Exam 3- Thoracic Cavity Flashcards Preview

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Flashcards in Exam 3- Thoracic Cavity Deck (118):
1

Thoracic Wall

Thoracic cage and skin, Fascia, and Muscles
The Cage consists of 12 pairs of ribs and costal cartilages, 12 Thoracic Vertebrae and IV discs, and Sternum

2

Diaphragm

The prime mover of respiration and the accessory muscles of respiration
Quiet Respiration prime mover
Innervated by a pair of Phrenic Nerves
Blood Supply from the Inferior Phrenic Artery

3

Ribs 1, 2, 11, 12

These are atypical ribs (Ribs 3-10 are normal)

4

Costochondral, Sternocostal, Costovertebral, and Costotransverse Joints

These are all somewhat mobile except for the first rib, which isn't mobile at all

5

Superior Thoracic Aperture

The opening at the top of the Thoracic Cage surround by the 1st Ribs, Manubrium, and T1

6

Inferior Thoracic Aperture

The opening at the bottom of the Thoracic Cage surrounded by T12, Costal Cartilages 7-10, 11th and 12th pairs of Ribs, and the Xiphisternal Joint
Closed by the Muscular Diaphragm

7

Accessory Muscles of Respiration

Serratus Posterior Superior (proprioception), Serratus Posterior Inferior (proprioception), Levator Costarum (elevates ribs), Transcersus Thoracis (depresses ribs), Subcostal (elevates ribs), Intercostal Muscles (forced respiration and support), and Sternocleidomastoid and Scalenes (forced respiration)

8

Thoracic Cavity

Subdivided into 3 cavities by pleural membranes (right and left pulmonary and central mediastinum)

9

Muscles of Inspiration

Accessory: Sternocleidomastoid (elevates sternum), Anterior Scalenes, Middle Scalenes, and Posterior Scalenes (elevate and fix upper ribs)
Principal: External Intercostals (elevate ribs), Interchondral part of internal intercostal (elevate ribs), and Diaphragm (increase cavity and elevates ribs

10

Muscles of Expiration

Quiet Breathing: Results from passive recoil of lungs and rib cage
Active Breathing: Internal intercostals and Abdominals (depress lower ribs and push the diaphragm up): Rectus Abdominis, External Obliques, Internal Obliques, and Transversus Abdominis

11

Serous Fluid

Creates cohesion which is essential for lung inflation and lubrication which is essential for lung movements during respiration
Produced by Serous Membranes (Pleura)

If air enters the Pleural Cavity (pneumothorax), the lung will collapse due to elasticity of its tissue
Excess Fluid (serous fluid or blood from trauma) may accumulate in the Plueral Cavity and Compress the lungs.

12

Visceral Pleura

Covers Lung
Provides surface cohesion
Insensitive to pain

13

Parietal Pleura

Covers wall of Thorax
4 parts: Cervical (covers apex of lung and extends into the root of the neck), Diaphragmatic (covers the superior surface of the diaphragm), Costal (covers posteriolateral and anteriolateral surfaces), and Mediastinal (covers lateral mediastinum)

14

Recesses

These are gaps between the lung and the parietal pleura to permit expansion
It makes provision to allow expansion of the lung in full inspiration.
It is the most dependent part of the pleural sac; if fluid appears in the pleural sac; it collects first in the costodiaphargmatic recess

15

Costodiaphragmatic Recess

Inferior Margin of the thoracic wall
Location of fluid collection

16

Costomediastinal Recess

Potential space between costal pleura and mediastinal pleura

17

Thoracocentesis

The process of draining fluid from the lungs
Insert a hypodermic needle through and intercostal space into the pleural cavity to remove blood or pus
Insert superior to the 9th rib in the 9th intercostal space, high enough to avoid the collateral branches and the inferior border of the lung

18

Pneumothorax

Pressure entering the thoracic cavity causing the lung to collapse
Penetrating wound of the parietal pleura
Result is a Collapsed Lung

19

Lungs

Apex- blunt end that extends above 1st rib into the root of the neck covered by cervical pleura
Base- concave surgace resting on the ipsilateral convex dome of the diaphragm
Lobes- 2 or 3 from 2 or 3 fissures
3 Surfaces- Costal, Diaphragmatic, and Mediastinal
3 Borders- Anterior, Inferior, and Posterior
The Lungs main function is an exchange of gas- CO2 Out and Oxygen In
Parasympathetic Innvervation by the Vagus Nerve

20

Hilum

This is where everything enters and leaves the lungs

21

Branchopulmonary Segments

The lungs are divided into 10 functional segments-Bronchopulmonary Segments

22

Rings in Trachea

They exist to prevent collapse

23

Divisions of Trachea

Trachea-->Primary Branch-->Secondary Branch-->Tertiary Bronchioles-->Conducting Bronchioles-->Terminal Bronchioles-->Respiratory Bronchioles-->Alveolar Ducts-->Alveolus

Things are more likely to be clogged in the Right Bronchus because it shoots down while the Left bronchus shoots left

24

Bronchopulmonary Arteries

The arteries supplying blood to the lungs

25

Lymphatics of the Lung

2 Lymphatic Plexi drain the lung: Superficial Lymphatic Plexus (deep to visceral pleura drains tissue into the bronchopulmonary lymph nodes in the hilum) and Deep Lymphatic Plexus (in lining of bronchi drains root of lung)
Both drain into the Thoracic Duct

26

Pulmonary Plexus

Innervates the Lungs and the Visceral Pleura
Things Vagus Nerve (CN X) does: Vasodilate, Bronchoconstrict, Stimulate gland secretion, Reflexive Receptors (cough, Hering-Breuer, pressoreceptor and chemoreceptors) or Nociceptive (pain)

27

Asthma Inhalers

They are sympathetics and act on these receptors to relieve symptoms

28

Lobes locations

Inferior Lobe is mostly the back
Middle Lobe is just a small portion of the front
Superior Lobe is mostly the front

29

Horizontal Fissure

Follows the Fourth rib

30

Oblique Fissure

Starts from the Horizontal Fissure, crosses the 5th rib and terminates at the 6th rib

31

Fibrous Skeleton

This acts as an Anchor

32

Divisions of Mediastinum

Anterior Mediastinum
Inferior Mediastinum: Middle (Contains heart and pericardium and great vessels), Posterior (Contains esophagus and vessels), and Superior (Contains vessels, thymus, and trachea)

33

Pericardium

Inelastic tough sac that covers heart and beginnings of vessels
Prevents heart from overinflating leading to mechanical failure
2 Layers: Fibrous Pericardium (external, continues with vessels, and is the toughest part and Serous Pericardium (2 Layers- Parietal: lines inner surface of fibrous. Visceral: adheres to the heart)
Produces Serous Fluid for lubrication
Pericardiacophrenic Artery supplies blood to the Pericardium and comes from Internal Thoracic Artery
Coronary Artery supplies blood to the Visceral Layer of the Pericardium
Phrenic Nerves are the Sensory Nerves for the Pericardium

34

Cardiac Tamponade and Pericardiocentesis

Excess Fluid in the Pericardial Space
From Trauma, Infection, Cancer, or Autoimmune problems
Pericardiocentesis is the process of draining the fluid (needle is placed at 5th/6th intercostal)

A procedure that uses a needle to remove fluid from the pericardial sac. This is the tissue that surrounds the heart.

35

Atria

Receiving chambers of blood

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Ventricles

Pumping chambers of blood

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Diastole

Filling of the Ventricles of the Heart

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Systole

Forceful contraction and emptying of the Heart

39

Walls of the Heart

Epicardium (aka Visceral Pericardium)
Myocardium (Double Helical bands of cardiac muscle)
Endocardium (Covers valves, enourages smooth blood flow, and prevents clots)

40

Right Coronary Artery

Possibly the most important Artery in the Heart
Branches: SA Nodal Artery (SA Node), Right Marginal Branch (Right Border of the Heart), AV Nodal Branch (AV Node), and Right Interventricular Artery (Invterventricular Septum)
********Supplies R Atrium, most of R Vent, Diaphragmatic part of L Vent, IV Septum and usually AV (80%) and SA Nodes (60%)

41

Left Coronary Artery

Branches: Anterior Interventriucular Branch (LAD) (Left Ventricle and Interventricular Spetum), Circumflex Branch, and Left Marginal Artery (Left Border of the Heart)
Supplies L Atrium, most of L Vent, most of IV Septum, and AV Node (20%) and SA Node (40%)

42

Coronary Sinus

In Coronary Sulcus
Drains blood into the Right Atrium from: Great Cardiac Vein (in Anterior Interventricular Sulcus), Middle Cardiac Vein (in Posterior Interventricular Sulcus), and Small Cardiac Vein (wraps around in Coronary Sulcus)

43

Arterior Veins

Originate on the Anterior surface of the Right Ventricle, course over the Coronary Sulcus, and drain straight into the Right Atrium

44

Widowmaker

Left Anterior Descending Artery (Anterior Interventricular Artery)

45

Auricle

Ear- It's a projection of extra capacity

46

Fossa Ovalis

Remnant of Foramen Ovalis, which bypasses the Lungs in the a Fetus

47

Valves

The valves prevent the backward flow of blood
The backflow of the blood is responsible for the heart sounds
The cusps are attached to Cordae Tendonae which is attached to a Papillary Muscle that helps with the opening and closing of the valves

48

Right AV Valve

Tricuspid Valve- 3 Cusps

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Trabecula Carnae

The rough border of the inside of the Ventricles

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Conus Arteriosus

Smooth Cone
Helps with a smooth outflow through the Pulmonary Trunk

51

Crista Terminalis

Conductive Ridge of muscle important for contractility

52

Ventricular Walls

The Left Ventricular Walls are about 2-3x thicker than the Right Ventricular Walls

53

Prolapse

A slipping forward or down of one of the parts or organs of the body
Chordae Tendonae and Nodules of Semilunar Valves prevent prolapse

54

Fibrous Skelton

Framework of Dense Collagen
4 Rings that surround and anchor the 4 Major Valves (Right AV Valve, Left AV Valve, Pulmonary Valve, and Aortic Semilunar Valve)
Prevent overexpansion of Valve
Provides attachment of leaflets, cusps, and Myocardium
Provides an electrical "insulator" so that Atria and Ventricles contract independentlySA Node

55

SA Node

Natural Pacemaker- Roughly 70 bpm

56

AV Node

Distributes signal through heart skeleton

57

Heart Pressure

The pressure goes for 0 to beyond the Aortic Pressure

58

Annurism

This is a common defect to the aorta

59

Vagal Nerve

Part of the Sympathetic and Parasympathetic innervation of the Heart
Stimulation of the Parasympathetic Vagus Nerves constricts coronary arteries

60

Referred Pain of the Heart

Vervical and superior 5 Thoracic Sympathetic Ganglia are sensitive to Ischemia (tissue damage due to lack of Oxygen)
This causes referred pain to the dermatomes of these regions (Chest and along the Left Arm)

61

Parturition

Child Birth

62

Abdominal Cavity

Divided into two sections: Abdominal Cavity and Pelvic Cavity
The pelvic cavity is a body cavity that is bounded by the bones of the pelvis

Subdivisions of the Abdominal Cavity From Top Left to Bottom Right. 3 per row
Right Hypochondrium, Epigastium, Left Hypochondrium
Right Flank, Umbilical, Left flank (Lumbar)
Right Inguinal, Hypogastrium, Left Inguinal

63

Right Upper Quadrant

Liver: Right Lobe, Gallbladder, Stomach: Pylorus, Duodenum, Pancreas: Head, Right kidney and Suprarenal Gland, Right Colic Flexure, Ascending Colon, Transverse Colon

64

Left Upper Quadrant

Liver: Left Lobe, Spleen, Stomach, Jejunum and Proximal Ileum, Pancreas, Body and Tail, Left Kidney and Suprarenal Gland, Left Colic Flexure, Transverse Colon, and Descending Colon

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Right Lower Quadrant

Cecum, Appendix, Most of Ileum, Ascending Colon, Right Ovary, Right Uterine Tube, Right Ureter, Right Spermatic Cord, Uterus (If enlarged), and Bladder (If very full)

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Left Lower Quadrant

Signmoid Colon, Descending Colon, Left Ovary, Left Uterine Tube, Left Ureter, Left Spermatic Cord, Uterus (If enlarged), and Bladder (If very full)

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Transverse Planes

Subcostal and Interspinous Planes (Most Common)
Transpyloric and Interspinus Planes

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Sagittal Planes

Midclavicular Lines (Most Common)
Semilunar Lines

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Xiphoid Process

T9

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Transpyloric Plane

Pylorus, Pancreatic Neck, Duodeno-Jejunal Flexure, and Hila of Kidneys
L1

71

Subcostal Plane

L3

72

Umbilicus

L3/L4

73

Iliac Crest Plane

L4

74

Sacrum

Anterior Superior Iliac Spine
ASIS

75

Campers Fascia

Superficial Fatty Tissue
Looks like Popcorn

76

Scarpa's Fascia

Deep Membranous
Continuous with Fascia of Perineum (Colle's Fascia)
Looks like a sheet

77

Anterior Abdominal Wall Muscles

Functions are to Compress and Support Viscera and to Flex and Rotate the Trunk
The layers of the Anterior Abdominal Wall are:
Skin
Subcutaneous tissue
Fascia-Camper's fascia (fatty superficial layer) and Scarpa's fascia (deep fibrous layer)
Muscle: External oblique abdominal muscle, Internal oblique abdominal muscle, Rectus abdominis, Transverse abdominal muscle, Pyramidalis muscle
Fascia transversalis
Peritoneum

78

Abdominal Vessels

The Arteries and Veins are all paired together
Superior Epigastric Branches of Internal Thoracic
Inferior Epigastric and Deep Circumflex branches of the External Iliac
Superficial Circumflex branches from Femoral
Posterior Intercostal and Subcostal Vessels

79

Superior Epigastric Vessels

From: Internal Thoracic Artery
Supply: Rectus Abdominis Muscle and Superior Ubilical Regions

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Inferior Epigastric Vessels

From: External Iliac Artery
Supply: Rectus Abdomins Muscle and Inferior Umbilical Regions

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Superficial Circumflex Iliac Vessels

From: Femoral
Supply: Superficial Abdominal Wall of Inguinal Region and Iliac Fossa

82

Superficial Epigastric Vessels

From: Femoral
Supply: Superficial Abdominal Wall of Pubic and Inferior Ubilical Regions

83

Thoracoepigastric Vein

It's a direct connection between Femoral Vein and Axillary Vein in the case of clogs or needs to be redirected

84

Lymphatics

Horizontal Bar can be palpated more easily due to being more superficial than the deep Vertical Bars

85

Caput Medusae

Collateral Venus Return resulting from IVC blockage or patients with Portal Vein Hypertension

86

Ilioinguinal Nerve

Cutaneous Field is the area surround the sex organ

87

Iliohypogastric

Cutaneous Field is about the area of ASIS and portion that almost looks like a pair of briefs

88

Lateral Cutaneous Nerve of the Thigh

Cutaneous Field is the Lateral portion of the thigh

89

Inguinal Ligament

Connects ASIS to the Pubic Tubercle
Clinically important site of herniation
Formed by Aponeuroses of the External Oblique

90

Myopectineal Orfice

Site of Hernias

91

Inguinal Canal

Lies superior and parallel to the Inguinal Ligament
From Deep Inguinal Ring to Superficial Inguinal Ring
Spermatic Cord (Males), Round Ligament (Females), and Genitofemoral Nerve passes through this
Ilioinguinal Nerve passes through but does not enter via Deep Inguinal Ring

Same: Ilioinguinal Nerve, Genitofemoral Nerve, Lymphatic Vessels
Different (Women): Round Ligament of Uterus
Different (Men): Spermatic Cord, Ductus (Vas) Deferens, Cremaster Muscle (Internal Oblique)

92

Round Ligament

In women the Round Ligament follows the same pattern as the Ductus Deferens (carries sperm)
This anchors the Uterus to the skin

93

Indirect vs. Direct Hernia

Indirect is lateral to the Epigastric Vessels and Direct is medial to the Epigastric Vessels

94

Thymus

It's job is to recognize receptors that hold molecules
It gets worse with age (Old people get sick easier)

95

Superior Mediastinum Contents from Superficial to Deep

Sternum-> Thymus-> Internal Thoracic Vessels-> Brachiocephalic Veins-> Brachiocephalic Trunk-> Paratracheal Lymph Nodes-> Common Carotid Artery-> Trachea-> Subclavian Artery-> Esophagus-> Thoracic Duct

96

Left and Right Brachiocephalic Veins

Left is twice as long as the right as it crosses midline because the tilt causes it to need to travel a longer distance
They unite to create the Superior Vena Cava

97

Arteries compared to Veins

Generally Posterior

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Trachea

It is not part of the mediastinum

99

Aortic Annurism

Could cause vocal cord injury

100

Ligamentum Arteriosum

Attaches inferior to Aortic Arch from pulmonary trunk
Remnant of Ductus Arteriosus in the fetus (bypasses lungs)

101

Branches of Aortic Arch

Brachiocephalic
Left Common Carotid
Left Subclavian
Around the areas of 1st rib/clavicle

102

Azygos System

On either side of vertebral column
Drains the back, Abdominal walls, medistinal viscera
Azygos, Hemiazygos, Accessory Hemiazygos

103

Splanchnic Nerves

3 Splanchnic Nerves: Greater Lesser, and Least

104

RBC path to Esophagus

Left Ventricle, Aortic Arch, Thoracic Aorta, Esophageal Aorta

105

Superior Mediastium from Posterior to Anterior

Esophageal Plexus then Thoracic Duct

106

Blood supply to Lungs, Trachea, and Esophagus

Lungs get their blood supply from the Bronchial Artery and returned via Pulmonary Veins- Comes from Thoracic Aorta
Trachea gets its blood from the Bronchial Artery
Esophagus gets its blood differently in different locations. The cervical portion is supplied by the inferior thyroid artery. The thoracic portion is supplied by bronchial and esophageal branches of the thoracic aorta. The abdominal portion is supplied by ascending branches of the left phrenic and left gastric arteries

107

Psoas Major

Origin: Sides of T12-L5 and discs between; Transverse Processes of all Lumbar
Insertion: Lesser Trochanter of Femur
Action: Flexes thigh at hip joint and stabilizes the joint
Nerve: Anterior Rami of Lumbar Nerves (L1, L2, L3)
Blood Supply: Lumbar branches of Iliolumbar Artery

108

Psoas Minor

Origin: Sides of T12-L1 and discs
Insertion: Pectineal Line, Iliopectineal Eminence via Iliopectineal Arch
Action: Flexes thigh at hip joint and stabilizes the joint
Nerve: Anterior Rami of Lumbar Nerves (L1, L2)
Blood Supply: Lumbar branches of Iliolumbar Artery

109

Iliacus

Origin: Iliac Crest, Iliac Fossa, Ala of Sacrum, and Anterior Sacroiliac Ligaments
Insertion: Tendon of Psoas Major, Lesser Trochanter, and Femur
Action: Flexes thigh at hip joint and stabilizes the joint
Nerve: Femoral Nerve (L2,L3)
Blood Supply: Iliac Branches of Iliolumbar Artery

110

Quadratus Lumborum

Origin: Medial Half of Posterior Iliac Crest and Iliolumbar Ligament
Insertion: Transverse Processes of L1-L4 and Medial half of 12th Rib
Action: Extends the Vertebral Column and also laterally flexes the vertebral column
Nerve: Subcostal Nerve and Ventral Rami of L1-L4
Blood Supply: Lumbar Artery

111

Rectus Sheath

The rectus sheath is made up of two parts, known as the posterior sheath and the anterior sheath

112

External Oblique

Origin: External Surfaces of Ribs 5-12
Insertion: Linea Alba, Pubic Tubercle, Anterior Half of Iliac Crest
Action: Compresses and Supports Abdominal Viscera, Flexes and Rotates Trunk
Nerve: Ventral Rami of 6 Inferior Thoracic Nerves
Blood Supply: Superior and Inferior Epigastric Arteries

113

Internal Oblique

Origin: Thoracolumbar Fascia, Anterior 2/3 of Iliac Crest, Lateral Half of Inguinal Ligament
Insertion: Inferior Borders of Ribs 10-12, Linea Alba, Pubis via Conjoint Tendon
Action: Compresses and Supports Abdominal Viscera, Flexes and Rotates Trunk
Nerve: Ventral Rami of 6 Inferior Thoracic and First Lumbar Nerves
Blood Supply: Superior and Inferior Epigastric and Deep Circumflex Iliac Arteries

114

Transverse Oblique

Origin: Internal Surfaces of Costal Cartilages 7-12, Thoracolumbar Fasic, Iliac Crest, Lateral Third of Inguinal Ligament
Insertion: Linea Alba, Pubic Crest, and Pecten Pubis via Conjoint Tendon
Action: Rotation, Flexion, and Lateral Flexion0
Nerve: Ventral Rmai of 6 Inferior Thoracic and First Lumbar Nerves
Blood Supply: Deep Circumflex Iliac and Inferior Epigastric Arteries

115

Rectus Abdominis

Origin: Pubic Symphysis, Pubic Crest
Insertion: Xiphoid Process, Costal Cartilages 5-7
Action: Flexes Trunk, Compresses Abdominal Viscera
Nerve: Ventral Rami of 6 Inferior Thoracic Nerves
Blood Supply: Superior and Inferior Epigastric Arteries

116

Pyramidialis

Origin: Body of Pubis, Anterior to Rectus Abdominis
Insertion: Linea Alba
Action: Tenses Linea Alba
Nerve: Iliohypogastric Nerve
Blood Supply: Inferior Epigastric Artery

117

Great Vessels that enter and leave the heart

Superior and Inferior Vena Cava
Pulmonary Trunk
Right and Left Pulmonary Veins
Ascending Aorta

118

Drain into Superior Vena Cava

Right and Left Brachiocephalic Vein and Azygous Vein