exam 2 Flashcards
(217 cards)
1
Q
why is the T4 dermatome important?
A
in line with the nipple
2
Q
why is the T10 dermatome important
A
in line with umbilicus
3
Q
contents of intercostal spaces
A
external fascia, external intercostal m, internal intercostal m, neurovasculat layer, innermost intercostal m, endothoracic fascia, intercostal n + a + v, collateral n + a + v
4
Q
posterior border of superior thoracic aperature
A
T1 vertebral body
5
Q
lateral border of superior thoracic aperature
A
first ribs + their cartilage
6
Q
anterior border of superior thoracic aperature
A
superior border of manubrium
7
Q
posterior border of inferior thoracic aperature
A
T12 vertebral body
8
Q
posteriolateral border of inferior thoracic aperature
A
11th + 12th pairs of ribs
9
Q
anterolateral border of inferior thoracic aperature
A
joined costal cartilages of ribs 7-10
10
Q
anterior border of inferior thoracic aperature
A
xiphisternal joint
11
Q
structures associated with T2 bony landmarks
A
jugular notch
12
Q
structures associated with T3-T4 bony landmarks
A
manubrium
13
Q
structures associated with T4-T5 bony landmarks
A
sternal angle + 2nd rib attachment
14
Q
structures associated with T5-T9 bony landmarks
A
body of sternum
15
Q
structures associated with T9 bony landmarks
A
xiphisternal joint
16
Q
movement of ribs 2-6
A
elevates + depresses the sternal ends of ribs (pump handle movement)
17
Q
movement of ribs 7-10
A
elevates + depresses lateral most aspects of ribs (bucket handle movement)
18
Q
what causes the contraction of the diaphragm + increases the height of thoracic cavity
A
inspiration
19
Q
what causes the relaxation of the diaphragm decreasing vertical height
A
expiration
20
Q
pectoral fascia
A
surround most of pectoralis major
21
Q
clavipectoral fascia
A
suspended from the clavicle, envelops the pectoralis minor muscle. deep to pectoral fascia
22
Q
endothoracic fascia
A
lines internal surface of thoracic cage + attaches coastal parietal pleura to thoracic wall
23
Q
serratus posterior superior m action
A
forced inspiration, elevates ribs 1-4, proprioception
24
Q
serratus posterior inferior m action
A
forced expiration, depresses inferior ribs, proprioception
25
levator costarum m action
forced inspiration, elevates ribs
26
what direction are the fibers of the external intercostal muscles
from more lateral to medial
27
external intercostal m action
forced inspiration
28
internal + innermost intercostal m action
active expiration
29
what direction are the fibers of the internal intercostal muscles
medial to lateral
30
what direction are the fibers of the innermost intercostal muscles
medial to lateral
31
transversus thoracis m action
weak forced expiration, help depress ribs, proprioception
32
subcostalis muscles action
forced expiration + depresses ribs
33
what helps with inspiration
interchondral part of internal coastal muscles, serratus posterior superior, levator costarum
34
what muscles help with expiration
serratus posterior inferior, internal + innermost intercostal muscles, subcostalis m, transversus thoracic
35
serratus posterior superior m innervation
2-5 intercostal n
36
serratus posterior inferior m innervation
anterior rami T9-T12 thoracic spinal
37
levator costarum m innervation
posterior primary rami C8-T11 nerves
38
external intercostal m innervation
intercostal n
39
internal intercostal m innervation
intercostal n
40
innermost intercostal m innervation
intercostal n
41
subcostal m innervation
intercostal n
42
transversus thoracis m innervation
intercostal n
43
bed of breast
lateral border of sternum to midaxillary line + from 2-6 ribs vertically
44
retromammary space
loose subcutaneous tissue plane between the breast + the pectoral fascia
45
axillary process/tail of breast
small part of the mammary gland extending along the inferior lateral edge of pectoralis major toward the axillary fossa
46
what is another name for the axillary process
tail of spence
47
mammary duct system
differentiate during 1st pregnancy to produce milk
48
what type of gland are mammary glands
apocrine glands
49
what type of tissue does the mammary gland come from
mesoderm
50
effect of estrogen in breast
growth of ductal system + fat deposition during puberty
51
effect of progestrone in breast
differentiate the lobular-alveolar system during 1st pregnancy
52
effect of prolactin in breast
stimulates enzymes for milk production
53
where does prolactin come from
anterior pituitary gland
54
effect of oxytocin in breast
stimulate smooth muscle contraction of milk "let down"/expulsion
55
where does oxytocin come from
posterior pituitary gland
56
sensory innervation from skin of breast + nipple
anterior + lateral cutaneous branches of 4-6 intercostal nerves
57
motor innervation of breast
sympathetic postganglionic fibers of T4-T6 ventral rami
58
arterial supply of breast
medial mammary branches, anterior intercostal thoracic a, lateral thoracic a, thoraco-acromial a, posterior intercostal a 2-4
59
venous drainage of breast
into axillary v + internal thoracic v
60
what quadrants of the breast drains into the anterior/pectoral nodes to axillary lymph nodes
lateral breast quadrants
61
what quadrants of the breast drains into the parasternal nodes to tracheobronchial lymph nodes
medial breast quadrants
62
which quadrant is breast cancer most common
superio-lateral quadrant/tail of spence
63
what does dorsal rami innervate
skin on back, facet joints, deep back muscles
64
what nerves become the intercostal nerves
anterior rami of T1-T11
65
what nerve becomes the subcostal n
anterior rami of T12
66
branches off of the intercostal nerves
collateral n, white rami communicantes, gray rami communicans, lateral cutaneous branch, anterior cutaneous branch
67
where do intercostal nerves 3-11 run
costal grooves on the ribs
68
where does intercostal nerves 1 + 2 run
inside of 1st + 2nd ribs
69
intercostobrachial n supplies...
floor of the axilla
70
where does the lateral cutaneous branches change names to thoraco-abdominal nerves
at the costal margin
71
what nerves give rise to the lateral cutaneous branch nerves
intercostal nerves 7-11
72
anterior cutaneous branches innervate...
pierce rectus sheath near median plane
73
what does the posterior intercostal a supply
spinal cord, vertebral column, deep back muscles, + skin on the back
74
what does the subcostal a supply
abdominal wall
75
what does the vertebral a supply
blood to brain and superior spine
76
what does the anterior intercostal a supply
1-9 intercostal spaces, intercostal muscles, pectoral muscles, breast, skin
77
what does the superior epigastric a supply
abdominal wall
78
what does the musculophrenic a supply
diaphragm
79
what does the supreme intercostal a supply
1st + 2nd intercostal spaces
80
what does the superior thoracic a supply
pectoral muscles
81
what does the lateral thoracic a supply
lateral thoracic wall (axillary lymph nodes, pec major + minor)
82
what branches come off of the thoracic aorta
posterior intercostal a + subcostal a
83
what branches come off of the subclavian a
vertebral a, internal thoracic a, costocervical trunk, thyrocervical trunk
84
what branches come off of the axillary a
superior thoracic a + lateral thoracic a
85
where do anterior intercostal v drain into
internal thoracic v
86
where do internal thoracic v drain into
brachiocephalic v
87
what do the posterior intercostal v drain
skin + muscles of the back
88
what does the posterior intercostal v drain into
brachiocephalic v + azygous system
89
what veins drain into the azygous v
4-11 posterior intercostal + subcostal v on right side
90
what drains into the accessory hemiazygous v
4-8 posterior intercostal v on left side
91
what drains into the hemiazygous v
9-11 + subcostal v on left side
92
mediastinum
central compartment of the thoracic cavity between the 2 pulmonary cavities
93
contents of mediastinum
thoracic viscera + all structures EXCEPT lungs + pleura
94
superior border of mediastinum
superior thoracic aperature
95
inferior border of mediastinum
diaphragm
96
anterior border of mediastinum
sternum + costal cartilage
97
posterior border of mediastinum
thoracic vertebrae
98
contents of superior mediastinum
superior vena cava, brachiocephalic veins, arch of aorta, arch of azygos v, thoracic duct, trachea, esophagus, thymus, vagus n, left recurrent laryngeal n, phrenic n
99
divisions of inferior mediastinum
anterior, middle, + posterior
100
contents of anterior mediastinum
loose connective tissue, fat, lymphatic vessels, lymph nodes, internal thoracic vessels
101
contents of middle mediastinum
phrenic n
102
contents of posterior mediastinum
esophagus, thoracic aorta, azygos v, hemiazygos v, thoracic duct, vagus n, splanchnic n
103
what forms the brachiocephalic veins
internal jugular v + subclavian v coming together
104
which brachiocephalic v is longer
the left is 2x longer
105
what forms the superior vena cava
left + right brachiocephalic veins
106
what nerve travels along the superior vena cava
r phrenic n
107
where in the mediastinum is the superior vena cava
superior mediastinum
108
where does the ascending aorta start
middle mediastinum
109
what branches come off of the ascending aorta
l + r coronary arteries
110
what part of the mediastinum is the descending aorta in
posterior mediastinum
111
what are the branches off of the arch of the aorta
brachiocephalic trunk, l common carotid a, + l subclavian a
112
what region of the mediastinum is CN X in
superior mediastinum
113
what are the branches off of CN X
recurrent laryngeal n (l + r), pulmonary plexus, cardiac plexus, esophageal plexus
114
what region of the mediastinum is the phrenic n in
superior mediastinum
115
what is the bifurcation of the trachea called
carina
116
where in the mediastinum is the trachea
superior mediastinum, slightly to the right
117
what mediastinum is the esophagus in
superior + posterior mediastinum
118
what are the structures that pass through the diaphragm
inferior vena cava @ T8, esophagus @ T10, + aorta @ T12
119
where does the thoracic aorta begin? end?
level of T4; T12
120
what are the branches off of the thoracic aorta
anterior-unpaired visceral branches, lateral-paired visceral branches, + posterolateral-parietal branches
121
pleural cavity
potential space between the visceral + parietal layers of pleura
122
visceral pleura
shiny outer surface, adheres to the lungs
123
parietal pleura
line pulmonary cavities, adheres to thoracic wall, diaphragm, + mediastinum
124
what are the divisions of the parietal pleura
costal, diaphragmatic, cervical, + mediastinal
125
supraclavicular fossa
depressions posterior + superior to clavicles + lateral to SCM tendons
126
what structures are found in the supraclavicular fossa
supraclavicular lymph nodes, internal jugular vein, subclavian vein, + brachial plexus
127
pleura cupula
cup like dome of cervical pleura formed over apex of lung
128
suprapleural membrane
fibrous extension of endothoracic fascia reinforcing cervical pleura
129
phrenicopleural fascia
thin elastic layer of endothoracic fascia. connects the diaphragmatic pleura w/the muscular fibers of diaphragm
130
right sternal line location
straight down anterior median line to xiphoid
131
left sternal line location
straight down 4th costal cartilage to 6th
132
bare area
on left side where left sternal line pulls out. direct access to pericardium w/o puncturing the pleura
133
why is the bare area important
direct access to pericardium without puncturing the pleura
134
costodiaphragmatic recess
space where the diaphragm meets the inferior ribs
135
costomediastinal recess
posterior to sternum
136
mid-clavicular line pleural reflection
8th costal cartilage
137
mid-clavicular line lung inferior margin
6th rib
138
midaxillary line pleural reflection
10th rib
139
midaxillary line lung inferior margin
8th rib
140
scapular line pleural reflection
12th rib
141
scapular line lung inferior margin
10th rib
142
visceral pleura innervation
vagus n
143
costal pleura + peripheral diaphragmatic pleura innervation
intercostal nerves
144
central diaphragmatic pleura innervation
phrenic n
145
anterior border of the lung
where costal + mediastinal surfaces meet anteriorly + overlap heart
146
inferior border of the lungs
diaphragmatic surface
147
posterior border of the lung
where costal + mediastinal borders meet posteriorly
148
how many lobes does the left lung have
2
149
how many lobes does the right lung have
3
150
what are the lung surfaces
costal surface, diaphragmatic surface, mediastinal surface
151
costal surface of lungs
smooth + convex impressions from ribs
152
diaphragmatic surface of lungs
concave, on base of lung
153
mediastinal surface of the lungs
concave, includes the hilum
154
what structures are found in the root of the lung
pulmonary a, superior + inferior pulmonary v, main bronchi, pulmonary plexus, lymphatic vessels
155
where is the left pulmonary artery in relation to other structures in left lung
most superior
156
bronchi
cartilaginous c-rings, conduct air, no gas exchange
157
bronchial
pertaining to the bronchi
158
bronchiole
smaller airways, smooth muscle
159
tracheobronchial tree
trachea > primary bronchi > secondary bronchi > tertiary bronchi
160
how many right tertiary bronchi are there from superior secondary bronchi
3
161
how many right tertiary bronchi are there from middle secondary bronchi
2
162
how many right tertiary bronchi are there from inferior secondary bronchi
5
163
how many left tertiary bronchi are there from superior secondary bronchi
usually 4, sometimes 5
164
how many left tertiary bronchi are there from inferior secondary bronchi
sometimes 4, usually 5
165
what are bronchopulmonary segments
largest subdivision of the lung. pyramidal shaped w/apices
166
where are the arteries + bronchi located in bronchopulmonary segments
IN the segments
167
where are veins located in the bronchopulmonary segments
IN BETWEEN the segments
168
where does gas exchange take place in the lungs
bronchioles
169
pulmonary artery branches in the left lung
superior lobar + inferior lobar arteries
170
pulmonary artery branches in the right lung
superior lobar, middle lobar, + inferior lobar arteries
171
what kind of blood do the pulmonary arteries carry
deoxygenated blood away from the heart
172
what kind of blood do pulmonary veins carry
oxygenated blood back to the heart
173
what drains into the bronchopulmonary (hilar) lymph nodes
lung parenchyma + visceral pleura lymph plexus
174
what do the hilar lymph nodes drain into
tracheobronchial + bronchomediastinal lymph nodes
175
pancoast tumors
mediastinal tumors that affect the recurrent laryngeal n
176
what causes horners syndrome
pancoast tumors tht press on the brachial plexus and/or the stellate ganglion
177
signs of horners syndrome
miosis, ptosis, anhydrosis
178
layers of the pericardium
fibrous pericardium, serous pericardium
179
what tissue makes up the fibrous pericardium
180
what innervates the pericardium
phrenic n, sympathetic trunk, + vagus
181
what tissue makes up the serous pericardium
182
what is the blood supply to the pericardium
pericardiacophrenic a, bronchial a, esophageal a, coronary a
183
what type of tissue makes up the heart
simple squamous endothelium
184
what is the fibrous skeleton of the heart
complex framework of dense collagen anchoring the cardiac muscles
185
what is the function of the fibrous skeleton
electrical insulator, prevents overdistension, attachment for myocardium
186
coronary sulcus
atrioventricular groove encircling heart between atria + ventricles
187
anterior + posterior interventricular sulci/grooves
indentation marking the border between ventricles
188
apex of heart
points anterior + to the left
189
base of heart
faces posteriorly
190
what chamber of the heart is associated with the apex of the heart
left ventricle
191
what chamber of the heart is associated with the base of the heart
left atrium
192
anterior/sternocostal surface of the heart
mainly composed of the right ventricle
193
diaphragmatic/inferior surface of the heart
mainly composed of left ventricle
194
right pulmonary surface of heart
formed by right atrium
195
left pulmonary surface of the heart
formed by left ventricle
196
openings in the right atrium
superior vena cava, inferior vena cava, coronary sinus, anterior veins of R ventricle, + tricuspid valve
197
trabeculae carnae
interconnecting muscular ridges located in ventricular wall
198
papillary muscles
cone-shaped muscles that connect to chordae tendonae
199
chordae tendonae
attache papillary muscles to borders of the cusps of tricuspid/bicuspid valves
200
conus arteriosus
upper portion of the R ventricle which ends in pulmonary trunk
201
supraventricular crest
thick, muscular ridge that separates conus arteriosus from R ventricle
202
septomarginal trabecula
large trabecula that extends from interventricular septum to base of the anterior papillary muscles
203
openings in the R ventricle
tricuspid valve + pulmonary valve
204
where is the tricuspid valve
between the right atria + right ventricle
205
openings in the left atrium
pulmonary veins + mitral valve
206
aortic vestibule
smooth-walled portion of the L ventricle, below the cusps of the aortic valve
207
openings in the left ventricle
mitral valve + aortic valve
208
where is the bicuspid/mitral valve
between the L atria + ventricles
209
know blood supply pattern
DRAW FLOW CHART
210
great cardiac vein drains
anterior portion of the heart
211
middle cardiac vein drains
212
small cardiac vein drains
213
posterior vein of L ventricle drains
214
oblique v of L atrium drains
215
where is the SA node found
upper end of crista terminalis near junction of R atrium + SVC
216
where is AV node located
septal wall of R atrium
217
where is AV bundle located
septomarginal trabecula of R ventricle + papillary muscles of L ventricle
