Clinical contact of thoracic anatomy Flashcards
Examples of structures passing through superior thoracic aperture
Trachea, oesophagus, L common carotid, l subclavian, l brachiocephalic, l phrenic vein
Difference between parietal and visceral
Parietal is next to lungs, visceral is next to ribs
Suprasternal notch level
T2
Angle of louis
T4/5
Inferior angle of scapula
T8
Xiphisternum
T9
Lowest part of costal q0th rib
L3
Apex beat level
5th intercostal space, mid-clavicular line
Innervation of lungs
Pulmonary plexus at hilum
Sympathetic T2-6 and PS fibres
Afferent from nociceptors and efferent to bronchodilators
Cause of muscle wasting in hand
Subclavian artery, vein and BP can be trapped against rib 1 - especially T1
Where do you conduct centesis?
Mid-clavicular line, second intercostal space on same side of collapsed lung
Why can lung cancer affect voice?
Vagus affects recurrent laryngeal nerve
Where in relation to the rib should a chest drain be placed?
Superiorly
Thoracic outlet syndrome
Obstructed by extra ribs or abnormally tight band connecting ribs and spine
F 30-40 are risk factors
Causes pain in neck and shoulder + paraesthesia in ulnar hand/forearm
Flail chest
- Fracture in two places of 3 adjacent ribs
- Segment of chest wall is unstable and becomes free
- Moves in opposite direction to respiratory movements
