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184 Cards in this Set
- Front
- Back
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Understand the structural components and articulations of the bony thorax.
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"12 vertebrae.
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Describe the organization of the parietal layer of pleura.
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"Lies along cervical, costal, diaphragmatic and mediastinal planes.
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NA for External Intercostals (nerve, action)
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"N: Intercostal Nerves
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NA for Internal Intercostals
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"N: Intercostal Nerves
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NA for Innermost Intercostals
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"Intercostal Nerves
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NA for Transversus Thoracis
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"Intercostal nerves
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NA for External Oblique
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"N: Thoracoabdominal nerves and subcostal nerve
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NA for Internal Oblique
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"N: Thoracoabdominal nerves and first lumbar nerves
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NA for Rectus Abdominis
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"N: Thoracoabdominal nerves
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NA for Transversus Abdominis
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"N: Thoracoabdominal nerves and first lumbar nerves
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Describe the organization of the visceral layer of pleura.
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"Located on actual organ, usually not removable
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Name the recesses of the thorax and their purpose.
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"Costodiaphragmatic - on diaphragm surface.
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Differentiate between aspiration of solid and liquid substances.
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"Differences happen because of angle and width of the birfucation of the trachea.
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Discuss the clinical consequences of an open pneumothorax.
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Open area in the body wall. Trachea deviates.
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Discuss the clinical consequences of a closed pneumothorax.
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A flap is on the body wall and closes when trying to send pressure out. This causes an increase in pressure in the mediastinum, compressing the vena cava and preventing blood flow return to the heart, causing cyanosis.
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Describe the functional organization of a bronchopulmonary segment
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"Contains a central core of bronchial tree and matching artery which continue segmenting inside the segment.
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Describe lymphatic drainage of lungs.
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"There are superficial and deep lymphatic vessels in lung tissue.
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Describe the primary mechanical method to increase thoracic volume during respiration
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Primary - diaphragm - 75%. Increases thoracic cavity volume because of contract, while decreases pressure internally which will allow air to flow in.
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Describe the secondary mechanical method to increase thoracic volume during respiration
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Intercostal muscles - 25% - will pull transversely (pump motion on ribs), anterior/posteriorly (bucket), vertically. Increases thoracic cavity volume, decreases pressure.
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Describe other mechanical methods to increase thoracic volume other than the diaphragm or intercostal muscles.
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"Erector spinae
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Identify the heart borders.
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"Right side - superior vena cava, right atrium
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Describe the coverings of the heart.
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Outside to inside - fibrous pericardium, parietal pericardium, visceral pericardium. Fibrous is attached to diaphragm.
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Describe the location of the cardiac sinuses.
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"Transverse sinus - separates inflow from outflow from the heart.
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Describe the clinical condition of cardiac tamponade and the anatomical basis for the life threatening consequences
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"Arterial hemorrhage causes cyanosis because of increased thoracic pressure clamping off venous return.
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Explain the blood supply to components of the conduction system.
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"AV node is supplied by the AV nodal branch which comes off of whatever dominant artery supplies the posterior inter ventricular artery (most likely right)
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Describe the venous drainage of the heart.
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"a.
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b.
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Middle cardiac vein with posterior interventricular artery into coronary sinus
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c.
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Anterior cardiac veins, running perpendicular to GCV, dump directly into right atrium
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d.
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Small cardiac vein accompanies right marginal and then right coronary artery towards coronary sinus
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e.
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Oblique vein – joins great cardiac vein to form coronary sinus
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Describe the major components of the conduction system of the heart.
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"a.
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i.
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Forces atria to work together
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ii.
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P portion of wave of ECG
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b.
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AV node – found between fossa ovalis and annulus fibrosus (atrioventricular orifice)
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i.
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Bundle of his
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ii.
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Papillary muscles in the ventricles (supplied by the bundle branches off of the bundle of his) - Lub noise
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iii.
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Sends electrical activity down towards papillary muscles, activates QRS wave
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Contrast the structure of the AV heart valves and the semilunar valves.
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"a.
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i.
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Leaflets with chorda tendinae and papillary muscles attached
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ii.
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Chorda tendinae are fixed structures and papillary muscles stop the leaflets from entering the atria.
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iii.
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Decreased pressure involved, increase in their diameter
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iv.
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Annulus fibrosis anchor the leaflets
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v.
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Each leaflet attaches to papillary muscles
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vi.
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Closed during systole
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b.
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Semilunar valves between ventricles and their eventual tubes
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i.
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Cusps, sinuses, nodes. Aortic sinuses have openings for coronary arteries
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ii.
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Closed during diastole
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Describe the timing of the opening and closing of AV and semilunar valves with systole and diastole.
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"a.
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b.
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Semilunar opens during systole and closes during diastole
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Describe the production of heart sound and contrast the differences between 1st and 2nd heart sounds to the pressure in the chambers
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"a.
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i.
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Ventricle will be high
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ii.
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Atria will be low
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b.
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2nd heart sounds – dub – closure of semilunar valves – diastole
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i.
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Ventricle will be low
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ii.
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Atria will be high
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Identify the four acquired defects, what part of the cardiac cycle they would be heard, and where you would hear the noise.
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"a.
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i.
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Left atrium to ventricle. During systole, ventricle contracts and blood flows out through the aorta and the atrium.
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ii.
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Left 3rd ICS, Left 5th ICS
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iii.
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Lub-shh-dub
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b.
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Mitral stenosis – bicuspid valve
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i.
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Flow issue from left atrium to ventricle
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ii.
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Late diastole
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iii.
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Slowly empties, contraction causes huge amount to go through
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iv.
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Hear at 5th ICS
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v.
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Shhhhhh-dub
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c.
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Aortic stenosis – semilunar valve
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i.
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Flow issue from left ventricle to aorta
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ii.
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Right 2nd ICS
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iii.
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Lub-shhhh-dub
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d.
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Aortic regurgitation (incompetence) – semilunar valve
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i.
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Flow issue from aorta to left ventricle
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ii.
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Left 3rd/4th intercostal space
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iii.
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Lub-dub-shhhhhh
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Identify the common congenital cardiac defects and the type of murmur they produce
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"a.
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i.
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Lub-shhhh-dub
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ii.
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Left 4th ICS
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b.
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Pulmonary stenosis/tetralogy of fallot
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i.
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Systolic murmur in left 2nd intercostal space
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ii.
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Lub-shhhh-dub
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c.
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Patent ductus ateriosus
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i.
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Left 2nd ICS
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ii.
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Murmur heard throughout cycle
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iii.
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Train driving through tunnel (tunnel murmur)
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What is the difference between Camper's and Scarpa's fascia? Where is it located?
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"Camper's - outside fatty layer of fascia in abdomen
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Identify the inguinal ligament. What is it made from, where does it connect?
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"Made up of external abdominal oblique aponeurosis. (inferior border of this muscle)
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Where is the lacunar ligament, what does it connect to, what is it made up of?
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"Connects inguinal ligament to the pectineal ligament near the point where they both insert on the pubic tubercle.
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Where is the pectineal ligament, what is it made up of?
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"Extension of lacunar ligament
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Describe the structure of the superficial inguinal ring.
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"Triangle aperture in the aponeurosis of the external abdominal oblique.
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Where are the neurovascular bundles found in the abdominal muscles?
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In between transversus abdomens and internal abdominal oblique.
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Where attach?"
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"Lateral 2/3
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Describe the direction of the inguinal canal.
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"Oblique
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How does this differ from IAO?"
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"Lateral 1/3
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What is conjoint tendon made up of, where is it located?
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Fibers from internal abdominal oblique originating from the lateral 2/3 of the inguinal ligament, as well as fibers from the transverses abdominis originating from the lateral 1/3 of the inguinal ligament, going to the pubic crest.
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What is significant about the transveralis fascia?
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Forms the deep inguinal ring.
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What is the floor of the superficial inguinal ring?
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Inguinal ligament
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What is the roof of the superficial inguinal ring?
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Intercrural fibers.
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Describe the coverings of the spermatic cord/testicle
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"External spermatic fascia - external abdominal oblique
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Describe the layers of the testicle.
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"External spermatic fascia (EAO), cremaster muscle (IAO), internal spermatic fascia (TF)
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What are the contents of the spermatic cord?
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"Papiniform plexus of veins which surround testicular artery.
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What nerve innervates the anterior portion of the scrotum?
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"Goes through superficial ring but not in spermatic cord
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Track movement of sperm
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Seminiferous tubules, epididymis, vas deferens
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Draw a picture of the anterior abdominal wall with the folds and fossae.
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Medial inguinal fossa (Hesselbach triangle) is important why? Borders?
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"Lateral border of rectus abdomens
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Indirect hernias occur where?
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Occur through the deep inguinal ring (transveralis fascia) and follow with the contents of the spermatic cord.
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Understand the structural components and articulations of the bony thorax.
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"12 vertebrae.
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Sternum (manubrium
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body
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Ribs (Vertebrosternal 1-7
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Vertebrochondral 8-10
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Apertures (superior
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inferior)
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Landmarks (midclavicular
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midaxillary
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Describe the organization of the parietal layer of pleura.
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"Lies along cervical
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Found at ribs 8
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10
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NA for External Intercostals (nerve
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action)
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NA for Internal Intercostals
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"N: Intercostal Nerves
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NA for Innermost Intercostals
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"Intercostal Nerves
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NA for Transversus Thoracis
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"Intercostal nerves
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NA for External Oblique
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"N: Thoracoabdominal nerves and subcostal nerve
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A: Compress and support abdominal viscera
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flex and rotate trunk"
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NA for Internal Oblique
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"N: Thoracoabdominal nerves and first lumbar nerves
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A: Compress and support abdominal viscera
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flex and rotate trunk"
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NA for Rectus Abdominis
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"N: Thoracoabdominal nerves
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A: Flex trunk
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compress abdominal viscera"
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NA for Transversus Abdominis
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"N: Thoracoabdominal nerves and first lumbar nerves
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Describe the organization of the visceral layer of pleura.
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"Located on actual organ
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Therefore
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at a neutral position
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Name the recesses of the thorax and their purpose.
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"Costodiaphragmatic - on diaphragm surface.
|
|
Differentiate between aspiration of solid and liquid substances.
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"Differences happen because of angle and width of the birfucation of the trachea.
|
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Liquid substances go down both equally
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because all they want is to get as part inferior as possible (gravity longs!)"
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Discuss the clinical consequences of an open pneumothorax.
|
Open area in the body wall. Trachea deviates.
|
|
Discuss the clinical consequences of a closed pneumothorax.
|
A flap is on the body wall and closes when trying to send pressure out. This causes an increase in pressure in the mediastinum
|
|
Describe the functional organization of a bronchopulmonary segment
|
"Contains a central core of bronchial tree and matching artery which continue segmenting inside the segment.
|
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Describe lymphatic drainage of lungs.
|
"There are superficial and deep lymphatic vessels in lung tissue.
|
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These drain into pulmonary lymph nodes
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which drain to the hills lymph nodes (bronchopulmonary)
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Describe the primary mechanical method to increase thoracic volume during respiration
|
Primary - diaphragm - 75%. Increases thoracic cavity volume because of contract
|
|
Describe the secondary mechanical method to increase thoracic volume during respiration
|
Intercostal muscles - 25% - will pull transversely (pump motion on ribs)
|
|
Describe other mechanical methods to increase thoracic volume other than the diaphragm or intercostal muscles.
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"Erector spinae
|
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Accessory muscles - scalenes
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sternomastoid
|
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Identify the heart borders.
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"Right side - superior vena cava
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Diaphragmatic - right ventricle
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portion of left ventricle (blends in with diaphragm mostly)
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Left side - aortic arch
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pulmonary trunk
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Describe the coverings of the heart.
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Outside to inside - fibrous pericardium
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Describe the location of the cardiac sinuses.
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"Transverse sinus - separates inflow from outflow from the heart.
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Oblique sinus - Wide
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slit-like recess posterior to the heart that extends posterior to the left atrium. Cover pulmonary veins and IVC as it enters the fibrous sac and their respective atria."
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Describe the clinical condition of cardiac tamponade and the anatomical basis for the life threatening consequences
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"Arterial hemorrhage causes cyanosis because of increased thoracic pressure clamping off venous return.
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Also could be an infection of the pericardial sac
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which causes a general stretching of the heart and accumulation of fluid.
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Explain the blood supply to components of the conduction system.
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"AV node is supplied by the AV nodal branch which comes off of whatever dominant artery supplies the posterior inter ventricular artery (most likely right)
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Describe the venous drainage of the heart.
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"a. Great cardiac vein with anterior interventricular artery and then the left circumflex
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c. Anterior cardiac veins
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running perpendicular to GCV
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Describe the major components of the conduction system of the heart.
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a." SA node – found between crista terminalis and superior vena cava
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iii. Sends electrical activity down towards papillary muscles
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activates QRS wave
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Contrast the structure of the AV heart valves and the semilunar valves.
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a." Tricuspid and bicuspid valve between atria and ventricles
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iii. Decreased pressure involved
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increase in their diameter
|
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i. Cusps
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sinuses
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Describe the timing of the opening and closing of AV and semilunar valves with systole and diastole.
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a." AV opens during diastole and closes during systole
|
|
Describe the production of heart sound and contrast the differences between 1st and 2nd heart sounds to the pressure in the chambers
|
a." 1st heart sounds – lub –closure of AV valves – systole
|
|
Identify the four acquired defects
|
what part of the cardiac cycle they would be heard
|
|
i. Left atrium to ventricle. During systole
|
ventricle contracts and blood flows out through the aorta and the atrium.
|
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ii. Left 3rd ICS
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Left 5th ICS
|
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iii. Slowly empties
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contraction causes huge amount to go through
|
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Identify the common congenital cardiac defects and the type of murmur they produce
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a." Interventricular septal defect (VSD) – systolic murmur on left side of sternum
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What is the difference between Camper's and Scarpa's fascia? Where is it located?
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Camper's - outside fatty layer of fascia in abdomen"
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Scarpa's - inside membranous layer of fascia
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abdomen"
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Identify the inguinal ligament. What is it made from
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where does it connect?
|
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Where is the lacunar ligament
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what does it connect to
|
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Where is the pectineal ligament
|
what is it made up of?
|
|
Describe the structure of the superficial inguinal ring.
|
Triangle aperture in the aponeurosis of the external abdominal oblique. "
|
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Where are the neurovascular bundles found in the abdominal muscles?
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In between transversus abdomens and internal abdominal oblique.
|
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Where attach?
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""Lateral 2/3"
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Describe the direction of the inguinal canal.
|
"Oblique
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How does this differ from IAO?
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""Lateral 1/3"
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What is conjoint tendon made up of
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where is it located?
|
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What is significant about the transveralis fascia?
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Forms the deep inguinal ring.
|
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What is the floor of the superficial inguinal ring?
|
Inguinal ligament
|
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What is the roof of the superficial inguinal ring?
|
Intercrural fibers.
|
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Describe the coverings of the spermatic cord/testicle
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"External spermatic fascia - external abdominal oblique
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Describe the layers of the testicle.
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"External spermatic fascia (EAO)
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Then have tunica vaginalis parietal layer
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tunica vaginalis visceral layer. These two only on test.
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What are the contents of the spermatic cord?
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"Papiniform plexus of veins which surround testicular artery.
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What nerve innervates the anterior portion of the scrotum?
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Goes through superficial ring but not in spermatic cord"
|
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Track movement of sperm
|
Seminiferous tubules
|
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Draw a picture of the anterior abdominal wall with the folds and fossae.
|
|
|
Medial inguinal fossa (Hesselbach triangle) is important why? Borders?
|
"Lateral border of rectus abdomens
|
|
Indirect hernias occur where?
|
Occur through the deep inguinal ring (transveralis fascia) and follow with the contents of the spermatic cord.
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