anatomy lecture exam 2
What tissues make up the breast? [Know the internal structures of the breast, including the importance of the retromammary space and suspensory ligaments.]
(1) glandular tissue (2) fibrous tissue including the suspensory ligaments (3) adipose tissue
What is the innervation of the subcostalis? [In regards to the ribs, where is the location of the intercostal vessels and nerves? What is the Clinical significance of this information?]
4-11 intercostal nerves
What are the different sections of the spinal cord, and how many vertebrae are in each? [Know the primary and secondary curvatures of the spine, as well as the number of vertebrae in each curvature. For the secondary curvatures, at what age do each develop?]
7 cervical, 12 thoracic, 5 lumbar, 5 sacral, and 4-5 coccygeal vertebrae in humans.
When do the secondary curves appear? [Know the primary and secondary curvatures of the spine, as well as the number of vertebrae in each curvature. For the secondary curvatures, at what age do each develop?]
Cervical curve develops as the infant begins to hold up the head Lumbar curve appears with standing and walking
What is COPD? [What are the clinical considerations of lung illnesses?]
Chronic Obstructive Pulmonary Disease. Irreversible decrease in the ability to force air out of the lungs. CHRONIC BRONCHITIS AND EMPHYSEMA
What are the unique characteristics of the lumbar vertebrae? [Know the common and unique characteristics for each type of vertebrae.]
Bodies are thick and robust Transverse processes are thin and tapered Spinous processes are thick and blunt and point posteriorly. Vertebral foramina are triangular Superior and inferior articular facets direct medially Allows flexion and extension (like when you touch your toes); rotation prevented.
What is the sympathetic afferent nerve responsible for? [extra innervations]
Bronchodilator, Vasoconstrictor, Inhibitory to glands in bronchial tree
How is cardiac tamponade treated? [What is the Clinical significance of the following: pericarditis and cardiac tamponade?]
Can go in and take out the fluid but if fluid fills in, a pericardiocentesis can be made in 5th or 6th left intercostal space near sternum and needle removes that fluid.
What is the function of a lumbar puncture? [At what level of the vertebral column does the spinal cord end? How is this information relevant when performing a lumbar puncture?]
Can help diagnose serious infections
How can you create inadvertent damage to the pleura? [What is the Clinical significance of a sucking and tension pneumothorax?]
Catheterization of the subclavian vein, brachial plexus block, injuries in the neck over the clavicle or during kidney surgery.
What are the unique characteristics of the AXIS vertebrae? [Know the common and unique characteristics for each type of vertebrae.]
Has a body and spinous process. The dens (odontoid process) projects superiorly.
Why would epidural anesthesia be given? [On the vertebral column, where is the site for epidural anesthesia? Why would this be given?]
Most commonly this is done during labor and delivery. During labor and delivery, a caudal epidural would block the pudendal nerve (of perineal area) to control the pain Can also be done in knee sculpting surgery, overall a superficial surgery. Caudal epidural would keep the patient awake during the surgery too.
How do the pectoralis major and minor play a part in elevating the thoracic cage? [Which muscles elevate the thoracic cage?]
Move the upper limb but help bring the cage up and open it up a little.
What branch comes off the internal thoracic artery? [In regards to the ribs, where is the location of the intercostal vessels and nerves? What is the Clinical significance of this information?]
Musculophrenic artery
What do the erector spinae muscles do? [Which muscles are included in the erector spinae? What are their locations?]
Posture muscles
What is osteroporosis? [What is the Clinical significance of spina bifida and spina bifida occulta?]
Problems with the spine. Over time, more bone reabsorption happens and that beats bone growth. This would mean that osteoids are more active than osteoblasts. Healthy bones arent weak but osteoporotic bones are
What is the clinical significance of fractures in the 1st rib cage? [What is the Clinical significance of fractures in the 1st, middle, and lower rib cage?]
Rarely fractures (due to danger to vessels). You would need a direct trauma, you would need damage to the clavicle first.
What are the contents of the vertebral foramen? [What are the contents of the following: vertebral foramen, intervertebral foramen, and transverse foramen of the cervical vertebrae?]
Spinal Cord, Nerve Roots, Meninges, CSF, Fat, Vessels
Out of the trapezius, latissimus dorsi, and levator scapula, which are superficial and which are deep? [Know the location and function of the following muscles: trapezius, latissimus dorsi, and levator scapula.]
Superficial layer: consists of the trapezius and latissimus dorsi Deep layer: levator scapulae
What are the primary curvatures of the spine? [Know the primary and secondary curvatures of the spine, as well as the number of vertebrae in each curvature. For the secondary curvatures, at what age do each develop?]
The thoracic and sacrococcygeal curves
Where do most breast tumors grow? [What is the Clinical significance of the following: Breast cancer, mastectomy, and gynecomastia?]
axilla
What is the retromammary space? [Know the internal structures of the breast, including the importance of the retromammary space and suspensory ligaments.]
between the breast and the deep fascia, a tumor here may contract the pectoralis major
What is pulmonary thromboembolism? [What are the clinical considerations of lung illnesses?]
blood clots in the lung originating mainly from veins of the lower limb
What is a hemothorax? How could it be caused? [Know the types of pleural effusion: hydrothorax, pyothorax, chylothorax, and hemothorax.]
blood in the pleural cavity; injury to right subclavian vein during catheterization
What is the vagal efferent nerve responsible for? [extra innervations]
bronchoconstriction, vasodilation, and secretomotor
What are the secondary curvatures of the spine? [Know the primary and secondary curvatures of the spine, as well as the number of vertebrae in each curvature. For the secondary curvatures, at what age do each develop?]
cervical and lumbar curves
What is the insertion of the transverse trapezius? [Know the location and function of the following muscles: trapezius, latissimus dorsi, and levator scapula.]
clavicle and scapula (acromion)
What is atelectasis? [What are the clinical considerations of lung illnesses?]
collapse of the alveoli in the lung prevents normal exchange of O2 and co2 hypoventilation occurs
What is hydrothorax? [Know the types of pleural effusion: hydrothorax, pyothorax, chylothorax, and hemothorax.]
congestive heart failure
Where do the MAIN cardiac veins drain into? 1. Great cardiac vein 2. Middle cardiac vein 3. Small cardiac vein 4. Posterior vein of the left ventricle 5-Left marginal vein 6-Anterior cardiac veins 7-Smallest cardiac veins (Thebesian veins) [Know the venous drainage of the heart.]
coronary sinus
What is the venous drainage of the breasts? [Know the internal structures of the breast, including the importance of the retromammary space and suspensory ligaments.]
corresponding veins (mainly to the axillary vein)
What is the insertion of the latissimus dorsi? [Know the location and function of the following muscles: trapezius, latissimus dorsi, and levator scapula.]
crest of the lesser tubercle of humerus
How does progesterone affect breath growth? [Which hormones are responsible for breast growth, and what specific structures are under the influence of each?]
development of milk secreting lobules. (seen post-ovulation for a few days and during pregnancy)
What is the innervation of the levator scapula? [Know the location and function of the following muscles: trapezius, latissimus dorsi, and levator scapula.]
dorsal scapular nerve (C4
What is the innervation of the rhomboids? [Know the location, function, and innervation of the rhomboid major and minor.]
dorsal scapular nerve (C4-C5)
What is the action of the levator scapula? [Know the location and function of the following muscles: trapezius, latissimus dorsi, and levator scapula.]
elevates the scapula
What's the areola? [Know the internal structures of the breast, including the importance of the retromammary space and suspensory ligaments.]
enlarges during puberty, contains sebaceous glands and gets darker during pregnancy
What is the suspensory (Cooper's) ligament? [Know the internal structures of the breast, including the importance of the retromammary space and suspensory ligaments.]
extend from the skin to deep fascia and support the breast; their invasion by tumor may cause dimpling of skin.
What is superficial to deep order of the heart walls? [Know the layers of pericardium and heart wall]
fibrous pericardium (S) parietal pericardium pericardial cavity epicardium myocardium endocardium heart chamber (D)
Where is the AV node located? [Know the blood flow pathway through the heart.]
floor of right atrium
What is pleural effusion? [Know the types of pleural effusion: hydrothorax, pyothorax, chylothorax, and hemothorax.]
fluid in the pleural cavity
How does lymphatic drainage work? [Know the internal structures of the breast, including the importance of the retromammary space and suspensory ligaments.]
follows veins to axilla; 75% of lymphatics is drained by axillary nodes
What's the function of breasts? [Know the internal structures of the breast, including the importance of the retromammary space and suspensory ligaments.]
lactation
What is the insertion of the descending trapezius? [Know the location and function of the following muscles: trapezius, latissimus dorsi, and levator scapula.]
lateral third of the clavicle.
Where does the great cardiac vein lie? [Know the venous drainage of the heart.]
lies in the anterior interventricular groove
Where does the middle cardiac vein lie? [Know the venous drainage of the heart.]
lies in the posterior interventricular groove
What is the clinical significance of fractures in the lower rib cage? [What is the Clinical significance of fractures in the 1st, middle, and lower rib cage?]
may damage the pleura and abdominal viscera (kidney, liver, spleen)
What vessels take place in the intercostals? (hint: intercostal nav) [In regards to the ribs, where is the location of the intercostal vessels and nerves? What is the Clinical significance of this information?]
nerves, arteries, veins
Where does the posterior vein of the left ventricle lie? [Know the venous drainage of the heart.]
on the inferior and posterior surface
What is bronchiectasis? [What are the clinical considerations of lung illnesses?]
permanent dilatation of bronchioles and bronchi; loss of airway tone --> air trapping leaves scarring
What innervates the parietal pleura? [extra innervations]
phrenic nerve
What is the function of the pericardial cavity? [Know the layers of pericardium and heart wall]
protects the heart against sudden overfilling attached to diaphragm, sternum, and great vessels of the heart
How does the left atrium receive blood? [Know the blood flow pathway through the heart.]
pulmonary veins
What is pyothorax? [Know the types of pleural effusion: hydrothorax, pyothorax, chylothorax, and hemothorax.]
pus in the pleural cavity
What is a masectomy? [What is the Clinical significance of the following: Breast cancer, mastectomy, and gynecomastia?]
remove all of breast tissue and even maybe lymph nodes if mastitis occurs. Long thoracic nerves might be in danger, resulting in "winged scapula".
What are true ribs? [Know the parts of the sternum and rib. For the rib, know which structures articulate with the body and transverse process of the vertebrae.]
ribs 1-7
What is the vagal afferent nerve responsible for? [extra innervations]
sensory in respiratory epithelium
What is the nipple composed of? [Know the internal structures of the breast, including the importance of the retromammary space and suspensory ligaments.]
smooth muscle
What is the pericardial cavity? [Know the layers of pericardium and heart wall]
space between the parietal and visceral layers
What is the innervation of the trapezius? [Know the location and function of the following muscles: trapezius, latissimus dorsi, and levator scapula.]
spinal root of accessory nerve (CN XI) and C3-C4 (proprioception and pain)
What is the insertion of the ascending trapezius? [Know the location and function of the following muscles: trapezius, latissimus dorsi, and levator scapula.]
spine of the scapula
What can rheumatic fever cause? [What is the Clinical significance of rheumatic fever?]
stenosis (mitral stenosis): narrowing of the mitral valve opening that blocks (obstructs) blood flow from the left atrium to the left ventricle
What are the contents of the suboccipital triangle? [What are the boundaries and contents of the suboccipital triangle?]
suboccipital nerve (dorsal ramus of c1) III part of vertebral artery suboccipital venous plexus
What is the insertion of the levator scapula? [Know the location and function of the following muscles: trapezius, latissimus dorsi, and levator scapula.]
superior angle of scapula
As the thoracic artery reaches the bottom of the rectus sheath, what is it then known as? [In regards to the ribs, where is the location of the intercostal vessels and nerves? What is the Clinical significance of this information?]
superior epigastric artery
Where does the right atrium receive blood from? [Know the blood flow pathway through the heart.]
superior vena cava, inferior vena cava, coronary sinus
What muscles make up the breast? [Know the internal structures of the breast, including the importance of the retromammary space and suspensory ligaments.]
⅔ of breast is on pectoralis major and ⅓ over serratus anterior
What are the boundaries of the suboccipital triangle? [What are the boundaries and contents of the suboccipital triangle?]
1- rectus capitis post. minor 2- rectus capitis post. major 3- oblique capitis superior 4- oblique capitis inferior
What is the innervation of the intercostal muscles? [In regards to the ribs, where is the location of the intercostal vessels and nerves? What is the Clinical significance of this information?]
1-11 intercostal nerves
What are the innervations of the breast and nipple? [Know the internal structures of the breast, including the importance of the retromammary space and suspensory ligaments.]
2-6 intercostal nerves (T4-T6), nipple corresponds to T4
How big in the SA node? [Know the blood flow pathway through the heart.]
2.5 cm long, .2 cm wide
What ribs do the breast extend from? [Know the internal structures of the breast, including the importance of the retromammary space and suspensory ligaments.]
2nd --> 6th
What's the order of the ribs (bone, muscles, vessels, pleura, cavity) as you go deeper in the body to the lungs? [In regards to the ribs, where is the location of the intercostal vessels and nerves? What is the Clinical significance of this information?]
*Skin (superficial) superficial fascia *serratus anterior muscle (with ribs) *external intercostal muscle *interior intercostal muscle *intercostal NAV *innermost intercostal muscle *endothoracic fasia *parietal pleura *visceral pleura *pleural cavity *lung
What is gynecomastia? (Linefelter syndrome) [What is the Clinical significance of the following: Breast cancer, mastectomy, and gynecomastia?]
-Abnormal breast enlargement in males -XXY -Most common congenital cause of infertility in males
What is the mammary gland? [Know the internal structures of the breast, including the importance of the retromammary space and suspensory ligaments.]
-Aporcrine gland -A modified sudoriferous (sweat) gland *milk is nutritious sweat oop!*
What dos a bronchopulmonary segment contain? [Know the tracheal divisions and bronchopulmonary segments within each lung, noting any unique features.]
-Segmental bronchus -Branch of pulmonary artery -Branch of bronchial artery -Tributaries of the pulmonary vein are found in the periphery between the adjacent bronchopulmonary segments -Surgical landmarks
What is the left coronary artery? What branches derive from it? [Know all the branches of the left and right coronary arteries. Look at pics to know the location.]
1-Anterior interventricular artery: supplies both ventricles and interventricular septum 2-Circumflex branch: supplies the left atrium, left surface of the heart, and left ventricle 3-Left Marginal artery: a branch of circumflex artery supplies left ventricle
Which muscles elevate the thoracic cage [Which muscles elevate the thoracic cage?]
1. Scalene muscles (Posterior, anterior and middle) 2. Pectoralis major and minor 3. Sternocleidomastoid (Sterno, clavicle, and mastoid interactions)
What structures would be found in the supracardiac mediastinum? [What structures would be found in the supracardiac mediastinum?]
1. Thymus 2. Great veins related to theart, the phrenic nerves, the thoracic duct and lymphatic trunks 3. Arch of aorta including its branches and the vagus nerves, sympathetic and parasympathetic nerves to the heart 4. Trachea and bifurcation 5. Esophagus, the recurrent laryngeal nerves.
What is rheumatic fever? [What is the Clinical significance of rheumatic fever?]
1. it is an inflammatory disease that may develop after an infection with streptococcus bacteria (such as strep throat or scarlet fever)
How many bronchopulmonary segments are in each lung? [Know the tracheal divisions and bronchopulmonary segments within each lung, noting any unique features.]
10
What are floating ribs? [Know the parts of the sternum and rib. For the rib, know which structures articulate with the body and transverse process of the vertebrae.]
11-12
How many ribs are there in total? [Know the parts of the sternum and rib. For the rib, know which structures articulate with the body and transverse process of the vertebrae.]
12
How long is the trachea? [Know the tracheal divisions and bronchopulmonary segments within each lung, noting any unique features.]
12 cm long and 2 cm wide from C6 to T4
What are the lobules composed of in the internal structure of the breast? [Know the internal structures of the breast, including the importance of the retromammary space and suspensory ligaments.]
15-20 glandular tissue (mammary gland
What are false ribs? [Know the parts of the sternum and rib. For the rib, know which structures articulate with the body and transverse process of the vertebrae.]
8-10
When do lungs develop? [What are the clinical considerations of lung illnesses?]
8th or 9th month of gestation, last organ in a fetus
What does it mean for a disc to herniate? [What is the function of the intervertebral disc? What does it mean for a disc to herniate? What is the most common site of herniation?]
A fragment of the disc nucleus that is pushed out of the annulus, into the spinal canal through a tear or rupture in the annulus.
What is the thoracocentesis? [What is the Clinical significance of pleuritis and thoracocentesis?]
A procedure to drain pleural fluid in pathological conditions performed posterior to the midaxillary line while patient is seated First determine the fluid level by percussion and go 1-2 intercostal spaces below the fluid level, but not below the 9th intercostal space (danger to injure the liver on the right side) Intercostal nerve block: In herpes Zoster (shingles) or rib fractures
What is the nuclear pulposus? [What is the function of the intervertebral disc? What does it mean for a disc to herniate? What is the most common site of herniation?]
A soft-like nucleus; inner jelly-like section
What is a serous membrane? [Know the layers of pericardium and heart wall]
A thin, continuous membrane lining a closed cavity of the body and covering its organs. HEART: parietal + visceral
What is scoliosis? [Know the Clinical significance of the following: scoliosis, kyphosis, and lordosis]
Abnormal curvature in the thoracic area only. S or C shape. Can be so bad that if a child has scoliosis, a brace will be given to fix their position.
What is the function of the intervertebral disc? [What is the function of the intervertebral disc? What does it mean for a disc to herniate? What is the most common site of herniation?]
Acts as a shock absorber, is compressible, permits slight degree of movement of the vertebrae over each other. Makes up approximately 20% if the total length of the vertebral column (taller in the mornings)
What is the function/insertion of the latissimus dorsi? [Know the location and function of the following muscles: trapezius, latissimus dorsi, and levator scapula.]
Adduction and lowering the arm, medial rotation and extension of the arm (humerus) Raises the body toward the arm when climbing.
What is the Clinical significance of a sucking pneumothorax? [What is the Clinical significance of a sucking and tension pneumothorax?]
Air enters and leaves the pleural cavity Mediastinal flutter (mediastinum shifted toward the normal side in inspiration and to the injured side in expiration) Each lung has its own pleura which means one lung could be compromised and the other perfectly fine.
What is the Clinical significance of a tension pneumothorax? [What is the Clinical significance of a sucking and tension pneumothorax?]
Air enters the pleural cavity but not leaving it Mediastinal shift: the mediastinum is shifted toward the normal side, increased intrathoracic pressures. Patient has dyspnea and/or cyanosis Hyper-resonant percussion tone, radiolucent area in lung, in radiography.
What are the unique characteristics of the thoracic vertebrae? [Know the common and unique characteristics for each type of vertebrae.]
All articulate with ribs Heart-shaped bodies from the superior view Each side of the body T1-T10 bears demifacets for articulation with ribs. - T1 has a full facet for the first rib - T10-T12 have only a single facet. Spinous processes are long and point inferiorly. Vertebrae foramen are circular Transverse processes articulate with tubercles of ribs Superior articular facets point posteriorly. Inferior articular processes point anteriorly - Allows rotation and prevents flexion and extension Costo-vertebral joints - The head of each rib articulates with 2 adjacent vertebrae and the disk between them . Costo-transverse joints: - Between the tubercle of the rib and the transverse process of its own vertebra.
What are the common characteristics of vertebrae? [Know the common and unique characteristics for each type of vertebrae.]
All of the vertebrae are mostly going to have the characteristics in the diagram^ Facet would be at the end of the processes. Vertebral foramen is where the spinal cord would pass through. Intervertebral foramen is where the spinal nerves would branch off. Ligaments connect one bone to another.
What is lordosis? [Know the Clinical significance of the following: scoliosis, kyphosis, and lordosis]
Also called "swayback" Lumbar spine curves inward
What is the visceral pericardium? [Know the layers of pericardium and heart wall]
Also called Epicardium, closely attached to the heart
What are the unique characteristics of the coccyx vertebrae? [Know the common and unique characteristics for each type of vertebrae.]
Also known as the "tailbone" Formed from 3-5 fused vertebrae Offers only slight support to pelvic organs Injury to coccygeal vertebrae - Falling on buttocks, especially in females (because of diff. structure). - Painful delivery, coccydynia: pain in coccyx.
What are the 3 levels of the end of the vertebral column? [At what level of the vertebral column does the spinal cord end? How is this information relevant when performing a lumbar puncture?]
Conus medullaris (bone) Cauda equina (nerves) Filum terminale (extension of the pia mater)
What are the four stages of herniation? [What is the function of the intervertebral disc? What does it mean for a disc to herniate? What is the most common site of herniation?]
Degeneration, prolapse, extrusion, sequestration DPES: damn, Pedro expects silverware
What are the three different parts of the trapezius? [Know the location and function of the following muscles: trapezius, latissimus dorsi, and levator scapula.]
Descending, Transverse, and Ascending
What are uncovertebral joints? [At what level of the vertebral column does the spinal cord end? How is this information relevant when performing a lumbar puncture?]
Develop by age 10. May become pathologic and permit disk herniation especially in C5 region.
Where do you perform a lumbar puncture? [At what level of the vertebral column does the spinal cord end? How is this information relevant when performing a lumbar puncture?]
Done at L3-L5 region. The intercristal line (iliac crests) is at the level of L4 approximately (safe region). You wouldn't run the risk as much if you inject it in this region, it is safer. Person gets in the fetal position and it is injected in subarachnoid space. Humans spinal cord ends at L1
What is the pericardium? [Know the layers of pericardium and heart wall]
Double wall of serous membrane covering the heart (1-Fibrous, 2-Serous)
What is the clinical significance of spina bifida? [What is the Clinical significance of spina bifida and spina bifida occulta?]
Failure to vertebral arches to form or fuse Usually in lumbar or sacral vertebrae Leading to meningocele (just meninges bulge out of the vertebral canal) or meningomyelocele (meninges plus spinal cord bulge out)
What is the clinical significance of spina bifida occulta? [What is the Clinical significance of spina bifida and spina bifida occulta?]
Folic acid substitution in conception and during pregnancy decreases the risk of spina bifida.
What is the function of the muscles of the ribs? [In regards to the ribs, where is the location of the intercostal vessels and nerves? What is the Clinical significance of this information?]
Function of these muscles is to help respiration and elevate or depress the ribs.
Which ribs have their head articulate with their own vertebrae? [Know the parts of the sternum and rib. For the rib, know which structures articulate with the body and transverse process of the vertebrae.]
Head of 1st, 11th, and 12th rib
What is the intrinsic impulse-conducting system? [Know the conduction system pathway of the heart.]
Heart contains a specialized muscle tissue (impulse-conducting system) which spontaneously generates rhythmic impulses. Heart is independent organ
What is the function of the rhomboids? [Know the location, function, and innervation of the rhomboid major and minor.]
Help press the scapula to the thoracic wall. Also retract the scapula medially.
What are the three different types of muscles that make up the erector spinae? [Which muscles are included in the erector spinae? What are their locations?]
Iliocostalis, Longissimus, Spinalis
What is pericarditis? [What is the Clinical significance of the following: pericarditis and cardiac tamponade?]
Inflammation of the pericardium severe pain, friction rub
What is the function/action of the trapezius? [Know the location and function of the following muscles: trapezius, latissimus dorsi, and levator scapula.]
It is responsible for elevating, retracting and rotating the scapula.
What are the unique characteristics of the ATLAS vertebrae? [Know the common and unique characteristics for each type of vertebrae.]
Lacks a body and spinous process. It supports the skull; the superior articular facets receive the occipital condyles. Allows flexion and extension of neck. This allows you to nod your head "yes"
What is the oxygenated pathway? [Know the pulmonary circulation pathway]
Lungs --> Pulmonary Vein --> Left Atrium --> Left Ventricle --> Aorta
What is chylothorax? [Know the types of pleural effusion: hydrothorax, pyothorax, chylothorax, and hemothorax.]
Lymph in the pleural cavity usually from a ruptured lymphatic vessel (thoracic duct)
What does the trachea divide into? [Know the tracheal divisions and bronchopulmonary segments within each lung, noting any unique features.]
Main bronchi (primary bronchitis) at T4 (sternal angle), Carina 2. Primary bronchi divide into: lobar bronchi (secondary bronchus) 3. Lobar bronchi divide into segmental bronchi (tertiary bronchus) Primary --> lobar --> tertiary
What are the 4 different parts of the sternum? [Know the parts of the sternum and rib. For the rib, know which structures articulate with the body and transverse process of the vertebrae.]
Manubrium, sternal angle, body, and xiphoid process
What are the contents of the intervertebral foramen? [What are the contents of the following: vertebral foramen, intervertebral foramen, and transverse foramen of the cervical vertebrae?]
Nerves/Nerve Roots, DRG, Vessels
What is cardiac tamponade? [What is the Clinical significance of the following: pericarditis and cardiac tamponade?]
Occurs when a patient who has had heart attack, happens because of blocked arteries, death of cardiac cells, in the days that follow heart attack the walls split and the blood is coming from a chamber and filling the pericardial sac and impedes the heart beating.
What is the clinical significance of breast cancer? How is it removed? [What is the Clinical significance of the following: Breast cancer, mastectomy, and gynecomastia?]
Orange peel: dimpling (invagination) and thickens skin if lymphatic system is blocked (since tumor is pulling ligaments). In mammography it will look like a little white dot, easiest to spot in a fatty breast. Removed by lumpectomy to analyze whether tumor is good or bad
Where is epidural anesthesia administered, in regards to the meninges? [On the vertebral column, where is the site for epidural anesthesia? Why would this be given?]
Outside of the meninges (specifically the dura mater) is the epidural space. This space has a lot of fat. If anestesia (epidural) was given, it would not be stuck into meninges. If so, paralysis would happen due to the mixture of CSF and anesthesia.
What are the different sizes and shapes of the bronchi? [Know the tracheal divisions and bronchopulmonary segments within each lung, noting any unique features.]
Right main bronchus: shorter (2.5 cm) wider and more vertical Left main bronchus: longer (5 cm), less steep
What is the deoxygenated pathway? [Know the pulmonary circulation pathway]
Right ventricle of the heart --> Pulmonary trunk and pulmonary arteries --> Right and left lungs
Where is epidural anesthesia administered, in regards to bone structure? [On the vertebral column, where is the site for epidural anesthesia? Why would this be given?]
Sacrum. Specifically in the sacral hiatus point
What are the unique characteristics of the cervical vertebrae? [Know the common and unique characteristics for each type of vertebrae.]
Seven cervical vertebrae (C1-C7) The body is wide, the spinous process is short but bifid Vertebral foramen large and triangular Transverse processes contain transverse foramina (vertebral artery)
What are the unique characteristics of the sacrum vertebrae? [Know the common and unique characteristics for each type of vertebrae.]
Shapes the posterior wall of pelvis Formed from 5 fused vertebrae Superior surface articulates with L5 Inferiorly articulates with coccyx Sacral promontory Where the first sacral vertebrae bulges into pelvic cavity. Center of gravity is 1 cm posterior to sacral promontory. Ala-develops from fused rib elements.
What are zygapophysial joints? [At what level of the vertebral column does the spinal cord end? How is this information relevant when performing a lumbar puncture?]
Small vertebral joints between the articular processes
What is the Clinical significance of the "Hangman Fracture?" Which specific vertebrae is affected? [What is the Clinical significance of the "Hangman Fracture?" Which specific vertebrae is affected?]
The axis (c2, cervical vertebrae is affected). Hangman fracture in the arch of the axis pushes the dens posteriorly and compresses the brain stem, leading to death. Fracture of the dens is a typical fracture of C2. when there is traumatic injury to the neck.
What is the annulus fibrosus? [What is the function of the intervertebral disc? What does it mean for a disc to herniate? What is the most common site of herniation?]
The outer tense part between the intervertebral discs; strong outer ligamentous ring
What fascia is the breast located in? [Know the internal structures of the breast, including the importance of the retromammary space and suspensory ligaments.]
The superficial fascia *separated from pectoral muscles by a deep pectoral fascia
How does alveoli affect gas exchange? [Understand the process of gas exchange within the lung in regards to the blood-air barrier]
The surface area for gas exchange is increased. The air comes into and out of the lungs, oxygenated air and fills the alveoli. Each little sac has a brand of artery and vein interacting with each other. CO2 out O2 in
What is the clinical significance of the intercostal vessels? [In regards to the ribs, where is the location of the intercostal vessels and nerves? What is the Clinical significance of this information?]
There are diseases that will cause an increase of fluid in the thoracic cavity. Also when doing surgery it's important to not damage any of these nerves.
Where do discs usually herniate? [What is the function of the intervertebral disc? What does it mean for a disc to herniate? What is the most common site of herniation?]
They occur posterolaterally (down, to the side). This area is the perfect place for compressing the nerves there. Also would allow for an increase in friction making it more problematic.
What is the innervation of the latissimus dorsi? [Know the location and function of the following muscles: trapezius, latissimus dorsi, and levator scapula.]
Thoracodorsal nerve (C6, C7, C8 u dont need to know bc its the root of the nerve)
Where is a pancoast tumor? [What are the clinical considerations of lung illnesses?]
Tumor in the apex of the lung
What are the contents of the transverse foramen? [What are the contents of the following: vertebral foramen, intervertebral foramen, and transverse foramen of the cervical vertebrae?]
Vertebral arteries pass through transverse foramen of the 6 upper cervical vertebrae. They enter the skull through the foramen magnum. Can participate in the circle of willis along with the internal carotid artery.
What causes a disc to herniate? [What is the function of the intervertebral disc? What does it mean for a disc to herniate? What is the most common site of herniation?]
When the Annulus Fibrosus is thinner. Abnormal displacement of tissue from one area to another.
What is kyphosis? [Know the Clinical significance of the following: scoliosis, kyphosis, and lordosis]
Where thoracic spine curves outward. Hunchback. Happens to usually everyone who lives long enough. Loss of muscle tonicity, bone and tissue age, it's part of the aging process.
What do the glandular tissues of the breast drain into? [Know the internal structures of the breast, including the importance of the retromammary space and suspensory ligaments.]
a lactiferous duct which opens into the nipple aka the lactiferous sinus
What is pericardial effusion? [What is the Clinical significance of the following: pericarditis and cardiac tamponade?]
accumulation of fluid in the pericardial cavity
What is a pneumothorax? [What is the Clinical significance of a sucking and tension pneumothorax?]
air in the pleural space surgery for it: Chest tube is at -10 cm H2O to reduce pneumothorax inserted anteriorly in 2nd intercostal space Or if fluid is also present, in 5th-6th space (near posterior axillary line)
What is emphysema? [What are the clinical considerations of lung illnesses?]
airspace enlargement, wall destruction
What is the coarctation of the aorta? [In regards to the ribs, where is the location of the intercostal vessels and nerves? What is the Clinical significance of this information?]
all these arteries are dilated, when you pinch the aorta the pressure increases
What is rheumatic fever characterized by? [What is the Clinical significance of rheumatic fever?]
arthritis, chorea, skin involvement (erythema), subcutaneous nodules and carditis (nodules can cause irregular blood flow causing a murmur)
What is the origin of the transverse trapezius? [Know the location and function of the following muscles: trapezius, latissimus dorsi, and levator scapula.]
from C7-T3 spinous process
What is the origin of the ascending trapezius? [Know the location and function of the following muscles: trapezius, latissimus dorsi, and levator scapula.]
from T3-T12 spinous process
Where is bronchiolar carcinoma? [What are the clinical considerations of lung illnesses?]
from epithelium of the bronchial tree
What is the origin of the descending trapezius? [Know the location and function of the following muscles: trapezius, latissimus dorsi, and levator scapula.]
from the external occipital protuberance, superior nuchal line, and Ligamentum nuchae.
How does estrogen affect breast growth? [Which hormones are responsible for breast growth, and what specific structures are under the influence of each?]
growth of tubular system (lactiferous ducts)
What happens if the rhomboids are damaged? [Know the location, function, and innervation of the rhomboid major and minor.]
if this is damaged it will cause a "wing scapula". In this case it will tilt out a bit.
What is chronic bronchitis? [What are the clinical considerations of lung illnesses?]
inflammation of the bronchi and bronchioles due to chronic exposure to irritants mucous gland hyperplasia
What is pleuritis? [What is the Clinical significance of pleuritis and thoracocentesis?]
inflammation of the pleura
What contributes the blood supply of the breasts? [Know the internal structures of the breast, including the importance of the retromammary space and suspensory ligaments.]
internal thoracic, axillary artery and intercostal arteries.
Why is the left atrium thicker than the right? [Know the blood flow pathway through the heart.]
it works harder
What is the right coronary artery? What branches derive from it? [Know all the branches of the left and right coronary arteries. Look at pics to know the location.]
supplies right atrium 1-Right marginal artery: supply both ventricles 2-Posterior and Interventricular artery-supplies both ventricles and posterior part of interventricular septum.
How do cortisol shots help premie babies? [What are the clinical considerations of lung illnesses?]
the fetocortisal triggers the maturation of the lungs, so if cortisol is injected, it can get to the placenta and help the lungs
How do breasts grow during puberty? [Know the internal structures of the breast, including the importance of the retromammary space and suspensory ligaments.]
the lactiferous ducts undergo branching, an increase of fat deposition leads to breast enlargement.
What is the clinical significance of fractures in the middle rib cage? [What is the Clinical significance of fractures in the 1st, middle, and lower rib cage?]
the most common fractures
What is the origin of the levator scapula? [Know the location and function of the following muscles: trapezius, latissimus dorsi, and levator scapula.]
transverse process of C1-C4
Where is bronchogenic cc? [What are the clinical considerations of lung illnesses?]
tumor of the mucosa of the bronchi, upper lobes
What is the innervation of the transversus thoracis? [In regards to the ribs, where is the location of the intercostal vessels and nerves? What is the Clinical significance of this information?]
upper intercostal nerves
Where is a sternal puncture performed? [extra innervations]
upper third of sternal body sternal puncture allows for a sample of bone marrow
What is the origin of the latissimus dorsi? [Know the location and function of the following muscles: trapezius, latissimus dorsi, and levator scapula.]
vertebral part T7-T12 spinous process. -Thoracolumbar part (from fascia) -Iliac part (from iliac crest) -Costal part 10-12th rib -Inferior angle of scapula
