Thorax

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Anonymous
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7919
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Thorax
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2010-02-23 23:10:00
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SGU anatomy
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  1. What are the 2 major parts of a typical vertebrae?
    body and arch
  2. What is the intervertebral foramen?
    opening b/w adjacent vertebrae allowing the passage of spinal nn
  3. How do the ribs articulate with the thoracic vertebrae?
    head articulates with bodies of contiguous while tubercule articulates with the transverse process of same #
  4. What is the name of the space b/w 2 adjacent ribs?
    intercostal space; it's palpable
  5. What do the costal cartilages of the last sternal and all asternal ribs form?
    costal arch
  6. What caps the xiphoid process?
    xiphoid cartilage
  7. How is inspiration accomplished?
    increase size of the thorax, thereby decreasing the pressure so that air rushes in
  8. What is the main respiratory muscle?
    diaphragm
  9. Name the 2 muscles extending between adjacent ribs
    internal and external intercostal mm
  10. What is the opening in to the thorax?
    thoracic inlet
  11. What divides the thorax in to 2 spaces?
    mediastinum
  12. Where is the heart located in the thoracic cavity?
    2/3 - 5/6 intercostal space in the bottom of the 2/3 of the cavity
  13. Which side of the aorta does the thoracic esophagus normally cross?
    Right side of aortic arch
  14. What covers the trachea in the cranial neck?
    strap mm....sternohyoideus and sternothyroideus
  15. What is the opening b/w the lobes of the lung where the surgeon's pericardium comes in contact with the thoracic wall?
    cardiac notch
  16. What do radiologists call the pulmonary trunk?
    "main pulmonary artery/segment" = MPA
  17. What is the mediastinum?
    space/wall that divides the thoracic cavity in to 2 pleural cavities
  18. List the parts of the pericardium?
    fibrous, serous pericardium (parietal and visceral parts)
  19. What is located in the pericardial cavity?
    serous fluid, only scant amount
  20. Which side of the heart is pulmonary circulation?
    right
  21. The left side of the heart is what circulation and why?
    systemic circulation b/c blood is pumped to heart and entire body
  22. What side of the heart is the right ventricle on? Left?
    right ventricle begins on right side and wraps around the left front side of the heart (it's cranial), the left ventricle is caudal
  23. What is the vestigial, fetal connection from the pulmonary trunk to the aorta?
    Ligamentum arteriosum
  24. What is the most caudoventral part oft he heart? Right or left side?
    apex, left
  25. What is the adult remnant of the fetal foramen ovale?
    Fossa ovale
  26. What separates the atria?
    interatrial septum
  27. Name the wall separating the 2 ventricles
    interventricular septum
  28. Which ventricle has a thinner wall and why?
    right ventricle b/c it's only for pulmonary circ. while systemic side has to pump blood to entire body/heart
  29. Name the 3 layers of the heart
    endocardium, myocardium, epicardium
  30. What are the valves in the heart?
    right and left AV; aortic and pulmpnary valves (semilunar)
  31. What is the function of the semilunar valves?
    prevent backflow in to atria during ventricular contraction
  32. What are the 3 parts of the conduction system of the heart?
    SA node (=pacemaker), AV node and atrioventricular branches
  33. What is the term for ventricular contraction and relaxation
    • contraction= ventricular systole
    • relaxation =ventricular diastole
  34. How do diastole and systole relate to heart sounds?
    • systole b/w the 1st and 2nd sounds
    • diastole b/w the 2nd and 1st heart sounds
  35. What causes closure and opening of the AV and semilunar valves?
    • opening= AV, diastole; semilunar, systole
    • closing= AV, systole; semilunar, diastole
  36. What does the recoil of the elastic aorta at the end of systole cause?
    Blood is pushed to body and back towards the heart, closing the aortic valve and filling coronary arteries
  37. What arteries travel up the neck to supply head and face?
    common carotid aa
  38. What artery travels on the floor of the thorax?
    internal thoracic a
  39. What vessels and nerves travel in the intercostal spaces caudal to the ribs?
    intercostal a, v and n.
  40. What 3 fetal structures bypass lungs and liver?
    ductus arteriousus, ductus venosous and formen ovale
  41. Where does the ductus artereriousus shunt most of the blood in the right ventricle from the pulmonary to the systemic circ?
    from the pulmonary trunk and aorta (2 aa)
  42. What is the adult remnant of:
    ductus arteriousus?
    foramen ovale?
    umbilical arteries?
    umbilical vein?
    • ligamentum arteriosum
    • oval fossa/fossa ovale
    • round ligaments of urinary bladder
    • round ligament of liver
  43. What is the large lymphatic channel draining the caudal animal?
    thoracic duct
  44. What lymph nodes are near the bifurcaton of the trachea?
    trachiobronchial lymph nodes
  45. What is the lymphatic structure in the cranial medastinum?
    cranial mediastinal lymph node
  46. What is the large nerve crossing heart, into diaphragm?
    phrenic n
  47. What is the branch of the vagus that returns to the neck? Where is it located in the thorax on the left and right sides?
    recurrent laryngeal n; around arch of the aorta on the left, around right subclavian artery on right
  48. What supplies cutaneous innervation to the top of the thoracic and abd walls?
    dorsal and ventral branches of the spinal nn in thoracic and lumbar regions
  49. What is the parasympathetic innervation to the thorax?
    vagus n
  50. What is the 2 series of connected ganglia lying on either side of the bodies of the thoracolumbar vertebrae and longus colli m?
    sympathetic trunk
  51. Which way do the motor fibers travel in to the vagosympathetic trunk?
    sympathetic go twd the head, vagus go away from the head
  52. what is a serosa?
    thin, continuous membrane lining a closed cavity and covering the organs in it
  53. What are the serous membranes of the pericardial cavity, thorax, abd, spermatic cord called respectively?
    • pericardium
    • pluera
    • vaginal tunics
  54. What serosa covers the walls of a cavity?
    parietal pleura
  55. what serosa covers an organ?
    visceral serosa
  56. What connects parietal and visceral or visceral with visceral serosa?
    connecting serosa
  57. what is the serosa lining the thoracic cavity?
    pleura
  58. Are the lungs located in the pleural cavities?
    no, just a scant amount of serous fluid there
  59. What is the line of pleural reflection?
    point of costal pleura reflects on to diaphragm
  60. What is the plura cupula?
    cranial pleural sac extending out through the thoracic inlet
  61. What does R or L marker on diff film view indicate?
    Lateral trunk
    DV/VD
    1 Limb
    • r of left lateral= side on cassette
    • VD/DV- sides of animal
    • limb in film
  62. How should DV/VD and lateral films be placed on viewing screen?
    • DV/VD- right side to your left in both
    • lateral- cranial side to left
  63. How are thoracic films evaluated for rotation?
    • Lateral: costochondral junctions and shoulder joint- same level
    • VD/DV- sternum and spinal column superimposed
  64. What structure is used to tell an expiratory from an inspiratory in film?
    position of diaphragm
  65. What is the cranial limit of the abd?
    diaphragm
  66. Can you visualize the sides of the diaphragm?
    cranial- yes, as contrasted with air in lungs, caudal no b/c water density is again liver/stomach
  67. What is the junction b/w to the 2 crura?
    Intercrural cleft
  68. What mediastinal structures are normally seen in the lateral view?
    trachea, aorta, heart in pericardium, caudal vena cava
  69. What mediastinal structures can be seen in VD view?
    heart in pericardium, caudal vena cava and left edge of descending aorta
  70. Is the esophagus usually visible on radiograph?
    no, only if it has swallowed air or contrast material
  71. What is the thick dark line in lateral radiograph of the cranial mediastinum?
    trachea
  72. What is the dark oval over the base of the heart in a lateral radiograph?
    tracheal bifurcation, "carina"
  73. The trachea normally makes a ? angle to the vertebral column in a lateral view?
    15 degree
  74. Name a dilation of caudal cervical and thoracic esophagus
    megaesophagus
  75. Which was does a megaesophagus displace the trachea and heart?
    ventral
  76. What is the line caused by the air in a megaesophagus and air in tracheal contrasting the adj walls of the 2 structures?
    tracheal-esophageal stripe
  77. What is the name for the VD appearance of a megaesophagus as it passes caudally to diaphragm?
    esophageal cone
  78. What are the 2 continuations of the trachea in the lungs?
    primary bronchi (main stem bronchi)
  79. Which is the most ventral aka dependent of the bronchi?
    right middle bronchus
  80. What are the normal longitudinal water densities in the lungs?
    pulmonary vessels, not bronchi
  81. What is a lobar bronchus and assoc lobar pulmonary artery and vein?
    Pulmonary triad?
  82. What is the normal relative size of an artery and vein or a pulmonary triad?
    about the same size
  83. Veins are always _____ and ______ (________) to the arteries of pulmonary triads in the lateral and DV views respectively
    Ventral and cranial (medial)
  84. In the DV/VD films, what's the position of the lobar arteries to the caudal lungs?
    4 & 8 o'clock positions
  85. What conditions will result in visible lung fissures (lobular pattern)
    collapsed lungs or pleural fluid/thickenings
  86. How many left lung lobes are there anatomically and radiographically?
    anatomically, 2... radiographically, 3
  87. The cranial lung of ______ lobe is seen in front of the cranial lobe of the ______ lung on a lateral view as a separate round air filled structure
    left, right
  88. What is located in the normal pleural space?
    only a little fluid
  89. What is the cranial extent of the pleural cavity?
    pleural cupula
  90. The pleural cupula is normally extending cranially past the ____ ______
    first rib
  91. What's located b/w vessels of the lungs?
    interstitium, parenchyma
  92. For what should the parenchyma of the lungs be evaluated?
    increased or decreased radio opacity/radiolucency
  93. Why don't you see the heart chambers in survey radiographs?
    heart is muscle, chambers are filled with blood so both are water densities
  94. Since you can't see the heart chambers in survey rads, how do you evaluate it?
    borders/silhouette
  95. What are the lateral radiographic locations of the diff compartments of the heart below:
    right ventricle
    descending aorta
    left ventricle
    • cranial edge (lower part)
    • dorsal thorax
    • caudal
  96. what is usually all that can be seen of the cranial vena cava in the lateral projection?
    ventral edge
  97. Tell if the structures below are seen and where they're located on DV/VD
    caudal vena cava
    right ventricle
    pulmonary trunk
    left ventricle
    apex
    descending aorta
    • yes; right side heart to diaphragm
    • yes, right side of heart
    • yes, cranial/left side of heart
    • yes, caudal half
    • yes, pointing to the left
    • yes, left lateral edge
  98. On what side of a DV is the caudal vena cava? VD view?
    right, Right
  99. What part of the DV silhouette does the right ventricle make up?
    right side from apex around cranial side to left cranial side
  100. The left atrium is over the ____ heart directly above the right ventricle. It's located just caudal to the _______
    caudal, tracheal bifurcation
  101. On what side of the heart is the apex located?
    left
  102. How does the descending aorta appear on a DV view?
    line to the left, left edge of aorta
  103. What is the normal amt of sternal contact in the heart?
    3 sternabrae
  104. What is found on the VD/DV and lateral views at each time area according to clock face analogy?
    2-6 o' clock
    5 o'clock
    6-9 o'clock?
    • left ventricle
    • apex
    • right ventricle
  105. What is found on the VD/DV at the 1-2 o'clock faced analogy?
    MPA, pulmonary trunk
  106. List some problems needing thoracic rads?
    cough, heart problems, abnormal lung sounds, dyspnea
  107. What is a radiograph indication of a diaphragmatic hernia?
    entire diaphragm can't be seen
  108. What are the mediastinal lymph nodes visible?
    when enlarged ie: lymphosarcoma in cats
  109. What is moving of the mediastinum to right or left?
    mediastinal shift
  110. What is the common term for bowing of the principle bronchi in VD/DV views?
    "cowboy legs"
  111. Fluid or air in the pleural space will eliminate the ______ pressure of the space and cause the lungs to collapse away from the chest wall
    negative
  112. What is excess fluid in the pleural space?
    pleural effusion
  113. What is the main radiographic sign of pleural effusion?
    separation of lungs/body wall allowing visualization of lung borders and fissure lines
  114. What are the 4 basic opaque long patterns and what characterizes them?
    interstitial: fuzzy, alveolar: air bronchograms, peribrochiolar: "donuts and tram lines" and vascular: increased, decreased or normal
  115. What is the #1 cause of an interstitial patter?
    expiratory film (normal)
  116. Give 2 signs of a peribronchiolar problem?
    • perivascual cuffing
    • - donuts and tram lines
  117. What should be the first thing that comes to mind when enlarged arteries of the lungs are seen?
    heartworm disease
  118. What is fluid in the lungs?
    pulmonary edema
  119. The increased opacity on rads of pulmonary edema can be either a _____ or _____ pattern or both depending on where fluid is
    alveolar, interstitial
  120. What is the mechanism of cardiogenic pulmonary edema?
    left heart failure backing up in to lungs
  121. Right ventricular enlargement is seen as _____ bulging on the lateral view, this will cause the heart to have more ____ _____
    cranial, sternal contact
  122. On VD view, right ventricular enlargement will bulge to the right, how is this shape often referred to?
    backwards, reverse "D"
  123. Give a cause of right ventricular enlargement?
    pulmonic stenosis, heartworm disease
  124. What are the common radiographic findings of right ventricular enlargement on lateral projection?
    increased sternal contact
  125. What is a common finding of right ventricle enlargement on the DV rad?
    reversed "D" sign
  126. What clincal condition should you think of if you see tortuous dilated pulmonary arteries?
    heartworm disease
  127. What are the 3 bumps seen on a canine DV if dog has PDA?
    MPA, left auricle and aorta
  128. What is a possible effect on the main stem bronchi in left atrial enlargement in a VD film?
    spread out aka "cowboy legs"
  129. LIst 2 most common finding of left atrial enlargement in DV
    Auricle projects as 2-3 o'clock position
  130. What is the reflex arch in a panniculous response?
    prick trunk, signal sent over thoracic and lumbar spinal nn to spinal cord, up to lateral thoracic n and out to cutaneous trunci m
  131. What is used clinically to evaluate level of thoracic cord damage?
    panniculous response
  132. If the spinal cord damage is the level of T10, where will the panniculous response NOT elicit a response?
    Level of T12
  133. What is the surgical opening of the thoracic cavity?
    thoracotomy
  134. How is the vacuum of the pleural cavity regained when closing the thoracic wall?
    Maximally inflate lungs during last part of closure
  135. Where is the intercostal space incised to open thorax and why?
    In center to avoid the vessels caudal to the ribs
  136. What vessels are of concern in midsternal thoracotomies?
    Internal thoracic a. and v.
  137. What is the term for segmental fractures of a # of sequential ribs causing the chest wall to move in during inspiration?
    flail chest
  138. What is aspiration pneumonia?
    swallowing foreign material in to lungs and subsequent pneumonia
  139. Which lobe is the most common site for aspiration pneumonia? and the 2nd?
    right middle b/c its' the most dependent, then cranial right lung lobe
  140. To which lung lobe will a light, inhaled foreign body which moves by air flow and not gravity, tend to go?
    straight, so to right caudal
  141. What is chylothorax?
    lymph in pleural cavity usually from a ruptured lymphatic vessel ie: thoracic duct
  142. What re the 3 common locations of clinical blockage of the esophagus in the thorax?
    thoracic inlet, base of heart and esophageal hiatus of diaphragm (start of esophagus)
  143. Name a dilation fo the caudal cervical and thoracic esophagus
    megaesophagus
  144. What is air in the mediastinum?
    pneumomediastinum
  145. What is the surgeon's pericardium?
    sac opened to access epicardial covered heart
  146. What is compression of the heart due to collection of blood or fluid in the pericardial sac?
    cardiac tamponade
  147. What is done with the pericardium during sx?
    left unsutured/loosely approximated to avoid cardiac tamponade
  148. Where does blood back up int o when the right heart is damaged, what are the clinical signs?
    pulmonic so blood backs up in to abdomen and there is a jugular pulse
  149. What is ascite? What causes it?
    Fluid in abd, caused by right heart failure
  150. Where does blood back up in left heart failure?
    blood backs up in to the lungs
  151. What are cardiomyopathies?
    progressive cardiac diseases
  152. What is inflammation of the heart muscle?
    myocarditis
  153. What parasite may residence in the right ventricle of the dog's heart?
    heartworms aka dirofilariasis, and adult roundworms aka nematodes
  154. What is normal blood pressure in a dog?
    120/80
  155. What structures constrict the esophagus in a persistent right aortic arch?
    aorta, ligamentum arteriosum, pulmonary trunk and base of heart
  156. Define PRAA?
    Right instead of left 4th aortic arch becomes aorta resulting in entrapment of esophagus
  157. What is a clinical sign of a persistent right aortic arch?
    regurgitates undigested food when weaned to solid food, large particles can't get past constriction
  158. The constriction due to persistent right aortic arch causes food to be stopped and the esophagus to balloon cranial to the _____ ______
    base of heart
  159. How is PRAA treated?
    ligamentum arteriosum is surgically isolated, ligaged 2x and cut b/w 2 ligatures
  160. What is the difference b/w a congenital and a hereditary defect?
    • congenital = present at birth, can be due to hereditary or environmental causes
    • Hereditary= passed on to offspring, may or may not be present at birth
  161. What is a PDA?
    Patent ductus arteriosus, failure of fetal ductus arteriosus to close
  162. What causes a washing machine murmur and why?
    caused by PDA, continuous, thus systolic and diastolic
  163. How is a PDA treated?
    surgically tie off ends and cut b/w them if caught early
  164. LIst the developmental anomalies making up tetralogy of fallot
    pulmonic stenosis, overriding aorta, VSD, hypertrophy of right ventricle
  165. What does cyanosis mean?
    bluish discoloration of tissue due to poor oxygenation
  166. What are the 3 bumps seen on a DV views of dog with PDA?
    MPA, left auricle, and aorta
  167. OF what is a patent ductus venosus an example?
    portosystemic shunt
  168. What cause valvular murmurs?
    insufficiency or stenosis
  169. What causes a stystolic murmur?
    semilunar stenosis or insufficiency
  170. What causes a diastolic murmur?
    leaky semilunar valve aka insuffcient AV
  171. What is the clinical significance of the line of pleural reflection?
    demarcates the pleural from the peritoneal cavity
  172. What is pleurocentesis/thoracocentesis?
    sx puncture of chest wall for fluid drainage
  173. Where is thoracocentesis done?
    middle of the 7-8 intercostal space just dorsal to costochondral junction
  174. How can the pleural cupular be clinically important?
    can open the pleural cavity with an incision near the thoracic inlet
  175. What is pneumothorax or pyothorax usually bilateral in carnivores?
    mediastinum is fenestrated
  176. What is hyaline membrane disease?
    premature parturition before the lung matures w/ insufficient surfactant produced
  177. What is air/gas/pus/chyle in the pleural space?
    pneumthorax, pyothorax, chylothorax
  178. In what could a tear in the thoracic part of the trachea result?
    pneumomediastinum
  179. How can infections of the neck migrate to the thorax?
    via deep fascis to endothoracic fascia
  180. What is the normal respiratory rate in dogs? cats?
    • dogs- 20 breaths/min
    • cats- 25 breaths/min
  181. How far cranially does the dome of the diaphragm extend?
    6th intercostal space just behind olecranon /heart
  182. Where is the heart located in relationship to the intercostal spaces and the arm mm?
    b/w 2/3-5/6 intercostal space, mostly under arm mm
  183. What is a memory aide for the heart valv's point of max intensity?
    Pam 345, right AV, low 5th right
  184. What vessels should be considered when opening the thorax?
    Internal thoracic aa on the thoracic floor of thee thorax, don't cut near sternum. Intercostal vessels and nn, caudal to rib so cut in the cent of the intercostal spaces
  185. Describe cavity to enter when inserting a needle to either side of the line of pleural reflection?
    craniodorsal = thorax 1st, caudoventral= abd
  186. Where is the basal border of the lung?
    approx 1-2 inches craniodorsal to and parallel to the line of pleural reflection
  187. What are the boundaries of the auscultation triangle?
    • cranial: caudal border of triceps brachii m
    • dorsal: epaxial mm
    • caudoventral: curved line from olecranon to next to the last dorsal intercostal space
  188. In relationship to what structure is a lung biopsy performed?
    craniodorsally to the basal border of the lung
  189. How is a cardiocentesis performed?
    In to 5th ICS in to palpated heartbeat
  190. What is the location for a thoracocentesis?
    7-8th ICS at intercostal space level of right olecranon

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