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CVR Week 1 > Anatomy - the thorax > Flashcards

Anatomy - the thorax Flashcards

1
Q

where is the thorax?

A

located between the neck and abdomen

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2
Q

what is contained within the thorax?

A

thoracic cavity contains the lungs and heart
also contains the major blood vessels, part of the trachea and oesophagus

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3
Q

what protects the contents of the thoracic cavity?

A

thoracic wall

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4
Q

what are the functions of the thorax?

A

respiration
protection
conduit (passageway)

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5
Q

what Is the shape of the thorax?

A

narrower at top and wider at the bottom
goes from the neck to the abdomen

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6
Q

what does the thoracic wall consist of?

A

-sternum
-thoracic vertebrae (T1-T12)
-ribs and costal cartilages
-intercostal muscles fill the intercostal spaces
-arteries and nerves that supply it

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7
Q

are the pectoral muscles part of the thoracic wall?

A

no they are considered upper limb muscles

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8
Q

what makes up the thoracic cage?

A

skeletal framework, bone and cartilage

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9
Q

what is the thoracic cage?

A

provides rigidity and flexibility

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10
Q

what kind of joints are between the vertebrae and the ribs?

A

synovial plane joints so allow some movement

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11
Q

what are the true ribs?

A

costal cartilage attaches directly to the sternum - sternocostal joints

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12
Q

what are false ribs?

A

costal cartilage attaches to the cartilage above - interchondral joints (ribs 8-10)

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13
Q

what are floating ribs?

A

do not attach to the sternum at all (11+12)

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14
Q

what are the costovertebral joints?

A

head of the rib articulates with the superior Demi-facet of the corresponding vertebra and the inferior Demi-facet of the vertebrae superior to it

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14
Q

what is the costotransverse joint?

A

the tubercle of the rub articulates with the transverse process of the corresponding vertebra

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15
Q

where does the rib joint on to the spine?

A

between 2 vertebrae, joins via Demi-facets

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15
Q

which ribs are atypical in terms of joints?

A

1, 10, 12
rib 1 - head only articulates with T1
10 and 12 don’t have demi facets only articulate with one vertebra

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16
Q

what is the superior thoracic aperture?

A

the doorway between the thoracic cavity and the neck and upper limb

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17
Q

what is the inferior thoracic aperture?

A

provides attachment for the diaphragm

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18
Q

what separates the thoracic and abdominal cavities?

A

diaphragm

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19
Q

what clinical problems can cervicle ribs cause?

A

sometimes also have a cervical band of tissue that extends anteriorly, structures passing through the thorax can be interrupted by this cervical band
brachial plexus and axillary can be affected

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19
Q

what are the boundaries of the superior thoracic aperture?

A

bones and cartilage of thoracic cage, - T1, medial border of rib one on either side and superior border od manubrium

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20
Q

what are the attachments of the diaphragm?

A

L1-L3 vertebrae
inferior costal cartilages and adjacent ribs
xiphoid process

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21
Q

what is the principle muscle of respiration?

A

diaphragm

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22
Q

how much can the domes of the diaphragm project upwards?

A

reach the level of the 5th rib

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23
Q

what is the nerve innervation of the diaphragm?

A

phrenic nerve, C3-5
C3,4,5 keep the diaphragm alive

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23
Q

why is the right dome of the diaphragm higher than the left?

A

the liver sits here

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24
Q

which kidney sits higher?

A

the left kidney

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25
Q

how much does the diaphragm move during quiet breathing?

A

1-2cm

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26
Q

what happens to the diaphragm when we breathe in?

A

it contracts, flattens out to increase space in thoracic cavity

27
Q

how much does the diaphragm move during forced breathing?

A

6-10cm

28
Q

where do the muscle fibres of the diagram insert?

A

the inferior thoracicapeture margins

29
Q

what is the thoracic cavity?

A

a conduit passageway, from throat, neck to abdomen

30
Q

what is the caval opening?

A

hole in the central tendon,

31
Q

what passes through the caval opening?

A

inferior vena cava at level of T8

32
Q

what passes through the diaphragm at the level of T10?

A

oesophagus, throighthe oesophageal hiatus (in the muscle of the diaphragm)

33
Q

when and where does the aorta pass through the diaphragm?

A

at T12 through the aortic hiatus. behind the diaphragm

34
Q

what are the external intercostal muscles?

A

occupy intercostal spaces from posterior to costochondral junction
muscle fibres run anterioinferiorly

35
Q

when are the external intercostals most active?

A

during inspiration
when they contract they lift the ribs up

36
Q

when are the internal intercostals most active?

A

during expiration
when they contract they depress the ribs

37
Q

what are the internal intercostal muscles?

A

occupy the intercostal spaces from anterior to angle of the ribs
muscle fibres run anteroposteriorly

38
Q

what are the innermost intercostal muscles?

A

deep part of internal intercostal muscles
form an incomplete layer that is most obvious laterally

39
Q

where do the intercostal neuromuscular bundles lie?

A

lie between internal and innermost intercostals

40
Q

how do the ribs move when breathing?

A

they slope inferiorly therefor elevation of the ribs increases the anterioposterior lateral dimensions of the thorax
contraction of the diaphragm increases the superoinferior dimensions

41
Q

what Are some accessory muscles of respiration?

A

sternocloidimastoid (from skull down to clavicle)
pectoris muscles

42
Q

how can accessory muscles help with respiration?

A

fixing of the arm and pectoral girdle allows neck and arm muscles to assist rib elevation in forced breathing

43
Q

which muscles can assist forced expiration?

A

abdominal muscles

44
Q

what is the order from top to bottom of the intercostal neuromuscular bundle?

A

vein, artery, nerve
VAN

45
Q

what is the groove called that the intercostal neuromuscular bundle sits?

A

subcostal groove

46
Q

what is the smaller bundle called that sits superior to the rib called?

A

collateral branches

47
Q

what roots form the intercostal nerves?

A

anterior rami of T1-T11

48
Q

what spinal nerve form the subcostal nerve?

A

the anterior ramus of T12

49
Q

what are the 2 branches of intercostal arteries?

A

anterior and posterior
they anastomose - important in establishing a collateral blood supply

50
Q

where do the posterior intercostal arteries originate from?

A

aorta

51
Q

where does the anterior intercostal artery originate from?

A

internal thoracic artery (or its branches)

52
Q

where does the internal thoracic artery originate from?

A

subclavian artery

53
Q

internal thoracic artery?

A

bifurcates into musculophrenic and superior epigastric arteries

54
Q

what happens if there is a stricture or damage to the proximal aorta?

A

internal thoracic arteries and anterior intercostal arteries can expand to maintain blood supply

55
Q

what does the musculofrenic artery supply?

A

diaphragm

56
Q

what does the superior epigastric artery supply?

A

skin over proximal abdominal wall

57
Q

what are the 3 subdivisions of the thoracic cavity?

A

pulmonary cavity
mediastinum
pulmonary cavity

58
Q

what are the pulmonary cavities?

A

contain the lungs, completely separate

59
Q

what is in the mediastinum?

A

the heart

60
Q

what are the layers of the pericardium?

A

visceral layer, serous pericardium
parietal layer, serous pericardium
fibrous pericardium - forms sac around heart

61
Q

what are the layers around the lungs (pleura)?

A

parietal pleura - connecte tissue layer
visceral pleura - closely associated with the thoracic wall

62
Q

what are the pleural recesses?

A

potential spaces between the costal and diaphragmatic pleura that the lungs can move into during inspiration

63
Q

what are serous membranes?

A

as an organ develops it pushes into a serous membrane which is like a water balloon.
the outermost layer is the visceral layer, the farther away part is the parietal.
there is a layer of fluid between the layers which lubricates
layers are continuous which represents blood vessels ect

64
Q

what is the most important recess?

A

the costodiapragmatic recess as its most likely where fluid will pool

65
Q

between which muscles does the neuruvascular bundles lie?

A

internal and innermost intercostal muscles

66
Q

what is the safest route to insert a needle to perform thoracentesis?

A

costodriaphragmatic recess, superiori to rib, just high enough to avoid collateral bundle branches of intercostal nerve

67
Q

what is a thoracotomy?

A

surgical procedure used to gain access into the pleural space

68
Q

why is the 1st rib rarely fractured?

A

protected very well

69
Q

what would happen with a spinal cord injury of C7?

A

Someone with a C6 – C7 injury is likely to still have some impaired diaphragmatic control, using accessory muscles of the back and chest more than someone without SC

70
Q

what is the safest route of a thorocentesis?

A

The preferred site for the procedure is on the affected side in either the midaxillary line if the procedure is being performed in the supine position or the posterior midscapular line if the procedure is being performed in the upright or seated position

CVR Week 1 (8 decks)

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