OAP-PRELIMS.pdf

OAP PRELIMS ossified at its proximal end CHEST WALL, CHEST CAVITY, during adult life, has no LUNGS & PLUERAL CAVITIES...

OAP PRELIMS ossified at its proximal end CHEST WALL, CHEST CAVITY, during adult life, has no LUNGS & PLUERAL CAVITIES articulation, this is where we Thorax- is the region b/w the neck and the locate when doing the CPR abdomen and protects organs Thoracic cage protects lungs and heart - CPR Anterior Sternum STERNAL ANGLE (Angle of Louis) Posterior Thoracic Vertebrae - formed by the articulation of Lateral Ribs manubrium and sternum True 1-7 (Attached by (manubriosternal jt) costal cartilage) - level of 2nd costal cartilage False 8-10 (Connects to - b/w T4-T5 ribs 1-7) - recognized w/ the transverse ridge Floating 11-12 (T11-12) on the ant aspect of sternum Superior Thoracic Outlet Inferior Diaphragm Xiphisternal Jt - T9 Suprasternal notch - b/w T2-T3 RIBS Typical ribs (2nd- 12th Ribs) - long, twisted, flat bone having a rounded, smooth sup border and a STERNUM sharp, thin inf border - midline of ant chest wall Atypical Rib (1st Rib) - Flat bone that divides into 3 parts which is the - small and flattened from above and Manubrium Sterni- articulates downward manubrium and body of Costal Cartilage sternum, also articulates to clavicle - contribute significantly to elasticity Body of the Sternum- and mobility of the thoracic wall articulates above w/ - ngaa elastic sa and mobile? Para sa manubrium and xiphoid expiration, and para sa lungs para process mag expand Xiphoid Process- thin plate - calcification- pag tig a sa bones due cartilage that becomes to calcium deposits KIRK ECHO LAMOSAO – BSPT-1A 1  OAP PRELIMS THORACIC CAVITY THORACIC CAGE MECHANISM - Chest cavity is bounded by the Thoracic Outlet thoracic wall and below by the - Its called and outlet bc important diaphragm vessels and nerves emerge from the - Extends upward into the root of neck thorax to enter the neck and upper out one fingerbreadth above limbs clavicle on each side - Emerges scalene, brachial plexus, MEDIASTINUM and subclavian artery - Thick, movable partition, root of - TOS (thoracic outlet syndromes) neck and inf to the diaphragm impingement of brachial plexus, - Has sup mediastina and inf subclavian arteries and scalene mediastina Rib Motions - Sup mediastina starts in T4-T1 in post and Ant is sternal angle and Ribs 1-5 – Pump-handle motion manubriosternal jt ❖ Superior/anterior (inhale) - Inf mediastina is t5-t12 post and ant ❖ Inferior/posterior (exhale) is diaphragm and sternal angle Ribs 6-10 – Bucket-handle motions - Inf mediastina has divisions which is ❖ Lateral/superior (inhale) middle (heart and pericardium), ant ❖ Medial/inferior (exhale) (body of sternum and spaces of Ribs 11-12 – Caliper motion pericardium), and post (t5-t12, heart ❖ Lateral (inhale) and pericardium) mediastinum ❖ Medial (exhale) DIAPHRAGM MUSCLES OF RESPIRATION - Dome-shaped, thin muscular and - Are also called the breathing pump tendinous septum that separates the muscles, complex arrangement in chest cavity above from the the form of semi-rigid bellows around abdominal cavity below the lungs - Origins are sternal, costal, and Inspiratory Muscles: vertebral Sternal- xiphoid Relaxed: (DE) Costal- lower 6 ribs and their - Diaphragm costal cartilage ❖ Primary for relaxed Vertebral- vertebral columns - External intercostals (???) form arcuate ligaments ❖ Assist diaphragm - Nerve supply- right and left phrenic nerves KIRK ECHO LAMOSAO – BSPT-1A 2  OAP PRELIMS Forced: (SUPAS) - Left lung is smaller than right because heart is located on the left - Sternocleidomastoid side ❖ bilateral - Apex- 1st rib - Upper Traps - Base- sits on the diaphragm, loads, ❖ Shoulder elevation costal surfaces, mediastinal surfaces - Pecs Major and Minor and diaphragmatic surface ❖ Chest expansion - Borders- Ant, Post, Inf - Ant, Med, Post Scalene ❖ Neck Lobes of Lungs - Serratus Ant, Post-Sup - Right is divided into 3 ❖ Boxer’s muscle - Left is divided into 2 Expiratory Muscles (No relaxed Muscles) Fissures- division of lung, there is 2 fissure Forced: (ASI) which is oblique and horizontal on right and only oblique in left lung - Abdominals - Serratus Post-Inf Left lung has a lingula, which is found in the - Internal Intercostals (???) upper load. Lingula is tongue-shaped because it is a space for the heart If inhaling, diaphragm goes down and expands PLEURAL CAVITY - Protects and cushions chest Helps w/ piston action of inhalation and - Thin layer exhalation - Lies in ant wall of chest cavity Diaphragm can be a muscle and a - 2 Pleural cavities which is parietal tendon and visceral - Pleural space- space b/w visceral Central tendon helps piston action of and parietal inhalation and exhalation mechanism - Visceral- sensitive to stretch, it is the LUNGS inside - Located in the thorax, mediastinum - Parietal- sensitive to pain, it is the - To oxygenate blood outside. It is sensitive to pain - Lies w/ thoracic cavity because this is where the nerve flows - Functions to oxygenate blood (Intercostal nerve) arteries also pass - Surrounded by a pleural cavity, through here, it receives blood from which is formed by the visceral and intercostal arteries parietal - What protects the lungs is ribs, - Cone-shaped visceral pleural and thoracic cage - Pleural space is a space b/w visceral and parietal KIRK ECHO LAMOSAO – BSPT-1A 3  OAP PRELIMS - Gadalagan sa sulod sang pleural - Upper has 3, nose, pharynx, Epiglottis space is pleural fluid ❖ Nose- primary entry of air, this - Normal pressure is -4mmHg is where nasal cavity located, - This should be negative to allow the hair filters the air which is rooms for lungs to expand especially called vibrissae during inhalation ❖ Pharynx- serves as common - If mag positive ma cause into lung pathway of air, Nasopharynx collapse or atelectasis (filters and humidifies are) and - Fluid is for shock absorption and oropharynx and lubrication langyropharynx is the conduits of air LUNG SEGMENT ❖ Epiglottis- during swallowing - For us to know to perform such ❖ Larynx- voice box, different activities to patient such as cough cartilaginous segment, which - Right lung has 10 segments is thyroid, cricoid, cuneiform, - Left has 8 segments epiglottis, hyenoid Bronchopulmonary segments WLA NAKO BALO HASGASGHSAGHASGHAS - Portion of the lung supplied DUGANGI NYO LANG IM TIRED! segmental bronchus and its vessels. - Subdivision of one lobe of a lung based on the connection to the segmental bronchus R L Upper Apical Post Ant Middle Lateral Medial Lower Sup Ant Lat Med RESPIRATORY TRACTS - Made of organ in exchange of oxygen and carbon dioxide - Upper and lower tracts KIRK ECHO LAMOSAO – BSPT-1A 4  OAP PRELIMS Hello 😊 – juju GODSPEED THE HEART, CORONARY VESSELS & PERICARDIUM HEART - 5-inch length - 3.5 width - 2.5 - 250g for women - 300g for men - It is found in mediastinum KIRK ECHO LAMOSAO – BSPT-1A 5  OAP PRELIMS LAYERS OF HEART - Post interventricular- external boundary of 2 ventricles - Oricle- pouch-like, serves as areas of atrium, when filling blood it can stretch CHAMBERS OF HEART - One-way movement - From upper extremities to right atrium then pass through right AV Valve Fibrous -- Parietal layer of serous -- then right ventricle then it will go to pericardial cavity – epicardium – pulmonary valve then pulmonary myocardium -- endocardium artery then lungs and lungs will give - Pericardium- a sac or covering of oxygenated blood to the heart and heart, it protects heart from other will go to pulmonary vein and go to organism and prevents left atrium then left AV valve to left overstretching of heart, also anchors ventricle then pass through aortic heart to diaphragm. Divides into valve to aorta to systemic circulation two: Fibrous and Serous; parietal and and coronary circulation to go to visceral. b/w parietal and extremities visceral(epicardium) is pericardial - Atrium is the receiving chamber, HFN cavity and inside of it is pericardial and lungs fluid (lubrication) - Ventricle is a pumping chamber - Myocardium- main muscle that - If patient is pale, the probable cause pumps blood in heart will be because of the ventricles - Endocardium- inner lining of the because of not enough blood heart, it is to decrease surface for pumped smooth inner surface of heart, or it Right Atrium prevents bruising - Receives blood form 3 veins; Superior SULCUS vena cava - Grooves in external heart, it is an ❖ Superior Vena Cava- drains external boundary of atria and blood from UE to right atrium ventricle ❖ Inferior Vena Cava- Organs - Heart has 2 atria and 2 ventricles from LE to right atrium - Deep coronary- boundary of atria ❖ Coronary Sinus- drains blood and ventricle that circulates in heart - Anterior interventricular- b/w - Pectinate Muscles is located at ant ventricles, ext boundary b/w 2 surface of inner atrium, wirnkled, ventricles KIRK ECHO LAMOSAO – BSPT-1A 6  OAP PRELIMS function is to accommodate more Preload- initial stretch of heart during filling blood, it streteches of ventricles - Interatrial septum- divides right and Afterload- amount of resistance the heart left atrium, once mapuno ang right must overcome to exert to pump blood ma go to right ventricle - Atrioventricular valve- passage way If preload increases= amount of blood will of right atrium to right ventricle, increase prevents backflow If afterload increase= amount of blood Right Ventricle that pumps will decrease - 4-5 mm in thickness HEART VALVES - Trabeculae carneae- underlining of - AV valves- right and left AV blood heart, part of conduction system (chordae tendinae- only attaches - Chordae Tendinae- cord-like here) structure that attach to valve, - Semilunar Valve- b/w right ventricle whenever ventricles contracts it will and pulmonary artery and left pull the chordae tendinae, it will not ventricle and aorta form a bulge, I hold ang vavle to CORONARY CIRCULATION close position (same purpose of If contracting, coronary artery closes to papillary muscle) prevent backflow, if relax and blood will go - Papillary Muscles- in to aorta, it will open - Interventricular Septum- divides ventricles of heart - Right Coronary Artery- divided into - Pulmonary Valve- b/w pulmonary two, which is marginal branch and artery and right ventricle, prevents inferior/ posterior interventricular backflow from right ventricle branch Left Atrium ❖ Marginal- right ventricle - 4 pulmonary veins ❖ Inf/post interventricular- gives - Left atrioventricular valve- seperates supply to right ventricle and left atrium to left ventricle left ventricle in post part - Left Coronary Artery- circumflex and Left Ventricle ant interventricular branch - 10-15 mm ❖ Ant inter- left ventricle and - Apex of heart right ventricle - Aortic Valve- seperates to aorta to ❖ Circum- right ventricle and left left ventricle atrium - Greatest force because it will push - What makes your valves close? It is blood when two chambers contract KIRK ECHO LAMOSAO – BSPT-1A 7  OAP PRELIMS If pressure in r atrium will increase, the r av valve will open and all fluid goes to r ventricle, the moment when r ventricle is higher, r av valve will close. Then r ventricle pressure, the pressure is still high in r pulmonary artery. Myocardium will contract pra mag bukas ang pulmonary valve pram aka eject ang blood pagwa – ISOVOLUMETRIC CONTRACTION KIRK ECHO LAMOSAO – BSPT-1A 8