and QL (lower rib stabilisation)
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Muscles involved in forced expiration
Abdo muscles (depress ribs and abdo (elevating the diaphragm) intercostals, latissimus dorsi, serratus posterior inferior
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What is the name of the point where the trachea splits
Carina
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From naso cavity to alveoli, list the respiratory tract
Nasal cavity, pharynx, layrnx, Trachea, Bronchi, bronchioles, alveoli
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Features of the nasal cavity to warm and humidify air
Very thin, mucosa is in folds - allows air to be warmed and humidified
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Feature of nasal cavity for immunology
Mucus ( secreted by goblet cells) serous glands, and cilia, hairs
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What do Mast cells release and what is the effect of this
Histamine and their granulations. Implications in hay fever and asthma
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Name the four paranasal sinuses
Frontal, Maxillary, Sphenoidal, Ethmoidal
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Functions of the paranasal sinus'
Decrease weight of skull, resonance, humidify air, buffer against blows to the face, insulate sensitive structures (eyes and dental roots) from rapid temp fluctuations.
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Receptors of the cough reflex
rapidly adapting irritant, non-myelinated C fibres (laryngeal and tracheobronchial)
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The receptors signal what down what nerve
Cough centre in the medulla (down the ipsilateral CNX) (or bronchial submucosal glands)
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Nerve pathways for the efferent signal
Phrenic and other somatic, recurrent larygeal, Vagal to bronchial tree
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List effector musculature of the cough reflex
Expiratory muscles, Larynx, Trachealis, Bronchial SM
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What part of the respiratory tract acts as a sphincter preventing entry of food
Larynx
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What level is the carina
T4/5
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After what division of bronchi does the airway become bronchioles
Third
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Airways are supplied by what artery
Bronchial arteries from the desc. thoracic aorta
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What arteries supply the larynx
sup. and inf. thyroid arteries
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The superior laryngeal supplies
The internal mucosa and above the vocal cord areas of the larynx
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What nerve supplies some musculature of the larynx
External laryngeal
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The recurrent laryngeal supplies
The rest of the musculature and sensory supply for below the vocal cords and upper aspect of the trachea
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What path does the R recurrent Laryngeal and L take
R dips below subclavian vessels, L loops below the aortic arch
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Where do all laryngeal nerves originate from
The inf. vagal ganglia
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C6 is where
The larynx ends and trachea begins
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How many lobes do the Right and Left lungs have
R-3, L-2
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What fissure is seen in both lungs and what only in the R
Both lungs - oblique, R lung also transverse (horizontal)
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How can a pneumothorax be seen on an X-ray
Blood appears slightly weight on an x-ray. Therefore if the outer aspect of the X-ray, no white whispy lines can be seen. You can assume the lung has collapsed. Degree of lack of white whispy lines differs
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Each lung is supplied by a what type of bronchi
Primary bronchi
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Secondary bronchi supply
Different lobes
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Tertiary bronchi supply what and how many are there
Bronchopulmonary segments and there are 10 in total
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Lymph nodes of the lung tend to follow
The bronchi
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The lymph nodes of the lung are known as
Bronchomediastinal nodes
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What exception in regard of lymph drainage is present in the left lung
The lower lobe of the left lung can drain up the left or right side of the trachea
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SNS nerves for the lungs come from
T2-4
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PNS nerves have what affect on bronchioles
Constricts them
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What are boundaries of the mediastinum
The sternum, thoracic verterbra and mediastinal pleural surfaces
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What contents can you see in the superior mediastinum (anterior to posterior)
Thymus gland, Brachiocephalis v., phrenic nerve, brachiocephalic trunk, Lcommon carotid, Trachea, vagus, L subclavian, oesophagus, L recurrent laryngeal, thoracic duct
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Directly behind the sternum lies what
Thymus gland
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Inferior mediastinum is mainly taken up by
The heart
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What other structures are seen in the inferior mediastinum (anterior to posterior)
oesophagus, aorta, azygous vein
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What are the 5 constriction points of the oesophagus and at what level are they
Cricoid cartillage (C6) Aortic arch (T4) Left main broncus (T5) Left atrium (T6-10) Oesophogeal opening into stomach (T10)
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What are the nerves of the mediastinum
Laryngeal branches, vagus nerve, cervical cardiac plexus, recurrent larygeal, phrenic nerve
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What nerve lies between the subclavian veins and arteries
Phrenic
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What are the three plexus's of the chest
Pulmonary, cardiac and oesophogeal
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SNS and PNS originatons of pulmonary plexus
SNS T1-5, PNS vagus
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SNS and PNS originatons of cardiac plexus
SNS T1-4, PNS vagus
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SNS and PNS originatons of oesophageal plexus
SNS T2-6, PNS vagus
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Other cards in this set

Card 2

Front

What vertebral processes allow for attachment

Back

Spinous and transverse processes

Card 3

Front

How many cervical vertebrae

Back

Preview of the front of card 3

Card 4

Front

How many thoracic vertebrae

Back

Preview of the front of card 4

Card 5

Front

How many lumbar vertebrae

Back

Preview of the front of card 5
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