5: Thoracic and Pleural Cavity Flashcards Preview

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Flashcards in 5: Thoracic and Pleural Cavity Deck (44):
1

skeleton of thoracic wall

12 pairs ribs and costal cartilage (7 true, 3 false, 2 floating)

sternum (manubrium, sternal angle, body, xiphoid process)

thoracic vertebra

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costochondral junction

rib to cartilage

3

what goes through superior thoracic outlet

trachea, esophagus, vessels, nerves

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sternal angle

bc manubrium and body in different planes

at 2nd rib

goes back to IV disk btwn T4 and 5; transverse thoracic line

5

transverse thoracic line

from sternal angle to IV disk between T4 and 5

6

what happens at midclavicular line

anterior and posterior intercostal arteries anastomose

5th intercostal space is apex of heart

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superior and inferior mediastinum

above and below transverse thoracic line

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parts of rib

superior and inferior articular facets, separated by crest of head

neck - has tubercle

angle

body -- costal groove is toward toes

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3 facets of ribs and how they work

thoracic vertebra have costal facets on body. superior facet of rib articulates with costal facet of vertebra one above. inferior with same#. tubercle with demifacet of transerverse process of same #

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tubercle

at junction of neck and body/shaft

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external intercostal muscle

from lateral superior to medial inferior; external intercostal membrane as they get close to sternum

elevate ribs during forced inhalation

12

internal intercostal muscle

superior medial to inferior lateral; depress the ribs; deficient posteriorly

13

innermost intercostal group

discontinuous group; all in same fascial plane

1. transverse thoracic: sternum to ribs; anterior side since from sternum
2. innermost: same fiber direction as internal intercostal
3. subcostal: cross 2 spaces, only on posterior side

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diaphragm

big muscle. tendonous in middle. aorta, esophagus, IVC, epigastric artery/veins pierce it

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parts of vertebra in thoracic wall

body, arch (pedicles+lamina), spine, transverse processes, facets

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where does crest of rib lie

IV disk

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what fills intercostal space between ribs

muscle, 3 layers

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2 origins of blood supply to thoracic cavity

aorta (posterior) -- gives posterior intercostal arteries on either side

internal thoracic artery (anterior)

anastamose at midclavicular line

19

which side posterior intercostal arteries travel more

right. aorta is on left. right posterior intercostal arteries must go around body of vertebra and behind major vessels

20

blood supply to anterior thorax; branches

internal thoracic artery; 2 terminal branches, divides at 6th rib = musculophrenic artery and superior epigastric artery

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phrenic

diaphragm

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vein system of anterior and posterior thorax

anterior: parallel veins

posterior: no aortic vein; azygous system---azygous vein on right and hemiazygous/accessory on left with veins going across

azygous arches around and enters posterior aspect of superior vena cava

23

nerve supply thoracic cavity

one source.

intercostal nerves: T1-11
subcostal nerve: T12

continuations of ventral rami of spinal nerves

intercostal nerve curves from spine and gives off lateral cutaneous branch around lateral part, continues to parasternal region adn terminates as anterior cutaneous nerve

24

vessels and nerves of thorax

in costal groove between internal adn innermost muscles; VAN

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all arteries and branches to thoracic cavity

posterior: aorta branches to posterior intercostal arteries

inferior: Internal thoracic artery branches to anterior intercostal artery, percardiacophrenic a., musculophrenic a., superior epigastric a

26

branches of internal thoracic artery

anterior intercostal a: in intercostal space, anastamose with posterior @ mid clavicular line

pericardiacophrenic a.: 1st branch of internal thoracic artery after it originates at subclavian; supplies pericardial sac and diaphragm; **accompanies PHRENIC nerve

musculophrenic a.: one of the terminal branches of internal thoracic; divides at 6th rib and runs in costodiaphragmatic recess to supply diaphragm

superior epigastric a: other terminal branch; passes posterior to costal margin and descends into abdominal wall

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anterior intercostal a

run in intercostal space btwn internal and innermost muscles; anastamose with posterior at mid clavicular line

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pericardiacophrenic a

1st branch of internal thoracic after originating from subclavian; supplies pericardial sac and diaphragm

accompanies PHRENIC nerve

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what accompanies phrenic nerve

pericardiacophrenic artery

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musculophrenic a

one of terminal branches of internal thoracic a., divides at level of 6th rib and runs in costodiaphragmatic recess to supply diaphragm

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superior epigastric a

other terminal branch of internal thoracic; passes posterior to costal margin and descends into abdominal wall

32

intercostal and subcostal nerves are from where

they are continuations of ventral rami of spinal nerves; they give off lateral cutaneous branches (those go anterior and posterior) and terminate as anterior cutaneous branches (those go sup/inf)

33

3 compartments of thoacic cavity

2 lateral = pulmonary; contain lungs/pleurae

1 medial = mediastinum; contains all other thoracic structures: heart, esophagus, thymus, great vessels, trachae

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viscera between pulmonary cavities

mediastinum

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pleurae

-visceral covers lungs
-lines pulmonary cavities (costal, diaphragmatic, mediastinal)

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what encloses root of lung

area of continuity between visceral adn parietal pleura; beneath is pulmonary ligament

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2 recesses:

costomediastinal: more accentuated on left side by heart

costodiaphragmatic: beneath both lungs, 8th-10th rib

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thoracocentesis

insert needle into recess, dont puncture lung

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pneumothorax

lung collapse bc air enters and surface tension btwn visceral and parietal pleurae is lost and lung not attached to wall

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transition of visceral to parietal pleura is where

root of lung

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lingula

tongue like flap on left lung

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hilus

no pleara, vessels to/from heart/lungs

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bronchi

from trachea, divides at sternal angle

primary right is wider and more vertical, this is where aspirated stuff goes

seondary: one for each lobe

44

pulmonary artery

usually above bronchus, thick/white/stronger than vein