the thorax Flashcards

1
Q

what is included in the thorax

A

sternum
costal cartilages
ribs
thoracic vertebrae
structures enclosed

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2
Q

how can the shape of the thorax be described

A

irregular

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3
Q

what are the two apertures of the thorax

A

the superior and inferior thoracic apertures.

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4
Q

what is the superior thoracic aperture

A

the opening at the root of the neck that is continuous with the neck

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5
Q

what is the inferior thoracic aperture

A

the opening which is closed by the diaphragm

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6
Q

what are the three compartments of the thorax

A

right and left pleural cavities and the mediastinum

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7
Q

what is found in the pleural cavities

A

the lungs

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8
Q

what is at the top of the thorax

A
  • first thoracic vertebrae
  • first rib
  • manubrium of the sternum
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9
Q

what is the jugular notch

A

the area where the trachea can be felt, and can make deviation clear, indicating any pathologies in the lungs like collapse or fluid

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10
Q

what are the pectoral girdle

A

bones which connect to the arm on each side

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11
Q

what is included in the pectoral girdle

A

clavicle and scapula

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12
Q

what is the clavicle

A

collar bone

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13
Q

what is the scapula

A

shoulder blade

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14
Q

what does the sternal angle show

A

where the second rib is

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15
Q

what is the sternal angle useful for

A

counting ribs inferiorly and laterally for chest drain insertion

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16
Q

what is effusion

A

fluid in the pneumothorax

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17
Q

where is the costochondral joint

A

the joint between the costal cartilages and the ribs

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18
Q

how many true ribs are there

A

7

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19
Q

what are the true ribs

A

1-7, as their costal cartilage links directly with the sternum

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20
Q

what are the false ribs

A

8-10

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21
Q

how many false ribs are there

A

3

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22
Q

why are they called false ribs

A

their costal cartilages are attached to the cartilage of the higher rib

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23
Q

what are the floating ribs

A

the vertebral ribs, 11 and 12, that are short and not attached to the sternum at all. instead, their costal cartilage terminates within the musculature of the lateral abdominal wall

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24
Q

what is the intercostal space

A

the space between the ribs

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25
Q

what is the intervertebral discs

A

the discs between the vertebrae

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26
Q

what is the mediastinum

A

the central portion of the thoracic cavity, surrounded by the left and right pleural sacs

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27
Q

what can the mediastinum be divided into

A

superior, anterior, middle, posterior

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28
Q

what is found in the upper portion of the superior mediastinum

A

first thoracic vertebrae

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29
Q

what is found in the lower portion of the superior mediastinum

A

sternal angle, which is the landmark for the second rib

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30
Q

what are the regions of the inferior mediastinum

A

anterior
middle
posterior

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31
Q

what is found in the anterior mediastinum

A

the fat and thymus gland

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32
Q

what is found in the middle mediastinum

A

the heart

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33
Q

what is found in the posterior mediastinum

A

the aorta and the oesophagus

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34
Q

what is the common carotid artery responsible for

A

blood supply to the head and neck

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35
Q

what are the great vessels

A
  • venae cavae
  • pulmonary trunk and its branches
  • pulmonary veins
  • aorta
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36
Q

what do the superior and inferior venae cavae do

A

drain venous blood from the head and neck and above the level of the heart, and below the level of the heart. both enter the right atrium of the heart

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37
Q

where does the pulmonary trunk exit the heart

A

the right ventricle

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38
Q

what does the internal carotid artery do

A

supply 80% of brain blood supply

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39
Q

describe the blood supply of the brain

A

80% internal carotid
20% vertebral artery

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40
Q

what does the external carotid artery supply

A

face
tongue
head external to the brain

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41
Q

what are the first main branches of the aorta

A

the coronary arteries

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42
Q

where is the brachiocephalic trunk

A

right side of the body

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43
Q

what does the brachiocephalic trunk give rise to

A

the right subclavian and the common carotid arteries

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44
Q

which blood is found in the pulmonary arteries

A

deoxygenated blood

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45
Q

what do the right and left internal jugular veins drain

A

the head and neck, including the brain down to join the right and left subclavian veins

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46
Q

what do the left and right subclavian veins drain

A

the left and upper right limbs

47
Q

what forms the brachiocephalic veins on the left and right side

A

the internal jugular and subclavians

48
Q

what does the superior vena cava drain

A

everything above the level of the heart

49
Q

what forms the superior vena cava

A

the unity of the left and right brachiocephalic veins

50
Q

what blood is found in the pulmonary veins

A

oxygenated blood

51
Q

what is the longus colli

A

a paired muscle found on the anterior vertebral column that results in contralateral contraction and both contracting results in neck flexion for bending down

52
Q

what is the largest lymphatic drainage

A

the thoracic duct

53
Q

where does the sympathetic trunk arise from

A

the first thoracic vertebrae to the second lower lumbar vetebrae

54
Q

what does the sympathetic trunk do

A

increase heart rate and breathing and take blood away from the gut

55
Q

what type of artery is the aorta

A

elastic

56
Q

what is the main artery of the body

A

the aorta

57
Q

which chamber does the aortic arch arise from

A

the left ventricle

58
Q

what is the rest and digest nerve

A

the vagus nerve

59
Q

what does the vagus nerve do

A

increase gut motility, reduce heart rate and breathing rate

60
Q

describe the hemiazygous vein

A

comes from the left lumbar ascending vein
it drains from the posterior trunk muscles and skin into the azygous

61
Q

describe the accessory hemiazygous vein

A

superior hemiazygous vein coursing through the posterior mediastinum, receives tributaries along the way

62
Q

what are the tributaries of the accessory hemiazygous vein

A

fifth, sixth, seventh and eighth posterior intercostal veins, left superior intercostal vein, and the left bronchial veins

63
Q

describe the route of the accessory hemiazygous vein

A

usually crosses the midline and terminates by draining into the azygous vein at the level of the seventh thoracic vertebrae

64
Q

describe the greater splanchnic nerve

A

a paired visceral nerve carrying autonomic fibres and sensory fibres from internal organs to the abdominal organs. all carry sympathetic fibres

65
Q

which nerves does the greater splanchnic receive

A

nerves from the fifth to the eighth vertebrae

66
Q

function of the internal thoracic vessels

A

supplies and drains the skin and muscles of the anterior aspect of the thoracic cage and the superior aspect of the abdominal wall, typical ribs, breasts, parietal pleura, sternum, pericardium and the thymys

67
Q

what is the left auricle

A

part of the left atrium

68
Q

what does the phrenic nerve innervate

A

the diaphragm

69
Q

what forms the phrenic nerve

A

cervical nerves 3-5

70
Q

what is the recurrent laryngeal nerve

A

part of the vagus nerve innervating the muscles of the larynx and sensation to the larynx, found below the vocal folds

71
Q

what is the cardiac plexus

A

this provides nerves to the heart

72
Q

describe the diaphragm

A

a musculotendinous structure that is dome shaped on either side, but is higher on the right than on the left due to the position of the liver

73
Q

where do the muscle fibres of the diaphragm arise from

A

the costal margins, converging to insert into the central tendon

74
Q

what kind of muscle is the diaphragm

A

skeletal muscle

75
Q

what supplies the diaphragm

A

the phrenic nerve

76
Q

what does the phrenic nerve contain

A

motor and senosry fibres

77
Q

what happens to the diaphragm as we inhale

A

the muscle flattens to increase capacity of the thoracic cavity

78
Q

what happens to the diaphragm when we exhale

A

the diaphragm returns to its dome shape

79
Q

describe the costodiaphragmatic recess

A

larger of the recesses found between the costal and diaphragmatic pleura of the right and left pleural cavities. provides space for the lungs to fill, but fluid can accumulate here

80
Q

how is air expelled

A

relaxation of the diaphragm coupled with the elastic recoil of the lungs

81
Q

what is the function of the ribcage

A

functions more for breathing than protection due to the spaces in between

82
Q

describe the irregularity of the shape of the diaphragm

A

it is narrow at the top and wider at the bottom

83
Q

do the lungs enter the neck

A

yes, up to the medial third of the clavicle

84
Q

where is CPR undertaken

A

the xyphoid process of the sternum

85
Q

why are the floating ribs risky

A

they can fracture and puncture organs like the spleen

86
Q

why are the floating ribs so prone to trauma

A

because they do not join with the costal cartilages and the rest of the ribcage

87
Q

what is referred pain

A

pathology on one side but pain felt on the other, because the nerves can get muddled and the brain gets confused

88
Q

examples of referred pain

A

irritation of the gall bladder felt as shoulder tip pain
hip pathology felt as knee pain and vice versa

89
Q

does the aorta pass through the diaphragm. explain your answer

A

no, it sits behind it. this prevents the lungs compressing the aorta during inhalation

90
Q

describe the opening of the superior thoracic aperture

A

narrow, and open to be continuous with the neck

91
Q

describe the opening of the inferior thoracic aperture

A

large, closed off by the diaphragm

92
Q

describe the mediastinum

A

soft tissue partition, orientated longitudinally in a median sagittal position.

93
Q

what is within the mediastinum

A

heart
oesophagus
trachea
major nerves
major systemic blood vessels

94
Q

what separates the left and right pleural cavities

A

the mediastinum

95
Q

are the pleural cavities completely separated from each other

A

yes

96
Q

why do abnormal events in the root of the neck impact the lungs

A

the apex of the lung extends into the root of the neck

97
Q

what machinery is necessary for breathing

A

diaphragm
thoracic wall
ribs
lungs

98
Q

what passes through the mediastinum

A

oesophagus
vagus nerves
thoracic duct

99
Q

what comprises the thoracic wall

A
  • skeletal muscle
  • 12 vertebrae
  • 12 ribs on each side
  • three layers of flat muscle
  • sternum
100
Q

what composes the distal end of each rib

A

costal cartilage

101
Q

function of costal cartilage

A

compose the distal end of each rib to attach to the sternum. contributes to the elasticity and mobility of the wall

102
Q

what seals the inferior thoracic aperture

A

musculotendinous diaphragm

103
Q

what forms the central tendon

A

the conversion of the muscle fibres of the diaphragm

104
Q

what lines the pleural cavities

A

mesothelial membrane called the pleura

105
Q

what attaches each lung to the mediastinum

A

a root formed from the
- airway
- pulmonary blood vessels
- lymphatic tissues
- nerves

106
Q

what is the axillary inlet

A

a gateway to the upper limb and lies on each side of the superior thoracic aperture. formed by the superior margin of the scapula, posteriorly, and the clavicle anteriorly

107
Q

where does the oesphagus penetrate the diaphragm

A

the oesophageal hiatus. an opening to the left of the midline of VX

108
Q

where do all preganglionic sympathetic nervous system come out

A

the spinal cord in the spinal nerves T1-L2

109
Q

which spinal nerve do the preganglionic sympathetic fibres destined for the head leave from

A

T1

110
Q

what is the major contribution to the phrenic nerves

A

C4 from the cervical plexus

111
Q

describe the route taken by the phrenic nerves

A

vertically through the neck and superior thoracic aperture, and through the mediastinum to supply motor innervation to the entire diaphragm.

112
Q

is the phrenic nerve in front or behind the lungs

A

in front

113
Q

why is the root of the phrenic nerve so far from the diaphragm

A

the tissue that gives rise to the diaphragm originates to the ultimate location of the diaphragm, which is why its innervation has cervical origin

114
Q

what are the muscles of the thorax

A

major and minor pectoralis, subclavius