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Cardiorespiratory 2 > Anatomy of the thorax > Flashcards

Anatomy of the thorax Flashcards

1
Q

What innervates sternocleidomastoid

A

XI

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2
Q

What innervate Pec Major

A
  • Pectoral nerves C5-T1
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3
Q

What innervates Pec Minor

A
  • Pectoral nerves C5-T1
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4
Q

What innervates serratus anterior

A
  • Long thoracic nerve C5-C7
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5
Q

What innervates the external intercostal muscles

A
  • Intercostal nerves T2-T11
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6
Q

What innervate the rectus abdominis

A
  • Intercostal and subcostal nerves T7-T12
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7
Q

describe where serratus anterior runs

A
  • This muscle runs deep to the scapula, it comes from the medial aspect of the scapula and runs towards the ribs
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8
Q

describe where the long thoracic nerve runs

A
  • The long thoaricic nerve runs sueprifically along the muscle and then pierces it
  • It makes up the medial border of the axilla
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9
Q

what are the roots of the long thoracic nerve

A

C5 C6 C7 wings to heaven

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10
Q

what do the external intercostal muscles do

A
  • These elevate the ribs bringing them up and out
  • They are involved in inspiration
  • Come from superior rib and wrap anterior superior direction
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11
Q

where does the rectus abdomens attach

A
  • This attacks to the costal margin and xiphoid process and runs along the abdomen to insert on the pubic symphysis
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12
Q

what is the role of the rectus abdomens

A
  • Pulls down the ribcage

- Involved in forced expiration

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13
Q

what do the internal and innermost intercostal muscles do

A
  • Go from an superior inferior position
  • Pulls the ribcage down and in
  • Involved in forced expiration
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14
Q

which order is the artery nerve and vein in in the chest wall

A
  • Goes VAN (vein artery nerve)
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15
Q

what are the two intercostal arteries

A
  • anterior and posterior intercostal artery
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16
Q

describe where the posterior intercostal artery originates from and where it drains

A
  • bigger than anterior
  • they are from the aorta branches
  • they drain into the azygous vein which arches up over the lung root to drain into the SVC
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17
Q

describe where the anterior intercostal artery originates from and where it drains

A
  • Anterior intercostal are from the internal thoracic artery,
  • they drain into the internal thoracic vein
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18
Q

what is thoracocentisis for

A
  • To sample pleural fluid

* Small needled into the pleural cavity to remove a small amount of fluid

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19
Q

How do you thoracocentesis

A
  • To avoid damage to the intercostal nerves the needle is inserted superior to the rib.
  • When the patient is in the upright position fluid will accumulate in the costophrenic recess.
  • The 9th mid-axillary line during expiration avoids the inferior border of the lung
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20
Q

How do you do a chest drain

A
  • The 5th intercostal space in the mid-axillary line is usually used
  • Safe triangle
  • Lateral border of pec major, apex below the axilla, anterior border to lat dorsi, a line superior to the horizontal level of the nipple
21
Q

what is the diaphragm innervated by

A
  • Innervated by the phrenic nerve C3, C4, C5 keeps the diaphragm alive
22
Q

what pierces the diaphragm and at what level

A
  • Vena cava T8
  • Oesophagus T10
  • Aorta hitatus T12
23
Q

What are the two types of pleura

A
  • Parietal pleura – thoracic wall and superior surface of diaphragm
  • Visceral Pleura – covers external lung surface
24
Q

what is between the parietal and visceral pleura

A

• Pleura (parietal) produce pleural fluid – fills cavity, this reduces friction when the lungs expand during breathing as well as help stick the lung to the parietal layer

25
Q

what is the pleura not supposed to be visible on

A

• It should not be visible on a chest X ray

26
Q

if you have a pneumothorax what can you see

A

• If you have a pneumothorax then you can see the pleura

27
Q

what is the nerve supply of the visceral pleura

A

has the same nerve supply as the lung, has para and sympathetic nerve supply, therefore it cannot perceive pain

28
Q

what is the nerve supply of the parietal pleura

A

has the same nerve supply as the chest cavity, T2-T12 intercostal nerves

29
Q

How is the costophrenic recess formed

A
  • Parietal plerua continues 2 ribs inferior to the inferior border of the lung lobe
  • It follows the dipahgran and you end up with a space below the lung which is the costeoprhenic recess, this helps form the costophrenic angle
30
Q

what does a blurred costophrenic angle mean

A
  • it means that there is fluid there
31
Q

describe the structure of the lungs and where they can be found

A
  • Apex of lung 2cm above the clavicle
  • Cardiac notch at 4th rib
  • The lungs can be found at 6, 8, 10
  • Pleura boundaries are at (midclavicular line)8,(axillary) 10, (posteriorly) 12
32
Q

what is the difference between the lobe on the right and the lobe on the left

A

On left hand side

  • Superior and inferior lobe
  • Divided by the oblique fissure

Right hand side

  • Superior, middle, inferior
  • Superior and middle are Divided by horizontal
  • and middle and inferior are divided by oblique fissure
33
Q

describe what the entrance into the right and left lung looks like

A

Pulmonary vein is inferior to the pulmonary artery

Bronchus has cartilage in it

34
Q

describe the divisions of the lungs

A
  • trachea - bifurcates at the level of the sternal angle into the main bronchus
  • main bronchus
  • lobar bronchus
  • segmental bronchi
  • conducting bronchioles
  • terminal bronchioles
  • respiratory bronchioles
  • alveolar ducts
  • alveolar sacs
35
Q

what is the difference between the right and left main bronchus

A

Right main bronchus is more vertically orientated and larger than left main bronchus
Left main bronchus is more horizontal

36
Q

How many ribs do you expect to see in a normal chest x ray

A
  • Expect to see between 5 and 7 ribs above the diaphragm
37
Q

if you can see more ribs that normal in a chest x ray what does this mean

A
  • If you can see more ribs than that then there is hyper expansion of the lungs, the lungs have too much air in
38
Q

describe emphysema

A
  • Destruction of alveolar walls leading to permanent enlargement of air spaces
  • Surface area dramatically reduced
  • Loss of elastic tissue so less recoil of the lungs
  • Narrowed bronchioles
  • This leads to air trapping within the lungs
  • Air not fully expired and the lungs become hyperexpansed
39
Q

where is the superior mediastinum

A

Superior Mediastinum is found above the angle of louis

40
Q

what does the superior mediastinum contain

A
  • Great vessel
  • Oesophagus
  • Trachea
  • Thymus
  • Phrenic nerves
  • Vagus nerves
  • Recurrent laryngeal nerves
  • Thoracic duct
41
Q

what is the inferior mediastinum divided into

A

the anterior, middle and posterior

42
Q

what is in the posterior mediastinum

A
  • Azygous azygoose
  • Vagus vagoose
  • Oesophagus oesophagoose
  • Throacici duct thoracic duck
  • Thoracic aorta
43
Q

where is the posterior mediastinum

A
  • Anterior to vertebrae T5-T12, inferior to sternal angle and posterior to pericardium
44
Q

what is the spinal segements of the sympathetic chain

A
  • T1-L2 sympathetic chain ganglion
45
Q

what does the sympathetic chain do

A
  • Fight or flight response
  • Pupil dilation
  • Bronchodilation
  • Cardiac acceleration
  • Inhibition of digestion
  • Filling of the bladder
  • Pheripheral vasoconstriction
  • Piloerection – erect of pili Hair
46
Q

what is the stellate ganglion

A

The stellate ganglion is a collection of nerves (sympathetic) found at the level of the sixth and seventh cervical vertebrae (the last vertebra of the neck)
- they supply the face and arm

47
Q

what is the recurrent laryngeal nerve

A

A branch of the Vagus nerve which branches within the thorax and loops around the arch of the aorta on the left and the Subclavian artery on the right.

48
Q

what does the recurrent laryngeal nerve supply

A

. It then runs back up to the larynx where it supplies the vocal cords (the intrsic muscle) which are responsible for moving the vocal cords and producing phonation).

Cardiorespiratory 2 (43 decks)

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