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Anatomy of the Cardiopulmonary System
Exam 1
123
Medical
Graduate
02/07/2012

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Cards

Term
T3 is at what rib level?
Definition
Rib 4
Term
What vertebral level is the location of the oblique fissures in the back?
Definition
T3
Term
What is another term for Lobar Bronchi?
Definition
Secondary
Term
What is another term for Segmental Bronchi?
Definition
Tertiary
Term
How many lobes is in the right lobe?
Definition
3
Term
How may lobes are in the left lung?
Definition
2
Term
What are the 3 lobes of the right lung called?
Definition
Superior, middle, inferior
Term
Name where the right lobes are located with respect to the ribs.
Definition
Superior lobe - above rib 4
Middle lobe - between ribs 4 and 5
Inferior lobe - below 5th rib (mor lateral)
Term
Where is the oblique fissure of the right lung located with respect to the ribs.
Definition
Between the 5th and 6th ribs
Term
What are the 2 lobes of the left lung and where are they located with respect to the ribs.
Definition
Superior Lobe - above 5th rib
Inferior Lobe - below 6th rib
Term
Where is the oblique fissure of the left lung located with respect to the ribs?
Definition
Between ribs 5 and 6
Term
This lung contains a deep cardiac notch on the anterior-inferior margin
Definition
Left Lung
Term
In a position with both UEs overhead (shoulders flexed at 180 and elbows flexed at 90), the medial borders of the scapula are located at the level of what on each lung?
Definition
Oblique fissures
Term
Name the 2 pleuras of the lungs
Definition
Visceral and Parietal
Term
This pleura is adhered to the lungs and along the lung surface.
Definition
Visceral Pleura
Term
This pleura lines the pulmonary cavity (ribs) on the thoracic cavity
Definition
Parietal Pleura
Term
The potential space between layers with fluid that sllows sliding (to minimize friction) during respiration. The surface tension keep the lungin contact with the wall to allow for expansion.
Definition
Plural Cavity
Term
If an object pierces the plural cavity, the patient may develop ___ and loose the vacuum which may cause the lung to collapse.
Definition
Pneumothorax
Term
The inferior recess where fluid may accumulate with a hemothorax and require drainage (thoracentesis or chest tube)
Definition
Costodiaphragmatic Recess
Term
At what level is the costodiaphragmatic recess located?
Definition
Ribs 8-10 level
Term
At what vertebral level is the hilum located?
Definition
T5-7
Term
The area on the medial surface of each lunch where structures listed below enter and leave the lung (aka the root of the lung)
Definition
Hilum
Term
The area on the medial surface of each lunch where structures listed below enter and leave the lung (aka the root of the lung)
Definition
Hilum
Term
This circulation receives right cardiac output. Each lung has this type of artery carrying blood to it (deoxygenated), and 2 pulmonary veins draining blood from it (oxygenated).
Definition
Pulmonary Circulation
Term
Arise from the pulmonary trunk at the level of the sternal angle.
Definition
R & L Pulmonary Arteries
Term
These veins carry oxygenated blood drom the lungs to the left atrium.
Definition
Pulmonary veins
Term
Prove nutrition to the lungs. Because they are small, they are likely destroyed during lung transplantation and collateral circulation develops.
Definition
Bronchial Circulation
Term
Once the bronchial circulation is detroyed during lung transplantation, where do the lungs then get their nutrition from?
Definition
Pulmonary ciculation
Term
During a lung transplant, what else is destroyed besides the bronchial circulation?
Definition
Nerves; this results in atypical physiological responses
Term
What makes up the upper respiratory tract?
Definition
Nasal Cavity
Pharynx
Term
This part of the respiratory tract moistens, warms, and cleans air
Definition
Upper Respiratory Tract
Term
Name the 3 parts of the pharynx
Definition
Naso, Oro, and Laryngo
Term
What all is included in the lower respiratory tract?
Definition
Trachea, mainstem and lobar bronchi, segmental and subsegmental bronchi, respiratory bronchioles and alveoli
Term
The level of the respiratory tract deals strictly with respiratory functions. It begins at the level of the cricoid cartilage and includes conducting airways and terminal respiratory units.
Definition
Lower Respiratory Tract
Term
Bifurcation into the primary bronchi occurs at the level of the sternal angle. The right side is larger and at less of an angle.
Definition
Trachea
Term
Where gas exchange occurs
Definition
Alveoli
Term
In which side of the trachea are foreign objects more likely to go into?
Definition
Right main bronchus
Term
Plays an important role in airway clearance technique (ACT) positioning as well as aligns segmental airways for gravity-assisted clearance
Definition
Bronchopulmonary segments
Term
What are the bronchopulmonary segments of the superior lobes?
Definition
Anterior, Apical, and Posterior
Term
R & L apical and anterior are similar enough to use the same techniques for ACT but R & L posterior segments differ in angle of inclination for ACT.
Definition
Superior Lobes
Term
R side only but lingula on the L side is functionally equivalent. ACT use same head down inclination but with contralateral trunk rotations.
Definition
Middle Lobe
Term
What bronchopulmonary segments are found in the infeior lobes?
Definition
Superior, posterior, lateral, and anterior basal segments (medial basal is not accessible)
Term
Has a similar inclination R & L (lateral basal uses contralateral sidelying - R or L)
Definition
Inferior Lobes
Term
__ side of the lung is comprised mainly of upper lobe and the __ side of the lung is comprised mainly of the lower lobe. This is important in terms of positional flow of fluid in the lungs.
Definition
Anterior
Posterior
Term
In the efferent (autonomic) innervation of the lungs, what do the parasympathetics (vagus nerve) do?
Definition
Bronchoconstriction
Pulmonary artery dilation
Increase glandular secretion (can clog up airways)
Term
In the efferent (autonomic) innervation of the lungs, what do the sympathetic (from sympathetic trunk) do?
Definition
-Dilation of respiratory tract
-Pulmonary artery constriction relatively allowing more blood flow to reach working muscles
-Decrease in glandular secretions
Term
Atropine is an anti-cholinergic that will ___ the parasympathetics
Definition
Block
Term
What is a medication that will increase sympathetics?
Definition
Albuterol (beta-2 receptors)
Term
In the afferent innervation of the lungs, what does the vagus reflexive fibers do?
Definition
-Connective tissue for cough reflexes and stretch reception
-Vascular tissue for pressure and chemo reception
Term
In the afferent innervation of the lungs, what does the intercostal and phrenic nerves do?
Definition
-Innervation of the parietal pleura
-Referred pain dependent on area of inflammation
Term
What cervical levels keep the diaphragm alive?
Definition
C4 C5
Term
This layer of the heart is a tough, inelastic outer layer that blends with the central tendon of the diaphragm. If you have increased fluid, this layer will not budge which causes problems with the heart (pericardial tampinate)
Definition
Fibrous Pericardium
Term
Name the 2 types of Pericardium of the heart.
Definition
Fibrous
Serous
Term
Name the 2 layers of the Serous pericardium of the heart?
Definition
Parietal and Visceral Layer
Term
This layer lines the fibrous pericardium
Definition
Parietal Layer
Term
The reflected layer covering heart and great vessels; it is adhered to the heart.
Definition
Visceral Layer
Term
The potential space betwene the serous layers of the pericardium. It reduces friction associated with the beating heart.
Definition
Pericardial Cavity
Term
What are some pathologies associated with the pericardial cavity?
Definition
Pericarditis (inflammation of serous layers), Percardial rub (friction rub), pericardial effusion with CHF
Term
This part of the heart is located posterior to the left 5th intercostal space, approximately 8-9 cm from the median plane (~the breadth of the person's hand)
Definition
Apex of the heart
Term
At what intercostal space is the apex of the heart located?
Definition
5th intercostal space
Term
-Hypertrophy of the L ventricle will cause the __ of the heart to shift left and down.
-In thin people this shifts downward
-During pregnancy, this shifts up
Definition
Apex
Term
The point of attachment; made up mostly of LA (where the vessels come in)
Definition
Base of the heart
Term
What is included in the right border of the heart?
Definition
Right atrium between SVC and IVC
Term
What is included in the inferior border of the heart?
Definition
nearly horizontal, formed by right ventricle and slightly the left ventricle
Term
What is included in the left border of the heart?
Definition
Obliquely vertical, formed by the left ventricle and slightly the left atrium
Term
What is included in the superior border of the heart?
Definition
Formed by the right atrium and the left atrium, ascending aorta and pulmonary trunk emerges from it.
Term
The inferior surface of the heart is also known as the diaphragmatic surface, what makes up the inferior surface of the heart?
Definition
Left ventricle forms the largest part
Term
The anterior surface of the heart is also known as the sternocostal surface, what makes up the anterior surface of the heart?
Definition
Right ventricle forms the largest part
Term
What makes up the left pulmonary surface of the heart?
Definition
Left ventricle, making the cardiac impression
Term
What makes up the right pulmonary surface of the heart?
Definition
Right atrium
Term
What 2 sides of the heart tend to have problems?
Definition
Anterior and Lateral
Term
This valvular disorder results in harsh sounds, a failure of the valve to open fully, and slow blood flow.
Definition
Stenosis
Term
This valvular disorder results in a blowing sound and the failure of the valve to close fully.
Definition
Regurgitation
Term
The coronary sinus dumps into where?
Definition
RA
Term
This heart chamber receives SVC and IVC, it is thin-walled, and includes the interatrial septum (fossa ovalis)
Definition
RA
Term
A complex congenital HD where the R side hypertrophies due to increased load.
Definition
Atrial Septal Defect
Term
What are the 3 cusps of the tricuspid valve that include papillary muscles.
Definition
Anterior
Posterior
Septal
Term
What pulls the cusps closed?
Definition
Chordae tendinae
Term
Attach to the adjacent cusps of the tricuspid valve and papillary contraction prevents separation and inversion - weakness results in prolapse with regurgitation of blood from ventricle to atrium.
Definition
Chordae Tendinae
Term
Includes the interventricular septum which is a thick muscular wall between the R and L ventricles and contains the AV bundle. There is a potential for defect (VSD) especially in the more superior membranous portion when HTN in present.
Definition
Right Ventricle
Term
This valve goes from the RV to the lung
Definition
Pulmonary (semilunar)
Term
Found at the apex of conus arteriosus (level of the 3rd costal cartilage), includes anterior, left and right cusps, stenosis can result from fusing of the cusps.
Definition
Pulmonary Valve (semilunar)
Term
This valve has lower pressure compared to AV valves - they do not have tendinous cords but act like pockets to catch blood as it flows back due to elastic recoil in the pulmonary trunk
Definition
Pulmonary Valve
Term
Pulmonary valve incompetence occurs when decreased flexibility or scarring from disease results in poor occlusion of cusps
Definition
Regurgitation murmur
Term
4 pulmonary veins enter here and it is thicker than the RA
Definition
LA
Term
Loced posterior to the sternum at the level of the 4th costal cartilage, it has anterior and posterior cusps and is larger than the tricuspid valve; has tendinous cord and papillary muscles.
Definition
Mitral Valve (L AV valve)
Term
This occurs in 1/20 (greater in young females)
Definition
MVP
Term
Performs more work than the RV due to higher systemic pressure - walls 2-3x thicker
Definition
LV
Term
At the apex of aortic vestibule of LV - posterior to the L side of sternum at the 3rd intercostal space; has posterior, right and left cusps -RCA and LCA exit from the corresponding aortic sinus; stenosis is most frequent valve abnormality - degenerative calcification. Leads to LV hypertrophy.
Definition
Aortic (semilunar) valve
Term
The pacemaker of the heart, deep to the epicardium at the junction of SVC and RA. The signal from this spreads myogenically (no physical connection)
Definition
Sinoatrial (SA) node
Term
This node is located is in the interatrial septum near the opening of the cardiac sinus. Includes the AV Bundle or bundle of His)
Definition
Atrioventricular (AV) Node
Term
Transmission to ventricles, divides at junction of membranous and muscular IVS. The R bundle has subendocardial branches (Purkinje fibers) to the RV. and the L bundle has subendocardial branches (Purkinje fibers)to the LV.
Definition
AV Bundle
Term
Increase heart rate
Definition
Cronotropic
Term
Increase force
Definition
Ionotropic
Term
Postganglionic fibers from the sympathetic trunk ganglia; Presynaptic from T1-6 IML; Terminates on SA and AV nodes and coronary arteries. Causes increased HR, force of contraction, and increased coronary flow.
Definition
Sympathetic autonomic supply to the heart
Term
Vagus nerve; opposes sympathetic
Definition
Parasympathetic autonomic supply to the heart
Term
This artery supplies the myocardium and epicardium of the heart.
Definition
Coronary artery (1st branches off the aorta)
Term
Arises from the corresponding aortic sinuses. Supplies both the atria and the ventricles.
Definition
R and L coronary arteries
Term
This artery comes off the left aorta cusp; includes the left main common trunk (LMCT) and runs under the pulmonary trunk.
Definition
Left Coronary Artery
Term
The left coronary artery has 2 major branches that begin at the level of the AV sulcus. what are they?
Definition
1. Left Anterior Descending (LAD) or Anterior IV
2. Circumflex Artery
Term
What is most common artery for coronary artery disease?
Definition
LAD
Term
Ths artery feeds the anterior surface of the heart, runs along the intraventricular sulcus toward the apex, supplies diagonal branches, and serves the anterior surfaces of LV, RV, and IV septum (and AV bundle branches)
Definition
Left Anterior Descending or Anterior IV
Term
This artery runs along the AV septum, gives rise to the L marginal branch (obstuse marginal artery), atrial branches, and posterior ventricular branches
Definition
Circumflex artery
Term
Supplies the lower lateral LV wall
Definition
L Marginal branch
Term
Supplies the L atrium
Definition
Atrial branches of the circumflex
Term
Supplies part of the posterior wall
Definition
Posterior ventricular branches
Term
This artery comes off the R cusp of the aorta. It branches to the SA node, AV node, and R atrium; Runs along AV septum, right marginal branch (acute marginal branch), posterior IV artery terminates in region of the posterior IV sulcus, and combination from RCA, CX, or both supply the posterior wall an some of the apex
Definition
Right Coronary Artery
Term
Supplies the R lateral wall and some posterior wall
Definition
Right marginal branch
Term
If plugged, starves the critical parts of the heart; Ischemia of the anterior, lateral, and some inferior and posterior LV
Definition
LCA Dz
Term
Diffuse anterior wall ischemia; impact on AV bundle - bundle branch block
Definition
LAD dz
Term
Less diffuse anterior wall ischemia
Definition
Diagonal branches dz
Term
Diffuse lateral wall with variable posterior and inferior wall ischemia
Definition
Circumflex artery dz
Term
Lower lateral wall ischemia; location of obstruction can frequently be deduced by EKG
Definition
Left Marginal dz
Term
Variable posterior and inferior wall ischemia; Possible SA and AV node injury or infarction (potential rhythm disturbances)
Definition
RCA dz
Term
Variable posterior wall and inferior wall involvement
Definition
Right Marginal Dz
Term
When in supine, what intercostal space is the areola found?
Definition
4th
Term
Name ausculation points
Definition
A(All) - Aortic (R 2nd intercostal)
P(Patients) - Pulmonary (L 2nd intercostal)
T(Take) - Tricuspid (L 5th intercostal)
M(Medicine) - Mitral (L 5th intercostal)
Term
Rhythm disturbances may be due to __ occlusion
Definition
RCA
Term
It is rare for an infarction of the __ to occur
Definition
RV
Term
Occlusion of several distal vessels is similary to the occlusion of a __ vessel
Definition
Proximal
Term
Which is more threatening; an occlusion to a proximal or a distal vessel?
Definition
Proximal
Term
__ varies based on variations and collateral circulation
Definition
Infarction
Term
Which wall of the heart is at greatest risk due to longer vessels that supply it. It has a great opportunity for occlusion at ta given point or just global narrowing. Varying contributions of the 3 major vessels to this area contribute to this risk.
Definition
Inferior wall (apex)
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