Anatomy Exam 3 Thorax Flashcards Preview

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Flashcards in Anatomy Exam 3 Thorax Deck (65):
1

Describe the intercostal neurovascular bundle?

Vein is Superior
Artery is Middle
Nerve is Inferior
Think NAV, nerve
is closest to the Navel

2

What structures are found in the Mediastinum

- Heart
- Great Vessels
- Trachea
- Esophagus

3

Number of lobes R and L lungs

L - 2
R - 3

4

Fissure of the left lung

Oblique and divides the upper and lower lobes

5

Fissures of the Right lung

Oblique divides the upper and lower. Horizontal divides the superior and middle

6

Right lung relations

- R brachiocephalic vein
- SVC
- Pericardium of RA
- Azygous Vein
- R vagus nerve

7

Left lung Relations

- Pericardium
- Aorta
- L phrenic nerve

8

Boarders of the heart

Inferior - costal and diaphragmatic
Anterior - Costal and mediastina
Posterior - rounded and non distinct

9

What is the costodiaphragmatic recess?

Potential space within the pleural cavity at the junction of the inferior boarder. During forced inspiration, lung fills the void. During expiration it is filled with fluid

10

Describe the SNS innervation of the bronchi

The pulmonary plexus resides posterior to the lung root. SNS fibers originate in the upper thoracic ganglia, they supply smooth muscle and pulmonary blood vessles

11

Describe the PNS innervation of the lungs

The pulmonary plexus resides posterior to the lung root. PNS fibers are derived from the Vagus nerve and supply bronchial smooth muscle and mucous glands

12

Boundaries of the mediastinum

Superior - Superior Thoracic Aperture
Inferior - Diaphragm
Anterior - Sternum
Posterior - Vertebral bodies

13

Mediastinal divisions

Superior
Inferior

14

Compartments of the Inferior mediastinum

- Middle (largest)
- Anterior
- Posterior

15

Contents of the Middle Mediastinum

Heart and fibrous pericardium

16

Contents of the Anterior Mediastinum

Fat and Thymus gland remnants

17

Contents of the Posterior mediastinum

- Esophagus
- Descending thoracic aorta
- Thoracic Duct
- SNS trunks

18

Contents of the superior mediastinum

- SVC and tributaries
- Aortic Arch and branches
- Trachea
- Esophagus
- Thorasic duct
- R and L Vagus and Phrenic nerves

19

Neurovasculature of the fibrous pericardium

- innervation by the phrenic nerves
- Supply by internal thoracic arteries
- Drainage pericardiophrenic veins

20

What are the 2 reflections formed by the continuation of the visceral and parietal serous pericardium

1. Transverse pericardial sinus
2. Oblique pericardial sinus

21

What comprises the transverse pericardial sinus?

Two sleeves
1. Surrounds the ascending aorta and pulmonary trunk
2. Surrounds the SVC, IVC and pulmonary veins

22

Right border of the heart

- RA
- Between the 3rd and 6th intercostal and 3 CM right of midline

23

Left border of the heart

- LV and L Auricle
- Slopes upward/ medially
- L 5th ICS to L 2nd ICS

24

Inferior border of the Heart

- RA and RV
- R 6th ICS to L 5th ICS

25

Anterior (sternocostal)surface of the heart

- RA, RV, -small strip of the LV and L Auricle

26

Posterior (base) Surface of the heart

- LA, small portion of RA

27

Inferior (diaphragmatic) surface of the heart

- RV and LV

28

Distinguishing features of the RA

- Right Auricle (overlaps the ascending aorta)
- Crista terminalis (anterior wall)
- Musculi pectinati (ridges)
- Fossa Ovalis (posterior/ septal wall)
- Coronary sinus drainage
- Valve of IVC (remnant of fetal development)

29

What is anatomically significant about the level of the 4th thoracic vertebrae

1. Trachea bifurcates
2. Aorta arches
3. Pulmonary artery divides to left and right

30

What is the moderator band?

- AKA septomarginal trabeculae
- Carries part of the RBB to the anterior papillary muscle
- Thus it facilitates conduction time

31

Describe the Brachiocephalic veins

- Formed by the union of the subclavian and internal jugular
- Drains into the SVC

32

What drains into the R brachiocephalic vein?

- Right Vertebral vein
- Right Internal Thoracic Vein

33

What drains into the Left Brachiocephalic vein?

- Left Vertebral Vein
- Left Internal Thoracic Vein
- Superior intercostal veins
- Inferior Thyroid Vein

34

What drains into the SVC

- Azygous Vein
- R and L brachiocephalic

35

The R phrenic nerve follows what vessels

- R brachiocephalic and SVC

36

The L phrenic nerve follows which vessel

Lateral to the L common carotid and crosses the aortic arch

37

Which roots give rise to the phrenic nerves

- C3, C4 and C5
- C3,4,5 keep the diaphragm alive

38

Innervation of the phrenic nerve results in what

1. Motor function of the diaphragm
2. Sensory to the fibrous and parietal serous pericardium
3. Sensory to mediastinal and diaphragmatic pleura
4. Sensory to the peritoneum

39

Neurovasculature of the trachea

- Inferior thyroid arteries and veins
- Recurrent laryngeal nerve provides sensory and PNS

40

Neurovasculature of the esophagus

- Supplied by the Inferior thyroid, descending aorta and gastric arteries
- Drained by brachiocepalic and left gastric vein with azygous veins (portacaval anastomosis)
- Innervation by vagi and recurrent laryngeal branches

41

Path of the R vagus nerve

Enters the thorax posterior to the bifurcation of the brachiocephalic artery right of the trachea. Posterior to the R lung root and to the esophagus

42

Path of the L vagus nerve

Descends posterior to the L common carotid, crosses the Aortic Arch, gives of the L recurrent laryngeal and continues posterior to the L lung root to the esophagus

43

What do the L and R vagus nerves form when they meet

The esophageal plexus. The anterior and posterior terminal branches continue with the esophagus

44

Where does the Aorta leave the thorax

T12 through the diaphragm

45

What branches off of the Descending Thoracic Aorta

1. Posterior intercostal arteries which supply 3-11 ICS then anastomose with the anterior intercostal arteries
2. Bronchial Arteries
3. Esophageal Arteries

46

Course of the Thoracic Duct

- Arises from the cysterna chili
- travels between the descending aorta and the azygous vein through the posterior and superior mediastinum
- Terminates at the confluence of L subclavian and L internal jugular veins

47

What areas drain into the Azygous vein

- Posterior thoracic wall
- bronchi
- pericardium
- intrathoracic esophagus

48

What drains the Right 1st ICS

R brachiocephalic

49

What drains the Right 2,3 ICS

R superior thoracic intercostal veins

50

What drains the left 2,3 ICS

L Superior Intercostal Vein (drains into the L Brachiocephalic)

51

What drains the Left 1st ICS

L Brachiocephalic Vein

52

What drains the right 4-11 ICS

The posterior intercostal veins

53

What drains the left 8-11 ICS

Hemi-Azygous Vein

54

What drains the left 4-7 ICS

Accessory Hemi-Azygois vein

55

What is a stellate ganglion

Fusion of vertebral ganglia most commonly the inferior cervical and superior thoracic

56

The autonomic prevertebral plexus innervates what

Thoracic structures such as the heart, lungs and esophagus

57

Lower thoracic ganglia form what

- Greater splanchnic
- Lesser splanchnic
- Least splanchnic
all which continue into the abdomen

58

Thorax Definition

The trunk comprised of; the sternum, costal cartilages, ribs, thoracic vertebrae. And the structures within

59

Define the thoracic outlet

The opening at the superior portion of the thorax comprised of; the first ribs, their costal cartilages and the manubrium.

60

What is Thoracic Outlet Syndrome

Compression of structures in the Thoracic Outlet by space occupying tumors

61

What is unique anatomically about the Axillary Tail of the breast?

It is the only portion of the breast which lays beneath the deep fascia

62

Why are the function of the fibrous septa (Ligaments of Astley Cooper) in the breast?

1. To subdivide the 15-20 glandular lobes
2. To loosely attach the skin of the breast to the deep fascia of the chest wall

63

What are clinical findings of breast cancer?

1. Dimpling of the skin due to the attachment of the fibrous septa
2. Lack of mobility when the pectoris major is flexed indicates that the breast is fixed to the chest wall muscle

64

What is the blood supply of the breast?

1. Internal Thoracic Artery
2. 2nd- 4th Intercostal Arteries
3. Lateral Thoracic artery
4. Thoracocromial Artery

65

Describe the Lymph drainage of the breast

Superior and Lateral aspects drain via the infraclavicular and pectoral into the central and apical axillary nodes.

Inferior and Medial aspects drain into the bronchomediastinal trunk to the root of the neck