Anatomy[THORAX] Flashcards
(188 cards)
1
Q
How many lobes in the rt and lft lung?
A
- Rt: 3 lobes by the fissures(upper lobe above the horizontal fissure-middle lobe between horizontal and oblique fissures - lower lobe below the oblique fissure)
- Left : 2 lobes(the upper above the oblique fissure and the lower is below it)
2
Q
The blood supply of the lung?and from where ut derives ?
A
- Right lung: bronchial Ā from rt post intercostal Ā
- left lung: 2 bronchial arteries branch from descending aorta
- right: to the azygos
- left : to superior hemiazygos
3
Q
7th rib articulate with sternum at
A
Xipho sternal joint
4
Q
Whats the anterior relation of the esophagus?
A
- ant gastric N
- diaphragm
- pericardium oblique acinus
- right pulmonary A & left bronchi
- trachea and left recurrent lareyngeal N
5
Q
Whats the atypical features of 11 and 12 thoracic vertebrae?
A
11-complet upper facet(between body and pedicile ), no inferior facet , no costal facet
12-complete upperfacet(in the pedicle) no inferior facet,short and thick spine,larg body, inferior artecular processes faces laterally
6
Q
Whats the manibruisternal joint and its type?
A
- secondary cartilaginous joint
- between the manibruim and the body
7
Q
The azygos vein pass behind the right root of
A
Lung
8
Q
Post intercostal arteries number? And they derives?
A
11 one in each space
- 1-2 from superior intercos Ā>costo cervical trunck>2nd part of subclivian Ā
- from3-11 branch of descending thoracic aorta
- subcostal 12 from descending aorta
9
Q
Whats the atypical ribs? And they distinguished by?
A
1-2-10-11-12
1-1st (no costal groove 2surfaces(upper lower) 2borders(ant and post) tubricle for scaleneus muscle)(its upper surface have ant grove for subclivian V and post groove for subclivian Ā)
2-2nd (oblique shaft - short costal groove)
3-10th( its head is one facet not seperated)
4-11-12th (only head no shaft nech or tubricle or costal groove)
10
Q
Ant and post relation of the apex of the lung?
A
Ant:subclivian groove
Post:neck of the first rib,superior intercostal a, sympathetic trunck, 1st thoracic nerve
11
Q
Whats the sternal costal joint and its type?
A
- With the first rib costal cartilage and sternum (1ry cartilaginous)
- with 2-7 synovial
12
Q
Nerve supply of parietal pleura?
A
Mediastinal: phrenic nerve
Costal: intercostal Nerve(typical)
Diaphragm:medially by phrenic N laterally by intercostal N(atypical)7-11
13
Q
Where dies the esophagus incline?
A
Its upper and lower part T8-T10 to the left
14
Q
Whats the pleura and what type of cells it have?
A
Its a closed serous sac that invaginated medially by the lung
-it have a single layer wall of mesothelium that secrete serous in the pleural cavity
15
Q
At what level the phrenic nerve pierce the diaphragm and with who?
A
At T8 with venacava
16
Q
Whats the type of intervertebral joint and what support it?
A
- 2ndry cartilaginous joint
- ant and post longitudinal ligaments
17
Q
Where does the trachea lays?
A
In the superior mediastinum
18
Q
The base of the lung related to?and its shape?
A
diaphragm
Concave
19
Q
The lymph nodes of pareital pleura?
A
Intercostal,parasternum,post mediastinum and diaphragmric
20
Q
What are the fissures of the left lung?and it’s begging and ending?
A
One fissure
-oblique starts from 3rd spine of thoracic vertebrae and end on 6th costochondral junction
21
Q
Whats the pleural Recesses?
A
The space inside the pleura occupied by the lung only in deep inspiration
22
Q
Where the 1st post intercostal veins draint to Lt
A
Brachiocephaliv vein
23
Q
The level of the hilum of the lungs is at?
A
T5,T6,T7
24
Q
Abnormal substances in the pleural cavities cases?
A
Blood: hemothirax Pus: empayema Water: hydrothorax Air:pneumothorax Inflammation:pleuracy
25
What distinguishes the typical ribs?
3-9 ribs (head nech tubrivle shaft)
1-Head(upper facet with vertebrae above - lower facet with body of vertebrae same number - tubricle for intervertebral disc
2-neck(post surface connected to inferior costotrasnvese lig - ant sufrace for pareital pleura-upper sharp border with superior costotrasverse lig-lower with post intercostal membrane)
3-tubricle: (medially surface with transverse process at same number laterally with lt costotransverse at the same number)
4-shaft :(inner and outer surface and upper and lower surface and costal groove at the lower border)
26
From where the thoracic duct begins?
L1-L2
27
Whats the bronchopulmonary segments?and how many of then in both right and left lungs?formed of?
Functional unit of lung
- formed of :tertiary bronchi,bronchiol, alveoli
- 10in rt lung - 8 in left lung
28
Where does the azygos vein originate and from where it passes?
From the back of IVC pass from the aortic opening
29
Where does the thoracic duct terminates?
At the joint between left internal jugular and left subclivian to the brachiocephalic vein
30
What forms the inferior hemiazygos?
Lft ascending lumbar
| Lft subcostal
31
Whats the biggest lymph duct in the body?
Thoracic duct
32
Nerve supply of trachea is?
Two vagi from para
| Two sympathetic chains
33
Whats the costo vertebral joint and its type?and supported by ?
- plane synophial
- superior small facet of the rib articulate with inferior facet of the vertebrae above
- inferior big facet of rib articulate with superior facet of vertebrae at the same level
- the cresr of the rib articulate with intervertebral disc
- triradiat ligamt
34
Where the cervical pleura extends and what is it covered with?
Above the thoracic inlet to the root of the neck
- covers the apex of the lung
- covered by suprapleural membrane
35
How many borders of the lung and related to?
- Anterior (sharp) related to costo-mediastinal recess
- posterior border(rounded) related to vertebraes
- inferior border(sharp) related to costo-diaphragmtic recess
36
Root of the hilum of left lung formed of?
- 1 bronchi( most posterior)
- pulmonary A the most superior (from right ventricle)
- inferior pulmonary v the most inferior
- superior pulmonary v the most Anterior
- ant and post pulmonary plexus
- 2 left bronchial Ā
- bronchiopulmonary lymph nodes
37
Where does the esophagus being and terminates?
Beginning: c6 lower border of pharynx (ciricoid cartilage)
| Terminates : T11
38
Whats the xiphosternal joint and its type?
Between xiphoid and body of sternum
| -secondary cartilaginous joint
39
Whats the anterior surface of the lung related to?
To ribs costal cartilage and intercostal space and muscles
40
What are the constrictions of the esophagus?
- At the beginning 6 inch from the incissors
- by aortic arch at 9
- by left bronchi at 11
- by left diaphragm curs at 16 inch
41
What are the fissures of the left lung?and it’s begging and ending?
One fissure
| -oblique starts from 3rd spine of thoracic vertebrae and end on 6th costochondral junction
42
What bronchopulmonary segment is missing in the left lung?
Medial basal in the lower lobe
43
What lines the thoracic cavity and whats its tissue type?
Endothoracis facia(loose fibrocellular)
44
How many fissures in the right lung and thier begening and ending?
2 fissures
-oblique starts from 4th thoracic spine
Ends at 6th costochondral junction
-horizontal start at 4hh costal cartilage
End on the mid axillary line on the
Oblique fissure
45
The surface anatomy of the lung?
- About 0.5-1inch sbove medial 1/3 of calvicle
- descending to 2nd costochondral
- then to4th costochondral
- then 6th costochondral
- then the 6th rib at midclavicular line
- the 8th rib at midaxillary line
- 10 thoracic vertebrae
- the posterior part is a line from the 10 to the apex
46
Where the 4th to 11th post intercostal veins drain to Rt
To vena azygos
47
Whats the bronchopulmonary segments of the left lung?
-In upper lobe: apicopsterior, ant, superior lingual
Inferior lingual
-in lower lobe:apicobasal ,ant basal , post badal ,lateral basal
48
Lymph drainage from thoracic content is due to?
- brachiocephalic LN
- trachiobronchial LN
- posterior mediastinal LN
49
The location of brachiocephalic LN and thier affernt and efferent?
Location:-left brachiocephalic vein
Affernt:-thyroid and thymus glands, heart ,pericardium,diaphragmatic LNs,esophagus
Efferent:- bronchiomediastinal trunk
50
Whats the branches of internal mammary artery?
- ant intercostal 1-6
- superior epigastric A
- musculophrenic A
- perforating A
- pericardia phrenic A
- mediastinal A
51
Location of diaphragmatic lymph nodes and it’s affernt and efferent?
Location: onboth sides of diaphragm
Affernt:- diaphragm and upper surface of liver
Efferent:- parasternal LN,posterior mediastinal LN
Brachiocephalic LN
Then to thoracic duct then to brachiocephalic vein
52
Whats the accessory phrenic nerve?
C5 of the origin of phrenic nerve forms this nerve by itself
53
Where the suprapleural membrane connected from the apex and the base? And its function? And it covers?
Apex: transverse process of C7
Base: costal cartilage and rib medial surface
Fucntion: prevent the apex if lunf from bulging during expiration and suction during inspiration
—————————
The apex of the lung wich is covered with cervical pleura
54
The location of posterior mediastinal LN and thier affernt and efferent?
Location: around the esophagus
Affernt: diaphragmatic LN,pericardium, esophagus
Efferent:thoracic duct on lt
Right thoracic duct on Rt
55
Whats the lymph drain from lungs and bronchi and trachea?and their efferent
- Trachiobronchial
- pumonary ln in lung tissue
- bronchopulmonary in hilum
- superior trachiobronchial above bifurcation
- inferior trachiobronchial between two bronchi
- pretrachial infront trachea
- paratrachial around trachea
- efferent to brochiomediastinal trunk
56
The thoracic duct in the posterior and anterior mediastinum its relation to the esophagus?
In post: right to it
| In anterior: left to it
57
Types of plural Recesses and thier site?
- costomediastinal: in ant border of the lung behind the sternum
- costodiaphragmatic: along the inferior border of the lung
58
Where the 2nd and 3rd post inercostal veins drain to Rt
Unite to form superior intercostal vein then drain to arch of vena azygos
59
At what level the esophagus penetrate the diaphragm v
At T10
60
The bronchiomediastinal that drain to the thoracic duct on the lft side have tributaries ?
- parasternal lymph nodes
- brachiocephalic
- trachiobronchial
61
What are the sternal joints?
- Manibruisternal
- xiphosternal
- costosternal(comdrosternal)
- costochondral
- intercondral
62
Whats the surface anatomy of the left lung?
-Same as the right but below 4th costochondral it has deviation called superficial cardiac dullness or cardiac bare area
63
The righ relation of trachea?
- rt vagus nerve
- inominate A
- rt lung and plura
- arch of azygos vein
- trachiobronchial lymph nodes
64
Where does the trachea begin?
At the lower border of larynx opposite to C6
65
What are the contents of thoracic cavity?
Pleural cavities,lungs,midiastinum
66
Blood supply of cervical part of the trachea?and veins
Bs:inferior thyroid A
Veins: inferior thyroid veins
67
Whats the posterior relations of the esophagus?
- Posterior gastric N
- diaphragm
- hemiazygos v
- descending thoracic aorta and its upper branches 3-7 right posterior intercostal A
- body of vertebrate of C6-T11
- prevertebral muscle and facia
- T5 thoracic duct
68
Parts of the esophagus?
- Cervical part in the neck
- Thoracic part in the superior and poster mediastinum
- abdominal part
69
Whats the trachea?
Tube that covey the air out of the lung
70
Where the 2nd and 3rd post inercostal veins drain to Rt
Unite to form superior intercostal vein then drain to arch of vena azygos
71
The hilum of the right lung formed of? And thier arrangment? What the other name of the the bronchi?
-two brochi( the most posterior)
-one right bronchial Ā between the bronchi
-pulmonary Ā blood from right ventricle(most Ant)
-sup pulmonary V carry blood to left atrium
-inferior pulmonary V
-ant and post pulmonary plexus
-brochiopulmonary lymph nodes
—————————————————-
Epiatrial the superior
Hypoatrial the inferior
-
72
Where does the suprapleural membrane extend?and its function
Medially: to transverse process of C7
Lat:to the lat part inner surface of 1st rib
-protect the cervical plexus
73
Where is the posterior intercostal lymph nodes located and it’s affernt and efferent?
Located:on posterior intercostal space
-affernt: posterolateral part of chest
-efferent:upper 5 to :thoracic duct
Lower 6 to cysterna chyli
74
From where the parasternal lymph nodes drain(affernt)? And efferent?
Affernt: deep structures of chest
Deep structure of medial half mammry g
Ant abdominal wall above ambilicus
Efferent: bronchiomediastinal trunk
Rt: to thoracic duct
Lt: to right thoracic duct
75
How many ribs and their classifications?
12 pair
According to the relation with sternum
-true(1-7) false[costal margin] (8-10) free(11-12)
According to specific features
-typical ribs(3-9) atypical (1-2-10-11-12)
76
Above the and below the T5 whats related to the esophagus?
- Below its left related to thoracic duct
| - above its left related to aorta
77
The non typical intercostal nerves?
-1st have two branches larg(brachial plexus)
Small(chest with no ant cutaneous branche)
-2nd (intercosto brachial)supply floor of acilla and arm its lat cutaneous branch have no ant post
-lower five supply the abdominal wall
78
Length and diameter of trachea?
Length:10-12cm
Diameter:1-2cm
79
The anterior intercostal veins from 7-9 drain to
Vena comitents of musculuphrenic vein
80
What are the tributaries of the thoracic duct ?and from where they drain?
- right and left Lumer trunk(legs)
- right and left posterior intercostal (back)
- bronchiomediastinal(left thoracic)
- left jugular (left neck and head)
- left subclivian (left upper limb)
81
Whats the interchondral joint and its type?
Between 7-10 costal cartilage
| -synovial joint
82
Whats the primary and secondary curves of the vertebral column?
Primary:thoracic,sacral concave
Secondary: cervical and lumbar convex
83
The relation of the thoracic duct in the posterior mediastinum?
The azygos vein on its right and the aorta on the left
84
Root of the hilum of left lung formed of?
- 1 bronchi( most posterior)
- pulmonary A the most superior (from right ventricle)
- inferior pulmonary v the most inferior
- superior pulmonary v the most Anterior
- ant and post pulmonary plexus
- 2 left bronchial Ā
- bronchiopulmonary lymph nodes
85
The ant intercostal veins of 4-6 drain to
Venae comitents of internal thoracic vein
86
When does the pleural cavity increases or decrease ?
Increase: in expiration
Decrease: in inspiration
87
What does the endothoracic facia covers Above,Below,lat,Med?
- Above:thickned to form suprapleural membrane
- Below:covers the diaphragm
- Med:losse ct of mediastinum
- Lat:forms fibroelastic membrane covers the thoracic wall
88
From where the thoracic duct drain?
Lower limp, abdomen, pelvis, left upp limbs and left side of head and neck and left side of thorax
89
Whats the content of intercostal space
Intercostal muscles/ vessels/ nerves
90
Course of intercostal nerves?
- Between post intercostal membrane and pareital pleura
- pierce internal intercostal muscle and spit it into internal and innermost intercostal muscle
- pass between inner most and internal intcos
- pass between intercostal intcos and pareital pleura
- pierce internal intcos and ant interco membrane and facia and skin and gives ant cutaneous nerve
91
At what level the azygos vein connected to SVC and IVC?and where it pierce the diaphragm?
SVC:second right costal cartilage
IVC:at L2
At T12
92
The surface anatomy of the lung?
- About 0.5-1inch sbove medial 1/3 of calvicle
- descending to 2nd costochondral
- then to4th costochondral
- then 6th costochondral
- then the 6th rib at midclavicular line
- the 8th rib at midaxillary line
- 10 thoracic vertebrae
- the posterior part is a line from the 10 to the apex
93
2nd rib articulate with the sternum at
At the sternal angle
94
From where the anterior intercostal arteries comes?
From 1-6 from internal thoracic artery
| 7-9 from musculo phrenic
95
What support the costo vertebral joint?
Triradiat ligament bind the head of the rib to e vertebrae and intervertebral disc
96
Whats the course of the internal thoracic (mamary) artery? And its branch of?
Branch of the 1rst part of subclivian A
| -pass behind the clavicle and 1st costal cartilage to the 6th costal cartilage then gives branches
97
The first 1to3 anterior intercostal veis draintto
Internal thiracic vein then to brachiocephalic v
98
Left relation of trachea?
- left vagus nerve
- left lung and plura
- aortic arch
- left subcleavian A
- left common carotid A
- left trachiobroncial lymph nodes
99
Sternocostalis muscle origin and insertion and action?
Origin back of the lower border of the body of the sternum
Insertion :2-6 intercostal cartilages
Action: depressing costal cartilage forced expira
100
Where is the paransternal lymph nodes are located?
On both sides of sternum
101
Whats the accessory phrenic nerve?
C5 of the origin of phrenic nerve forms this nerve by itself
102
What is the anterior and posterior relation of left bronchi?
Ant: left pumunary A , left atrium
| Post: esophagus, descending aorta
103
What part of pareital pleura bulges into the neck?
Cervical
104
Whats the blood supply of the esophagus?and veins?
-Cervical part:inferior thyroid A from subclivian
-Inominate V
-Thoracic part: esophageal vessels from descending aorta and left bronchial arteries
Drain to azygos and hemiazygos
-abdominal part : left gastric A
- left gastric v to portalcirculation
105
Where the trachea terminats?and what does it give?
Lower boreder of T4
Between T4 and T5
-it gives rt ant lt bronchi
106
Different between right and left lung?
```
Right 700g. Left 600g
2 fissures 1 fissure
3 lobes. 2 lobes
10 segments. 8 segments
Broad and heav. Narrow and tall
Straight ant bor. deviate ant border
2 main bronchi. 1 main bronchi
1 bronchial Ā. 2 bronchial Ā
```
107
The blood supply of the lung?and from where ut derives ?
- Right lung: bronchial Ā from rt post intercostal Ā
- left lung: 2 bronchial arteries branch from descending aorta
- right: to the azygos
- left : to superior hemiazygos
108
What the atypical thoracic vertebrae numbers?
1,10,11,12
109
Course of left phrenic nerve?
- pass behind the left inominate vein
- pass between left subclivian and left common carotid Ā then cross laterally to the left vegus and left superior intercostal veins and arch of aorta
- then laterally to pericardium covering the left ventricle
- descending on the apex of the the heart
110
The anterior&psterior relation of right bronchi are?
Ant:right pulumenary A
SVC , ascending aorta
Left atrium
Post: azygos vein , esophagus
111
The esophagus have tripled relations with two ?
Descending throacic aorta
-left,post,right
Thoracic duct
-right post left
112
Whats the parts of intervertebral discs?
Central:nucleus pulposum
Periphery: anula fibrosum
113
Whats the bronchopulmonary segments?and how many of then in both right and left lungs?formed of?
Functional unit of lung
- formed of :tertiary bronchi,bronchiol, alveoli
- 10in rt lung - 8 in left lung
114
Lymph drain of thoracic chest drain to these lymph nodes!
- parasternum lymph nodes
- posterior intercostal lymph nodes
- diaphragmatic lymph nodes
115
Where the 1st post intercostal veins draint to Lt
Brachiocephaliv vein
116
Branches of the phrenic nerve?
Motor: to the diaphragm muscles
Sensory: to pleura , pericardium, peritoneum of diaphragm
117
The right lymph duct length is?and where it terminates?
1cm long
| -between rt internal jugular and rt subclivian veins
118
What is the blood supply of the pareital pleura ?and vein drainage
Internal mammary, intercostal arteries, musculophrenic
119
The subcostal muscle origin insertion and location?
Location:post intercostal space below 6th rib
- Origin inner surface of the lower border of rib above
- insertion inner surface of upper border of the 2nd or 3rn rib below
- action:forced expiration
120
Branches of typical intercostal nerves?
-pericardial
-pleural
-articular
-ant cutaneous (med-lat)
-lat cutaneous (ant-post)
-cumunicates(white rami for the sympathetic trunk
Grey ramin for blood vessels and g)
-muscular(collateral) for intercos muscles
121
Posterior relation of trachea?and thier location?
- esophagus
- left recurrent laryngeal nerve(between esophagus and trachea)
- thoracic duct(onthe left boreder of esophagus)
122
Whats the course and relation of thoracic duct
Its passes from the aortic opening between the right rus of diaphragm and aorta
123
Whats the costochonral joint and its type?
-Between rib and its costal cartilage (1ry cartilaginous joint)
124
Where the first posterior intercostal vein drain RT
To brachiocephalic vein
125
Where do 4rth to 8th post intercostal veins drain o Lt
To superior hemiazygos vein
126
Internal intercostal muscle origin insertion nerve extension and action?
Origin:floor of the grove of rib above
- Insertion: inner surface of the upper border of rib below
- extension:from near sternum to angle of rib and continue as post intercostal membrane
- action:depressing the rib for expiration
127
How many fissures in the right lung and thier begening and ending?
2 fissures
-oblique starts from 4th thoracic spine
Ends at 6th costochondral junction
-horizontal start at 4hh costal cartilage
End on the mid axillary line on the
Oblique fissure
128
The azygos vein arch cross
Esophagus, trachea, rt vagus nerve
129
The course of the right phrenic nerve?
- Pass behind the rt innominate vein
| - The lat to innominate v , pericardium of right atrium , inferior vena cava
130
What makes the trachea incomplete posteriorly? And what encloses it?
Due to the c shaped tracheal cartilage
| -by trachialis muscle
131
From where intercostal nerves derives?and whats typical and atypical?
From ant primary rami of T1-T11 spinal nerves
Typical (3-6)
Atypical (1-2-7-8-9-10-11)-subcostal
132
Where dow the superior hemiazygos vein joint the vena azygos vein?
At 7th thoracic vertebrae
133
Where the 2ndand 3rd post intercostal vein drain to Lt
Unite to form superior intercostal vein then drain to brachiocephalic vein
134
The difference between the right and left bronchi?
```
Rt
-wider
-shorter 1inch
-more line in trachea 25 angle
-devides before entry to hilum
Lt
-narrow
-longer 2inch
-more deflected 45 angle
-devides after entering the hilum
```
135
The relations of the thoracic duct in the superior mediastinum?
Its on the left border of the esophagus
136
Whats the Atypical features of 1st thoracic vertebrae?
```
No heart shaped body
Triangular vertebral foramen
Complete upper facet
Small inferior facet
Horizontal spine
```
137
Tributaries of venae azygos?
- rt Ascending lumber
- rt subcostal
- hemiazygos
- pericardial
- esophageal veins
- bronchial
- post intercostal veins 4-11
- superior intercostal vein
138
What are the true and false and free ribs
Trure:1-7
False:8-10
Free:11-12
139
The azygos vein drain into
Middle of SVC
140
Who sepreate trachea from cerebral column
Esophagus
141
The length of the thoracic duct is?
45cm
142
Who supply the right and left bronci with blood?and veins
Same as the thoracic part of trachea
-Orderly right arteries for the right bronchi
Vise versa
143
The right side of the thoracic and head and neck and upper limb drain the lymph to? With what tributaries?
To the right lymphatic duct
- rt subclivian lymph
- rt jugular lymph
- bronchiomediastinal Lymph nodes
144
Whats the zygapophseal joint?
The inferior articulate facet of vertebrae above with the superior articulate facet of vertebrae below
145
Whats the pleural cavity?
The space between visceral and pareital pleural
146
What the bood and berve supply of the visceral pleura? Veins and lymph nodes?
Blood supply:bronchial artery
Veins:same as Ā
Nerves: sympathetic automatic nerves
Lymph nodes:bronchiopulumenary
147
Whats the right and left relations of the esophagus?
- Left:lungs , left recurrent laryngeal N,descending aorta,
| - Right:lung ,thoracic duct,descending aorta,azygos V
148
Course of trachea is?
Its descends in medial line its upper 5cm in the neck while its lower 5cm in superior mediastinum
149
Whats the joints of the thorax?
- intervertebral joint
- zygampohypophseal
- cosot vertabral
- costo transverse
- sternal
- fibrous joints
150
The course of the right phrenic nerve?
- Pass behind the rt innominate vein
| - The lat to innominate v , pericardium of right atrium , inferior vena cava
151
Inner most muscle origin insertion,extension nerve?
Origin insertion as internal intercostal ms
Extension:mix axillary line to the tubricle of rib
Nerve intercostal n
152
Whats the atypical features of the 10th thoracic vertebrae?
No inferior facet
Upper complete facet
Have costal facet
153
The superficial cardiac dullness form at?
4th and 5th intercostal space
154
Whats the pulmonary ligament?
Its the pleura around the root of the lung extends downward to the diaphragm and then folds
155
The ant relation of trachea?
-lft subclevian A
-thyrodin A
-inferior thyroid v
-sternum (sterno hyiod- thyroid)
-thymus gland
-deep cardiac plexus
-arch of aorta
-beginning of lft brachiocephalic A(inominate)
Left common carotid A, left inominate vein
156
What are the fibrose joints of the thorax and thier site?
- legamnt flava( between the lamina of vertebrae)
- interspinous(between the inferior border of spin above and superior border of spin below)
- supraspinous between the tips of spines
- intertrasverse between the transverse processes
157
Where the 2ndand 3rd post intercostal vein drain to Lt
Unite to form superior intercostal vein then drain to brachiocephalic vein
158
Name the muscular layes of the intercostal space
```
1st layer:ext intercostal muscle
2nd layer: inter intercostal muscle
3rd layer:inermost intercostal
Subcostal muscle
Transverse thoracic(sterno costalis)
```
159
How many trachea c shaped cartilage are exist?
10-12
160
What are the two types of pleura?
Pareital
| Visceral(the most adherent)
161
The origin of phrenic nerve?mainly?
C3 C4 C5
| C4 mainly
162
Whats the origin and insertion of external intercostal muscle and nerve supply, action? Extension?
- Origin:outer surface of lower border of rib above
- Insertion: outer surface of upper border rib below
- Nerve:inter costal N
- Extension: near the tubricle of the rib to costchondral and continue as ant intercostal membrane
- action: elevate ribs in increase volume in inspiration
163
What are the features of the typical thoracic vertebrae?and thier number?
- T2 to T9
- body heart shaped,sup demi facet,inf demi facet
- transverse process costal facet
- long bended backwards and downward spine
- circular vertebral foramen
- 2sup , 2 inf articulate processes
164
In the intercostal space which vessels or nerve is the most superior and inferior
Veins is the most superior then arteries then the nerve the most inferior
165
What are the parts of pareital pleura?
- Costal:covers ribs and thoracic wall inner surface
- cervical:
- mediastinal: covers mediastinum
- diaphragmatic: covers upper surface of diaphragm
- pericardial:part of mediastinal pleura but covers the pericadrium
166
What are the bronchopulmonary segments of the right lung?
-In the upper lobe: apical,ant,post
-In middle lobe:mid , lat
-In lower lobe: apico basal, ant basal ,post basal
Med basal , lat basal
167
Where does the thoracic duct pierce the diaphragm?
At T12
168
The length of the esophagus is?
10ich (25cm)
169
The blood supply of the thoracic part of trachea-thier origin?and veins ?
Bs:right bronchial A from 3rd posterior right intercostal artery
Left bronchial arteries 2 direct branch of - descending aorta
-veins:right bronchial veins drain to azygos
Left bronchial veins drain to superior
Hemiazygos
170
Where does the inferior hemiazygos vein unites with vea azygos at
In 8th thoracic vertebrae
171
In the neck the phrenic never pass between?
```
Sternomastoid muscle (above
Scaleneus anterior below
```
172
Whats the content of intercostal space
Intercostal muscles/ vessels/ nerves
173
Where does the 9th to 11th post intercostal veins drain to Lt
To inferior hemizygos vein
174
Where does the 9th to 11th post intercostal veins drain to Lt
To inferior hemizygos vein
175
The azygos vein passes right to
Aortic then behind the right side of esophagus and Rt to descending aorta
176
Region of pleura and lungs The line from the sternal angle to the lower border of T4 divides It into:
Superior mediastinum
| Inferior mediastinum .
177
The inferior mediastinum devided into? By?
according to their relation of the heart into:
1. Anterior mediastinum
2. Middle mediastinum
3. Posterior mediastinum
178
Boundaries of superior mediastinum?
• Superiorly: a line that extended from the upper border of the manubrium to the upper border of the first thoracic vertebra.
• Inferiorly: a line that extends from the lower border of the manubrium to the lower border of the 4th thoracic vertebra.
• Anteriorly: manubrium sterni.
• Posteriorly: upper 4 thoracic
vertebrae.
• Laterally: mediastinal pleura.
179
Content of superior mediastinum?
1-Oesophagus, trachea.
2-Arch of the aorta and its branches
(brachiocephalic, left common carotid and left subclavian arteries).
3-left and right brachiocephalic veins and join to form superior vena cava at right border.
4-Remnant of thymus gland and sternohyoid, sternothyroid muscles.
5-Right vagus nerve (on the right side of trachea) and left vagus nerve (on left side of left common carotid artery then crosses the arch of aorta).
6-Right phrenic nerve (on the right side of the brachiocephalic vein and superior vena cava) and left phrenic nerve (between the left common carotid and left subclavian arteries then cross the left side of arch of aorta).
7-Thoracic duct (along on left side of oesophagus)
180
Anterior mediastinum boundaries?
• Anteriorly: body of sternum. • Posteriorly: heart and
pericardium.
• Laterally: mediastinal pleura on each side.
181
Content of anterior mediastinum?
1-Remnants of the thymus gland and mediastinal lymph nodes.
2-Superior and inferior sterno- pericardial ligaments.
3-Transversus thoracic muscle.
182
Content of middle mediastinum?
- heart
- pericardium
- pulmonary artery
- pulmonary vein
- sup and inf vena cava
- deep cardiac plexus
- trachiobronchial lymph nodes
- right and left phrenic nerve
183
Boundaries of posterior mediastinum?
* Anteriorly: pericardium and diaphragm.
* Posteriorly: lower 8 thoracic vertebrae.
* Laterally: mediastinal pleura on each side.
184
Content of posterior mediastinum?
1-Descending thoracic aorta on the left side of vertebrae column then turns in front of it.
2-Oesophagus on the right side of the aorta then turns in front of its lower part.
3-Azygus vein in front of the vertebrae column on the right side of the aorta and behind the oesophagus.
4-Thoracic duct between descending thoracic aorta and azygos vein
5-Superior and inferior hemiazygos veins along the left side of descending thoracic aorta.
6- Right and left vagus nerves.
185
Boundaries of thoracic inlet?
* 1-Anteriorly: upper border of manubrium (lower border of T2 vertebra).
* 2-Posteriorly: 1st thoracic vertebra
* 3- On each side: 1st rib
186
Structures pass through thoracic inlet?
* 1- Muscles as sternohyoid, sternothyroid, longus cervices.
* 2-Trachea,esophagusandthymusgland.
* 3-blood vessels as brachiocephalic, left common carotid, left subclavian, internal thoracic, and superior intercostals arteries also brachiocephalic and inferior thyroid veins.
* 4-Nerves: 2 phrenic, 2 vagi, left recurrent laryngeal , pairs of first thoracic nerves and sympathetic trunks.
* 5-Lymphatic vessels as thoracic duct left side and right lymph trunk.
* On each side are occupied by apex of the lung and cervical pleura which is covered by suprapleural membrane.
187
Mediastinal surface of the right lung related to?
```
o Right atrium,
o IVC,
o SVC,
o ascending aorta and remains of thymus gland, o oesophagus,
o vena azygos ,
o trachea,
o phrenic nerve and vagus nerve.
```
188
Mediastinal surface of the left lung?
```
o Left ventricle,
o arch of aorta,
o descending aorta,
o oesophagus,
o left common carotid artery ,
o left subclavin artery,
o phrenic nerve, and vagus nerve
```
