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Anatomy > Module 3: Thorax > Flashcards

Module 3: Thorax Flashcards

1
Q

What are the bones of the thoracic wall?

A

Ribs
Thoracic vertebrae
Sternum

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2
Q

Function of the thoracic wall:

A

Protect thoracic content

- lungs, heart, blood vessels, esophagus, etc

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3
Q

True v. false. floating ribs. How many of each?

A

True : 1-7
False: 8-10
Floating: 11 and 12

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4
Q

Which ribs are typical and which are atypical? Why?

A

Ribs 3-9 are typical and have 2 costal facets
Ribs 1-2 and 10-12 are atypical

Atypical ribs only articulate w/ 1 vertebrae

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5
Q

Where on the rib is the most common fracture site?

A

Costal angle

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6
Q

Where does the tubercle of the rib articulate?

A

Transverse process

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7
Q

What is the clinical significance of the sternal angle of the sternum?

A
  1. Bifurcation of trachea
  2. Beginning and ending of the aortic arch
  3. Palpation of sternal angle is location for 2nd rib
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8
Q

What 3 segments make up the sternum?

A

Manubrium
Body
Xiphoid Process

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9
Q

The part of the sternum that is either ossified or cartilaginous is the ______.

A

Xiphoid Process

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10
Q

What are the 4 “major” articulations of the thoracic wall?

A
  1. Costovertebral joint
  2. Costochondral joint
  3. Sternocostal
  4. Sternoclavicular (“SC joint”)
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11
Q

The costovertebral joint articulates with…

A

Vertebral and TP’s of vertebrae

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12
Q

The sternocostal joint articulates with…

A

Articulation between costal cartilage and sternum

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13
Q

The sternoclavicular joint is unique from the other major articulations of the thoracic wall because…

A

It contains a disc and is critical for shoulder girdle function

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14
Q

Describe the movement of the thoracic wall during inspiration. I.e. what do the ribs do?

A

Rib cage increases in diameter because ribs motion in a “bucket handle” way

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15
Q

Where does the nipple of a male lie? (ribs and intercostal space)

A

Between ribs 4 and 5 in the 4th intercostal space

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16
Q

Where is the breast positioned on the female?

A

Between ribs 2-6 from the sternum to the mid-axillary line

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17
Q

When examining the breast of a female, how would you document where you have seen a lump/bump? i.e. how is the breast divided up to the clinician?

A

Document in quadrants

  • -> upper inner
  • -> lower inner
  • -> lower outer
  • -> upper outer
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18
Q

In terms of lymph drainage, where does the majority of breast drain into?

A

Axillary lymph nodes (75% of breast drains here)

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19
Q

What two things compose the female breast?

A

Glandular and adipose tissue

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20
Q

The superior aperture contains:

A
  1. Esophagus
  2. Trachea
  3. Nerves & blood vessels that supply the head, neck, and UE
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21
Q

The inferior aperture allows what structures to pass though?

A
  1. Esophagus
  2. IVC
  3. Aorta
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22
Q

Which intercostal muscles are responsible for inspiration?

A

External intercostals

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23
Q

Which intercostal muscles are responsible for expiration?

A

Internal intercostals

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24
Q

Does the transversus thoracis assist in inspiration or expiration?

A

Expiration (depresses rib)

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25
Q

Do the subcostal muscles assist in inspiration or expiration?

A

Inspiration (elevate ribs)

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26
Q

Do the levator costarum muscles assist in inspiration or expiration?

A

Inspiration (elevate ribs)

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27
Q

Where do the levator cosarum muscles attach?

A

Ribs and TP’s of C7-T11

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28
Q

Do the serratus posterior superior muscles assist in inspiration or expiration?

A

Inspiration

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29
Q

Do the serratus posterior inferior muscles assist in inspiration or expiration?

A

Expiration

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30
Q

What is the major function of the diaphragm?

A

INSPIRATION

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31
Q

What nerve innervates the diaphragm?

A

Phrenic Nerve

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32
Q

What are the 3 layers of musculature of intercostal spaces?

A
  1. External
  2. Internal
  3. Innermost intercostal muscles
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33
Q

What is the intercostal VAN?

A

The neurovascular bundle in the intercostal space that consists of vein, artery, and nerve

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34
Q

Describe what muscles are used during inspiration at:

a. rest
b. exercise
c. extreme exercise

A

a. rest: diaphragm
b. exercise: diaphragm + external intercostals
c. extreme exercise: diaphragm + external intercostals + accessory muscles (SCM & scalenes…pecs can assist too)

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35
Q

Describe what muscles are used during expiration at:

a. rest
b. exercise

A

a. rest: NONE - elastic recoil of lungs

b. exercise: internal intercostals + abdominal muscles

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36
Q

What are the two major sources of blood supply to the rib cage?

A
  1. Descending aorta

2. Subclavian arteries

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37
Q

The anterior intercostal arteries originate from __________.

A

Descending internal thoracic artery

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38
Q

The azygos and hemiazygos veins descend near the esophagus. Which side of the body is the azygos on? What side the hemiazygos?

A

Azygos - right side

Hemiazygos - left side
**(and accessory vein)

39
Q

What are the 3 compartments of the thoracic cavity?

A

2 pulmonary cavities

Mediastinum

40
Q

What structures does the mediastinum contain?

A
  • Heart
  • Great vessels
  • Trachea
  • Esophagus
  • Thymus
  • Lymph nodes
41
Q

Define pleurae:

A

two layers of continuous, thin, serous membranes

42
Q

Two types of pleurae and what they invest?

A

Visceral pleura - invests lungs

Parietal pleura - lines thoracic wall and diaphragm

43
Q

Costodiaphragmatic recess:

A

pleural recess that can accumulate fluid w/ various conditions, lateral and posterior removed via thorencentesis

44
Q

Costomediastinal recess:

A

smaller pleural recess located posterior to sternum

45
Q

What does the hilum of each lung contain?

A
  1. Primary bronchus
  2. 2 pulmonary veins (sup. and inf.)
  3. 1 pulmonary artery
  4. Bronchial vessels
  5. Pulmonary nerve plexus
  6. Lymph vessels
46
Q

The right lung has ___ lobes and the left lung has ____ lobes.

A

Right lung has 3 lobes

Left lung has 2 lobes

47
Q

Where can you find the base of lungs on the anterior side and posterior side of body

A

6th or 7th rib - anterior

9th or 10th rib - posterior

48
Q

The oblique fissure of the lung separates which two lobes?

A

Superior and inferior

Located on both left and right lungs

49
Q

The horizontal fissure of the lung separates which two lobes?

A

Superior and middle lobe

Located only on right lung

50
Q

Describe the bronchial tree

A

Trachea –> bifuricate into R/L primary bronchi –> divide into lobar bronchi –> Divide into segmental bronchi –> divde into smaller divisions of bronchioles (20-25 generations) –> end as terminal bronchiole which give rise to respiratory bronchioles

51
Q

Borders of the mediastinum?

  • Superior
  • Inferior
  • Anterior
  • Posterior
A

Superior: superior thoracic aperture

Inferior: diaphragm

Anterior: Sternum and costal cartilages

Posterior: thoracic vertebrae

52
Q

What is the mediastinum?

A

The region between the pleural cavities

53
Q

What does the superior division of the mediastinum contain?

A
  • thymus in children, remnants in adults
  • Arch of aorta/great vessels
  • Trachea
  • Esophagus
54
Q

What does the anterior portion of the inferior division of the mediastinum contain?

A

internal thoracic vessels

fat

few lymph nodes

55
Q

What does the middle portion of the inferior division of the mediastinum contain?

A

pericardium

heart

roots of great vessels

56
Q

What does the posterior portion of the inferior division of the mediastinum contain?

A

esophagus

descending aorta

thoracic duct

lymph nodes

57
Q

What is the heart enclosed in?

A

Pericardium

58
Q

What are the two layers of the pericardium?

A

Fibrous pericardium (outside)

Serous pericardium (inside)

59
Q

What are the two layers of the serous pericardium?

A 
Parietal layer
Visceral layer (outer layer)
60
Q

What does the pericardiacophrenic ligament connect?

A

Fibrous pericardium and diaphragm

61
Q

What does the sternopericardial ligament connect?

A

Fibrous pericardium and sternum

62
Q

Where is the pericardium cavity?

A

The space between the parietal and visceral pericardium where heart can “freely” move

63
Q

Differentiate between epicardium, myocardium, and endocardium:

A

Epicardium - visceral serous pericardium

Myocardium - cardiac muscle

Endocardium - thin, smooth endothelial layer that lines the heart and valves

64
Q

What are 3 functions of the fibrous skeleton of the heart?

A
  1. Provide attachments for myocardium of atria and ventricles
  2. Provide attachment for cardiac valves
  3. Provide electrical insulation between atria and ventricles
65
Q

Where is the apex of the heart?

A

tip of the left ventricle

5th intercostal space just medial to midclavicular line

66
Q

Where is the base of the heart?

A 
Posterior side of heart as it sits in cavity in vivo
Left atrium (technically some right atrium too)
67
Q

Right border of the heart:

A

right atrium, extending between SVC and IVC

68
Q

Left border of the heart:

A

Primarily left ventricle and some left atrium

69
Q

Inferior border of the heart:

A

Primarily right ventricle and some left ventricle

70
Q

Superior border of the heart:

A

junction where great vessels enter and leave heart

71
Q

Where is the sternocostal surface of the heart?

A

Mostly right ventricle

72
Q

Where is the diaphragmatic surface of the heart?

A

Mostly left ventricle and partially right ventricle

73
Q

Where is the pulmonary surface of the heart?

A

Mostly left ventricle

74
Q

Where is the tricuspid valve found?

A

In the right atrium connecting to the right ventricle

75
Q

Where is the bicuspid (mitral) valve found?

A

In the left atrium connecting to the left ventricle

76
Q

The branches of the aortic arch are:

A

Brachiocephalic trunk
Left common carotid artery
Left subclavian artery

77
Q

In which valve do you find the opening to the coronary sinus

A

Right atrium

78
Q

Where is the left sternal border and what is it’s importance clinically?

A

Found at 4th or 5th intercostal spaces

Can ausculate along it

79
Q

Where is the pulmonary valve located and what is it’s other name?

A

Located between the right ventricle and pulmonary trunk

Also called right semilunar valve

80
Q

Where is the aortic valve located and what is it’s other name?

A

Located between left ventricle and the aorta

Also called the left semilunar valve

81
Q

Where would you be able to auscultate the pulmonary valve?

A

left 2nd intercostal space

82
Q

Where would you be able to auscultate the aortic valve?

A

right 2nd intercostal space

83
Q

Where would you be able to auscultate the bicuspid valve?

A

Along apex…5th intercostal space

84
Q

Where do coronary arteries arise from?

A

The base of aorta –> the “backflow” from aortic pressure creates blood flow through coronary arteries

85
Q

The right coronary artery supplies _____ and _____.

A

Right atrium and right ventricle

86
Q

The marginal branch of the right coronary artery supplies…

A

right ventricle

87
Q

The left coronary artery divides into ____ and _____

A

anterior interventricular artery and circumflex artery

88
Q

The anterior interventricular artery supplies ____, _____, and _____.

A

right ventricle
left ventricle
majority of interventricular septum

89
Q

Circumflex artery supplies the ____ and ____.

A

left atrium

left ventricle

90
Q

Marginal branch of left coronary artery supplies…

A

left ventricle

91
Q

The coronary sinus drains into ….

A

right atrium

92
Q

The sympathetic nervous system ____ heart rate

A

increases

93
Q

The parasympathetic nervous system ____ HR

A

decreases

94
Q

The nodal branch of the right coronary artery supplies the…

A

SA and AV nodes

Anatomy (3 decks)

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