UNIT 5 Review Session 2 PDF

AMP REVIEW SESSION UNIT 5: THE HEART AND RESPIRATORY TRACTS 1 Nov 29th 2024 SESSION STRUCTURE CONTENT REVIEW (1hr) PRACTICE QUESTIONS (15min) Q&A (15min) 2 CONTENT OUTLINE Mediastina and Pericardium The H...

AMP REVIEW SESSION UNIT 5: THE HEART AND RESPIRATORY TRACTS 1 Nov 29th 2024 SESSION STRUCTURE CONTENT REVIEW (1hr) PRACTICE QUESTIONS (15min) Q&A (15min) 2 CONTENT OUTLINE Mediastina and Pericardium The Heart Respiratory Tracts 3  Content Outline: Thoracic Mediastina Thoracic Cavity and Thoracic Cages Pericardium Surface Anatomy Heart Position Mediastinum Pericardium 4 The Thoracic Cage 5 Image Credit: “Thoracic Cage” by Gabrielee Spurlock  Surface Anatomy Manubriosternal Joint Landmark for separating superior and inferior mediastina ClinicaTree Anatomy 6  Heart Position Transverse plane landmarks: Sternal angle Xiphisternal joint Vertical plane landmarks: Parasternal lines Midclavicular line 7 Heart position in relation to the rib cage. The University of Nottingham Mediastinum Sections Superior Mediastinum Inferior Mediastinum Anterior Mediastinum Middle Mediastinum Posterior Mediastinum 8 Left side view of the mediastinum (Gray’s Anatomy, 1918) Superior Mediastinum Image taken from HomeworkStudy Contains many nerves and vessels between the head and neck 9 Anterior Mediastinum Contents: Thymus Gland SIte of differentiation of T-lymphocytes (T cells) Lymph Nodes Fat Image taken from TeachMeAnatomy Connective Tissue 10 Posterior Mediastinum CONTENTS: D. escending aorta A. zygous vein T. horacic duct E. sophagus S. ympathetic trunk Vagal trunks travel through esophageal hiatus (TX) Posterior Mediastinum The esophagus and aorta cross at 3 points: Arch of the aorta Thoracic (descending aorta) Abdominal (descending aorta) Gilroy, Anatomy: An Essential Textbook, Copyright @ 2013 by Thieme Thoracic Aorta. Essential Echocardiography. 2022. Middle Mediastinum Contents: Heart, coronary aa, cardiac vv. Cardiac plexus Roots of great vessels Pericardiacophrenic aa. and vv. Phrenic nn. Primary bronchi 13 Mediastinum: Blood Vessels and Nerves  Phrenic Nerve Somatic nerve carrying sensory information Remember: The PHrenic nerve goes in PHront of the hilum of the lung, the vagus nerve goes behind Right hilum. Anesthesia key. 2021.. Gilroy, Anatomy: An Essential Textbook, Copyright 2013 by Thieme with markings by Dr. Sean McWatt  Vagus Nerve Travels BEHIND the heart Longest autonomic nerve The recurrent laryngeal nerve is a branch of the vagus nerve that innervates the laryngeal muscles 15 Anatomy of Thoracic Aorta and Its Branches. 2011.  The Pericardium Serous Membrane. CNX Openstax. StoryMD. Function: protective structure around the heart Three Layers: Visceral Parietal Fibrous 16 Pericardium. DIgital World Medical School. 2020.  Pericardial Sinuses Impressions in the pericardial sac that are formed at the points where the great vessels enter. Visible upon removing the heart Transverse Sinus: space behind the great vessels Oblique Sinus: space Taken from Dr. Sean McWatt behind the left atrium 17 The Heart Content Outline: and Heart Structure Blood Flow Coronary Valves Vessels Coronary Arteries Cardiac Veins Innervation 18  Heart Structure Left Atrium A Before V! Right Atrium Right Ventricle 19 Left Ventricle Septums Inside Vs Grooves Outside! Blood 1 5 = Lungs Flow 9 4 6 Body 7 Right Heart 2 Lungs 8 3 Left Heart 1 20 Body Libretexts. (2024, October 5). 18.7g: Blood flow in the heart. Medicine LibreTexts  Valves Try My AV AV Pulling Aorta Semilunar Semilunar Doernbecher Children’s hospital. OHSU. (n.d.). 21  Coronary Arteries These arteries receive blood flow upon relaxation (diastole) of the heart when the aortic valve closes 22  Coronary circulation. Coronary Circulation · Part One. (n.d.). https://partone.litfl.com/coronary_circulation.html RIGHT From Anterior Ascending Aorta Sinoatrial Nodal Artery Right Coronary Artery Right Marginal Artery Posterior Descending (Interventricular) Artery 23 “STUDENTS CONQUER MATH PROBLEMS”  LEFT Coronary circulation. Coronary Circulation · Part One. (n.d.). https://partone.litfl.com/coronary_circulation.html From Posterior Ascending Aorta Left Main Coronary Artery Anterior Interventricular Artery (Blockage Prone) Circumflex Artery Left Marginal (Not Shown) Remember Your Anastomoses! “CONNECTING IDEAS CREATES MOMENTUM” 24  Drain directly into right atrium Drain into coronary sinus Cardiac Veins 25 Volker, Dr. J. H. (2018, September 11). Venous drainage of the heart – coronary sinus, anterior cardiac veins, venae cordisminimae (Thebesian veins). Earth’s Lab. Innervation of the Heart CARDIAC PLEXUS CARRIES SYMPATHIC AND PARASYMPATHETIC FIBERS 26 Intraventricular conduction delay anatomy and physiology. wikidoc. (n.d.).  Upper and Lower Respiratory Tracts Content outline: Respiratory Tract Overview Boney Walls and Sinuses Larengal Musculature and Function Pleurae Gas Exchange Respiratory Musculature and Function 27 The respiratory system Upper respiratory Lower respiratory 28  The respiratory system Conducting zone Respritory zone Respritory zone 29 The Nasal Cavity Medial Wall AKA: The septum Cribriform plate Olfactory N (CN1) Nasopharynx Palentine Maxilla 30 The Nasal Cavity Lateral Wall More complex nasopharynx -> cartilage Spenoid, palentine, ethmoid, lacrimial, maxilla, nasal Scientists Prefer Examining Life's Molecular Nature Altar Cartilage Ethmoid: Maxilla: Superior and Middle Inferior nasal concha nasal conchae 31 The Nasal Cavity Structure, conchae and mucosa Roof: (ant to post) Nasal bone Frontal Bone Cribriform plate (ethmoid) Sphenoid Bone Floor: Hard palate (Maxilla) 32  The Paranasal Sinuses Paranasal Sinuses Hiatuses Passage ways for air and mucus Nasolacrimal duct drains tears into the inferior meatus (from top working down) Feeling Exhausted, Snot, More Frontal, ethmoid, sphenoid, Maxillary Semilunar Hiatus: Ethmoid Air Cells: Frontal ethmoid and maxillary --> middle meatus Ethmoid --> superior and middle meatus 33 Sphenoid sinus -> sphenoethmoidal recess-> superior meatus Larengeal Structure Every Human Talks After Clearing Epiglottis, Hyoid bone, Thyroid, Aarytenoid, Cricoid 34 How it Works 35 Muscles Rasing pitch Lowering pitch 36  Plurae Visceral vs. Parietal Pleural Regions Hilum (Root) of lung: In the mediastinal part of the pleura Contains essential blood vessels and bronchial structures 37  Hilum structures Right Lung Left Lung (Top down) (Top down) Raise Both Arms Victoriously Lower Arms Before Victory 38 Right, Bronchi, Artery (pulmonary), Vein (pulmonary) Left, Artery ( pulmonary), Bronchi, Veins(pulmonary) Think about how it looks spatially Posterior view Anterior view Notice the placement of the veins and arteries coming off of 39 the heart and going towards and into the lungs Treacheobronchial Tree The Tree: Larynx Primary bronchi R:1 L:1 Secondary bronchi R:3 L:2 Tertiary bronchi. R:10 L:10 Right vs Left Differences in structure Why? 40 Gas Exchnage! 41  Thoracic cage Movement (cool, but how does the air get to the alveoli?) Inspiration Exhalation (Always Active process) (Passive process) 1. Diaphragm contracts 1. Diaphragm relaxes upwards downwards 2. Creates less space in the thoracic cavity 2. external intercostal 3. = high pressure = air rushes out contracts 3. internal intercostal (Active process) contracts 1. Diaphragm relaxes upwards 4. rib cage moves upwards and 2. Innermost intercostal muscle contracts out downwards 5. creation of space in thoracic 3. Moves rib cage inwards and downwards cavity 4. Creates less space in the thoracic cavity 42 6. = low pressure = air rushes in 5. = high pressure = air rushes out PRACTICE QUESTIONS 43 QUESTION 1 A patient is experiencing a blockage in their mitral valve. Which structure is likely experiencing decreased blood flow as a result? A) The Pulmonary Arteries B) The Right Coronary Artery C) The Pulmonary Veins D) The Left Ventricle 44 QUESTION 1 A patient is experiencing a blockage in their mitral valve. Which structure is likely experiencing decreased blood flow as a result? A) The Pulmonary Arteries B) The Right Coronary Artery Remember the pathway of blood flow C) The Pulmonary Veins through the heart and valves! D) The Left Ventricle 45 QUESTION 2 What can the phenomenon of referred pain be attributed to? A) Direct nerve damage to the cardiac plexus B) Inflammation of the pericardium due to infection of the heart C) Increased blood pressure in the coronary arteries D) Shared nerve pathways between the heart and other structures 46 QUESTION 2 What can the phenomenon of referred pain be attributed to? A) Direct nerve damage to the cardiac plexus B) Inflammation of the pericardium due to infection of the heart C) Increased blood pressure in the coronary arteries D) Shared nerve pathways between the heart and other structures 47  48 Referred pain. Dr.S.Venkatesan MD. (n.d.). https://drsvenkatesan.com/tag/referred-pain/ QUESTION 3 Which of the following is NOT a component of the coronary circulation? A) Sinoatrial Nodal Artery B) Left Pulmonary Artery C) Right Marginal Artery D) Middle Cardiac Vein 49 QUESTION 3 Which of the following is NOT a component of the coronary circulation? A) Sinoatrial Nodal Artery B) Left Pulmonary Artery C) Right Marginal Artery The pulmonary arteries supply blood to the lungs and not to the heart! D) Middle Cardiac Vein 50  QUESTION 4 During cardiac surgery, a surgeon must avoid damaging the phrenic and vagus nerves. If the phrenic nerve is accidentally damaged on the left side, which of the following symptoms is most likely to occur? A) Loss of parasympathetic innervation to the heart B) Impaired sensory perception of the diaphragm C) Vocal cord paralysis on the left side 51 D) Reduced venous return from the middle cardiac vein  QUESTION 4 During cardiac surgery, a surgeon must avoid damaging the phrenic and vagus nerves. If the phrenic nerve is accidentally damaged on the left side, which of the following symptoms is most likely to occur? A) Loss of parasympathetic innervation to the heart B) Impaired sensory perception of the diaphragm Recall: the phrenic nerve carries sensory information to the C) Vocal cord paralysis on the left side diaphragm 52 D) Reduced venous return from the middle cardiac vein QUESTION 5 A patient sustains a fracture to a rib that articulates with the sternum and vertebra at T8. Which type of rib is this? A) True Rib B) False Rib C) Floating Rib D) Accessory Rib 53 QUESTION 5 A patient sustains a fracture to a rib that articulates with the sternum and vertebra at T8. Which type of rib is this? A) True Rib B) False Rib Recall: Ribs 8-10 are false because they connect to the sternum indirectly via the costal cartilage of the rib above C) Floating Rib D) Accessory Rib 54 QUESTION 6 A surgeon notes a tumour compressing the azygous vein and thoracic duct. In which part of the mediastinum is the tumour located? A) Superior Mediastinum B) Anterior Mediastinum C) Middle Mediastinum 55 D) Posterior Mediastinum QUESTION 6 A surgeon notes a tumour compressing the azygous vein and thoracic duct. In which part of the mediastinum is the tumour located? A) Superior Mediastinum Recall: DATES mnemonic The azygous vein and thoracic duct are located in the posterior mediastinum B) Anterior Mediastinum D. escending aorta A. zygous vein T. horacic duct C) Middle Mediastinum E. sophagus S. ympathetic trunk 56 D) Posterior Mediastinum QUESTION 7 An individual has an issue executing the end phase of swallowing AND singing/ speaking with a low-pitch. which of these muscle(s) are likely affected? A) Cricothyroid muscle B) Suprahyoid muscles C) Thyroarytenoid muscle D) Infrahyoid muscles 57 QUESTION 7 An individual has an issue executing the end phase of swallowing AND singing/ speaking with a low-pitch. which of these muscle(s) are likely affected? A) Cricothyroid muscle Key Info: Considering the function of swallowing AND pitch change B) Suprahyoid muscles This would involve the movement of the hyoid bone (not just the muscles that move C) Thyroarytenoid muscle vocal folds) = Infrahyoid muscles impacted D) Infrahyoid muscles 58 QUESTION 8 What would be the immediate consequence of a pneumothorax? (hole in the parietal plura) A) Liquid in intrapleural space B) Blood in the pleural cavity C) Unilateral lung collapse D) Bilateral lung collapse 59 QUESTION 8 What would be the immediate consequence of a pneumothorax? (hole in the parietal plura) Key Info: A) Liquid in intrapleural space If atmospheric air enters the intrapleural space this will eliminate the negative pressure B) Blood in the pleural cavity keeping it open The air rushing in will cause a collapse of the lung only on the C) Unilateral lung collapse side the puncture occurred The pleurae are not connected D) Bilateral lung collapse 60 QUESTION 9 If someone were to aspirate on their food (food> lungs) which lung would be more likely to be affected? A) Right Lung B) Left lung 61 QUESTION 9 If someone were to aspirate on their food (food> lungs) which lung would be more likely to be affected? Key Info: Because of the heart A) Right Lung (cardiac notch) the left lung bronchi are more horizontal and longer B) Left lung The right lung does not have to accommodate the heart, the bronchi are shorter wider and more vertical 62 QUESTION 10 Which cranial bone is coloured in PURPLE in this image? A) Sphenoid ? B) Ethmoid C) Maxilla D) Frontal 63 QUESTION 10 Which cranial bone is coloured in PURPLE in this image? A) Sphenoid ? B) Ethmoid C) Maxilla BONUS: What are the 3 D) Frontal key structures that the ethmoid 64 bone creates? CP, SNC, INC