Anatomy of thorax

Question 1

where does the anterior axillary line run from

Answer 1

from fold of muscle at anterior axilla/front of the armpit

Question 2

which layer does the mammary gland lie in

Answer 2

subcutaneous layer

Question 3

which muscle forms the anterior axillary fold

Answer 3

lowest n most lateral part of pectoralis major

Question 4

which ribs does the pectorals minor originate from

Answer 4

3rd
4th
5th

Question 5

does the medial pectoral supply the pectorals minor

Answer 5

yeeeeeeees

Question 6

which muscle do the lower ribs give rise to (5th to 8th)

Answer 6

eternal oblique - outer layer of abdominal wall muscles

Question 7

where does lymph drainage medial to the nipple pass through

Answer 7

intercostal spaces to thorax lymph nodes (internal mamary (thoracic) lymph nodes)

Question 8

where does lymph from lateral breast drain into

Answer 8

axillary lymph nodes

Question 9

where is a pacemaker inserted

Answer 9

under skin next to left cephalic vein

Question 10

which costal cartilage is the sternal angle

Answer 10

2nd

Question 11

what lies on either side of the centrally placed mediastinum

Answer 11

pleural cavities

Question 12

how is the lung connected to the mediastinum

Answer 12

only at 1 place - hilum

Question 13

how does contraction of pectorals major assist in breathing

Answer 13

when ring contracts, thoracic pressure rises to assist exhalation. this only oc
curs in disease n during exercise; normal exhalation is passive

Question 14

what forms the ring of muscles which encircle the thoracic cage

Answer 14

2 pectoralis muscles

scapula muscles

Question 15

which bony structures lie subcutaneously in the anterior chest wall

Answer 15

clavicles

sternum

Question 16

are the ribs subcutaneous

Answer 16

no, they lie beneath muscle

Question 17

what are the articulations of the clavicle

Answer 17

at the medial end to the manubrium; sternoclavicular joint

at the lateral end to the acromion of the scapula; acromioclavicular joint

Question 18

what forms the anterior axillary fold

Answer 18

lower edge of the pec major muscle

Question 19

what lies deep to the pec minor muscle

Answer 19

axilla

Question 20

which costal cartilage connects to the sternum at the sternal angle

Answer 20

2nd

Question 21

what is angle of Louis aka

Answer 21

sternal angle

Question 22

what is in the hilum

Answer 22

• main bronchus
• pulmonary artery
• 2 pulmonary veins
• brachial artery
• lymphatic vessels
• branches of vagus n sympathetic nerves

Question 23

contraction of the diaphragm causes the dome of diaphragm to ascend, decreasing the pressure in the thoracic cavity. what are the 2 effects?

Answer 23

1. if glottis is open, air is drawn into lungs

2. blood is drawn from IVC into RA

Question 24

which nerves carry sensation from the parietal pleura

Answer 24

parietal lines inside of thoracic wall

• supplied by the same nerves as tissue of thoracic wall
• spinal nerves t1-12

Question 25

which nerves carry sensation from visceral pleura

Answer 25

visceral covers lung surface - supplied by same nerves as lung\ - vagus and sympathetic nerves

Question 26

what is a bronchopulmonary segment

Answer 26

has a feeding artery n bronchus which run together through the centre of the segment n repeatedly branch to reach all parts of segment

Question 27

how is each bronchopulmonary segment separated

Answer 27

- anatomically and functionally | - layers of connective tissue n fissures

Question 28

what effect does contraction of diaphragm have on intrathoracic and intraabdominal pressure

Answer 28

decreases intrathoracic | increases intrabadominal

Question 29

what is intercostal recession

Answer 29

when a patient is having difficulty taking a breath in n having to create very neg pressures in thorax, intercostals get 'sucked in'

Question 30

which nerve passes to the left of the aortic arch more posterior than the phrenic nerve

Answer 30

left vagus nerve

Question 31

where does the vagus nerve pass in relation to the lung

Answer 31

behind the root of the lung to join the oesophagus

Question 32

where does the vagus nerve pass to give left recurrent laryngeal nerve

Answer 32

over aortic arch

Question 33

where does the recurrent laryngeal nerve pass back up into the neck

Answer 33

in the gore btwn the trachea anteriorly on oesophagus behind it

Question 34

what happens if u have a tumour of left lung

Answer 34

- can invade left recurrent laryngeal nerve - cause paralysis of muscles of left vocal cords - therefore hoarse voice

Question 35

if fluid collects in pericardium, what is limited

Answer 35

end diastolic volume | therefore cardiac output

Question 36

what is the developmental significance of the

Answer 36

remnant of shunt btwn pulmonary artery n aorta

Question 37

what are the main branches of left common carotid artery (2)

Answer 37

internal and external carotids

Question 38

what does the internal carotid supply

Answer 38

most of cerebral hemispheres

Question 39

what does the external carotid supply

Answer 39

left side of face and head

Question 40

what are the main branches of the left subclavian artery (3)

Answer 40

- vertebral - thyro-cervical - axillary

Question 41

what do the vertebral arteries supply

Answer 41

- cerebellum - brain step - occipital lobe - inferior temporal lobe

Question 42

what do the thyrocervical artery supply (2)

Answer 42

- thyroid gland | - neck

Question 43

what does the axillary artery supply

Answer 43

upper limb

Question 44

what structures are supplied by the vagus nerve

Answer 44

- pharynx - larynx - heart - lungs - foregut - midgut

Question 45

what is the surface marking for the apex of the heart

Answer 45

5th intercostal space | midclavicular line

Question 46

what is the RCA sometimes known as

Answer 46

right coronary sulcus

Question 47

where does the circumclfex artery run

Answer 47

grove btwn LA and LV (left coronary sulcus)

Question 48

what is the coronary sinus

Answer 48

major venous drainage of heart

Question 49

what are cusps made of

Answer 49

fibrous tissue | covered with endothelium

Question 50

what are the chord tendinae

Answer 50

tendinous cords that are attached to the free edge of cusps

Question 51

at which phase of the cardiac cycle do the coronary arteries fill n why

Answer 51

during ventricular diastole | - pressure in aorta is high, pressure in myocardium drops to 0

Question 52

how many bundles to right and left ventricle

Answer 52

1 for right - right | 2 for left - anterior and posterior

Question 53

what is the blood supply of the SAN and AVN

Answer 53

SAN - RCA (60%), LCA (40%) AVN - PIVA

Question 54

where is SAN located

Answer 54

crista terminals where SVC enters RA

Question 55

what is crista terminalis

Answer 55

ridge of tissue inside btwn RA and right atrial appendage

Question 56

on a chest x ray, which chambers and vessels form the right and left borders of the cardiac shadow

Answer 56

right heart border - RA | left heart border - left auricular appendage superiorly and LV

Question 57

which lymph does the thoracic duct drain

Answer 57

from lower half of body n bowel into the confluence of left subclavian and internal jugular (left side of neck)

Question 58

which vessels run horizontally lying over the vertebral bodies

Answer 58

intercostal vessels

Question 59

which side are the azygous veins on

Answer 59

right

Question 60

which side are the semi-azygous veins on

Answer 60

left

Question 61

what is the sympathetic chain formed from

Answer 61

a series of ganglia (neurone cell bodies) connected by nerve fibres (axons and dendrites)

Question 62

how many ganglia are in the thorax, neck and abomen/pelvis

Answer 62

thorax - 12 (1 each) neck - 3 abdomen/pelvis (1 per vertebra also)

Question 63

from the 5th-12tth thoracic ganglia, there are nerves running forwards over vertebral bodies. what do these form

Answer 63

3 splanchnic nerves

Question 64

where does all sympathetic nerve supply to head and neck travel through

Answer 64

T1 ganglia of sympathetic chain

Question 65

what is Horner's syndrome

Answer 65

pathology damaging ganglia - loss of sympathetic innervation to face n eye - no facial sweating, drooping eye lid, constricted pupil and an eye slightly drawn in

Question 66

where does a patient experience pain felt by greater splanchnic nerve

Answer 66

epigastrium

Question 67

where does patient experience pain felt by lesser splanchnic nerve

Answer 67

umbilicus area

Question 68

where does a patient experience pain felt by least splanchnic nerve

Answer 68

suprapubic area

Question 69

which structure lies immediately behind LA in lower thorax

Answer 69

oesophagus

Question 70

which structures drain blood into azygous system

Answer 70

lateral and posterior chest/abdominal wall

Question 71

why is the left recurrent laryngeal at risk from thoracic disease but not right

Answer 71

left passes into thorax, around aortic arch and back into next right doesn't pass through thorax

Question 72

where do sympathetic nerves attach to CNS

Answer 72

thoacic 1-12 | lumbar 1-2 spinal segment nerves