The Thorax Flashcards

(406 cards)

1
Q

What separates the thorax from the abdomen

A

The diaphragm

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2
Q

What protects the thorax

A

thoracic cage

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3
Q

Contents of the thorax

A
  • Heart
  • Great vessels
  • Lungs
  • Airways
  • Supporting circulatory and nerve networks
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4
Q

Define Mediastinum

A

the space between the lungs

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5
Q

3 Functions of the chest wall (thoracic cage)

A
  1. Protection of the thoracic and abdominal contents
  2. Breathing
  3. Attachements for the upper limb are located at the sternoclavicular joint
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6
Q

Explain how breathing occurs

A

Breathing occurs when the diaphragm contracts and relaxes, allowing air to enter and leave the lungs. When exertion is required the diaphragm is assisted by the intercostal, arm and neck muscles.

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7
Q

Where is the breast attached?

A

between ribs 2 and 6 (covering the pectoralis major)

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8
Q

Contents of the thoracic cage

A
  • 12 ribs
  • 12 vertebrae
  • the sternum
  • Inlet
  • Outlet
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9
Q

Where is the throacic cage widest?

A

at ribs 7 and 8

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10
Q

What is the inlet

A

The inlet is the 1st thoracic vertebra posteriorly, the 1st ribs (at the sides) and the superior aspect of the manubrium sterni

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11
Q

List structures that pass through the inlet (7)

A
  • Esophagus
  • Trachea
  • Common Carotid and Subclavian Arteries
  • Jugular and Subclavian Veins
  • Left and Right Vagus Nerves
  • Left and Right Phrenic Nerves
  • Left and Right Sympathetic Trunks
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12
Q

What is the outlet

A

The 12th thoracic vertebra, the 12th ribs passing into the 11th ribs and then the costal margin, which is the fused costal cartilage of ribs 7-10

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13
Q

List structures passing through the outlet (6)

A
  • Esophagus
  • Descending Aorta
  • Inferior Vena Cava
  • Left and Right Vagus Nerves
  • Left and Right Sympathetic Trunks
  • Thoracic Duct
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14
Q

Three components of the sternum

A
  • Manubrium
  • Body
  • Xiphoid process
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15
Q
A

Manubrium

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16
Q
A

Body

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17
Q
A

Xiphoid process

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18
Q

What joint unites the manubrium and body of the sternum?

A

Manubriosternal joint

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19
Q

What joint unites the body and xiphoid process of the sternum?

A

The xiphisternal joint

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20
Q

The groove at the top of the manubrium is called:

A

The suprasternal or jugular notch

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21
Q

Where does the second rib articulate with?

A

The angle of Louis on one side and the manubriosternal joint on the other side

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22
Q

What is the sterna angle (of Louis)

A

The angle in the anteroposterior plane that is created by the manubrium joining the body

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23
Q

Which costal cartilages articulate laterally with the sternal body?

A

3, 4, 5, 6

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24
Q

How does the 7th rib articulate with the sternum

A

By way of its cartilage, it articulates between the body and the xiphoid process

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25
True ribs
The upper 7 ribs that are directly attached to the sternum by means of its costal cartilage
26
False ribs
- The lower 5 pairs of ribs - Ribs 8, 9, and 10 attach indirectly to the costal cartilage of rib 7 - Ribs 11 and 12 are floating ribs because their costal cartilages do not articulate at all
27
Which rib is the widest, shortest and flattest?
1st rib
28
Where does rib 1 articulate?
It articulates with the body of its own vertebra (T1)
29
Scalene tubercle
the small bump in the centre of rib 1's upper surface
30
What passes through the scalene tubercle?
The subclavian vein and artery pass infront of and behind this tubercle, respectively
31
Components of a rib (5)
- Head - Neck - Tubercle - Shaft - Distal end
32
Describe how the head of a rib articulates with a vertabra
The head is pointed and has a demifacet, which articulates with the bodies of its own vertebra and the one above
33
Which vertebrae would rib 6 articulate with?
T5 abd T6
34
Which ribs articulate ONLY with their own vertebra?
1, 11, 12
35
How many facets does T1 have?
1.5
36
How many facets does T2-T9 have?
2
37
How many facets does T11 and T12 have?
1
38
The neck of the rib leads to the:
tubercle
39
2 parts of the tubercle
- articular surface | - non-articular part
40
The articular surface of the tubercle artoculates with which joint?
the costotransverse joint
41
The shaft of the rib
is flat and features the subcostal groove
42
The angle of the rib
1/3 around the shaft where the rib starts to point forward and downward
43
Where does the distal end of the rib attach?
its costal cartilage attaches to the sternum by means of the costosternal joint
44
What type of joint is the costosternal joint?
synovial
45
How does the head of a rib articulate with vertebrae?
The head of the rib typically has 2 demifacets that articulate with the equivalent demifacets on the bodies of two adjacet vertebrae (its own and the one above)
46
How is the head of the rib held in place?
- The radiate ligaments which are located anteriorly | - The intra-articular ligament deep in the joint secures the tip of the head with the disc
47
The tubercle of the ribs articulates with:
the articular part of the transverse (vertebral) process
48
How is the joint of the tubercel and transverse process strengthened?
by a large medial and smaller lateral costotransverse ligaments
49
Ligament of the neck
the medial ligament
50
Superior costotransverse ligament
- reinforces the joint of the tubercle and transverse process - runs between the neck of the rib and the transverse process
51
Lateral costotransverse ligament
52
Superior costotransverse ligament
53
Lateral costotransverse ligament
54
Medial costotransverse ligament
55
Radiate ligament
56
Tubercle
57
Disc
58
Intra-articular ligament
59
Medial costotransverse ligament (ligament of the neck)
60
3 layers of intercostal muscles of the rib cage
1. External intercostals (superficial) 2. Internal intercostals (middle) 3. Innermost intercostals (deep)
61
How do the fibers of the external intercostals point?
down and forward
62
Describe the composition of the external intercostals
- the posterior and lateral parts are muscular | - the anterior section is aponeurotic
63
How do the fibers of the internal intercostals point
down and posteriorly
64
Describe the composition of the internal intercostals
the aponeurosis is posterior and the muscular part is lateral and anterior
65
What are the 3 parts of the innermost intercostals
1. Anterior (AKA the transversus thoracis) 2. Lateral 3. Posterior
66
What joins the 3 parts of the innermost intercostals?
they are joined by thin aponeuroses
67
Innermost intercostals
68
Intercostal space
69
Internal intercostals
70
External intercostals
71
Subcostal space
The area below the 12th rib
72
Intercostal space location
is located between the internal and innermost layers of muscles
73
What does the intercostal space contain?
intercostal vein, artey and nerve nestled in the subcostal groove
74
The anterior rami of the spinal nerves
are the 11 pairs of intercostal nerves (T1-T11)
75
Which intercostal nerve helps make up the brachial plexus?
T1
76
What do the collaterals supply
the sensory innervation for the skin
77
What do the collateral merge with?
penetrating branches from the dorsal rami and the anterior cutaneous nerves
78
2 sets of arteries supplying the intercostal spaces:
anterior and posterior intercostal arteries
79
Majority of posterior intercostal arteries arise from the:
aorta
80
Which arteries do not arise from the aorta? Where do they arise from?
arteries 1 and 2 arise from the supreme intercostal artery
81
The anterior intercostal arteries are branches of the:
internal thoracic (internal mammary) artery
82
The internal thoracic is a branch of the:
subclavian artery
83
The internal thoracic runs where? with what?
It runs down lateral to the sternum behind the costal cartilages, accompanied by its venae comitantes
84
Where does the internal thoracic branch bifurcate?
in the costal margin
85
Where do the cartilages of ribs 7-10 fuse?
the costal margin
86
The internal thoracic branch bifurcates into the:
superior epigastric and musculophrenic arteries
87
The upper 6 anterior intercostal arteries come off of the:
internal thoracic
88
The lower 4 anterior intercostal arteries come off of the:
musculophrenic artery
89
Perforating branches of which arteries supply the skin of the chest wall?
the anterior and posterior intercostal arteries
90
Vein
91
Artery
92
Nerve
93
External intercostal
94
Internal intercostal
95
Innermost intercostal
96
Where do the posterior intercostal veins run?
back in the upper part of the intercostal space
97
Where do the intercostal veins on the right side of the thorax empty?
into the azygos vein
98
Where does the thorax drain?
into the hemiazygos veins which themselves drain into the azygos vein
99
Where do the anterior intercostal veins drain?
into the venae comitantes of the internal throacic artery and eventually into the brachiocephalic veins
100
What is the diaphragm
a thin musculotendinous partition separating the contents of the thorax from those of the abdomen
101
What passes through the diaphragm
- esophagus - aorta - inferior vena cava - vagi and sympathetic nerve
102
What innervates the diaphragm?
The left and right phrenic nerves (C3, 4, 5 keep the diaphragm alive)
103
What are the 3 origins of the diaphragm?
lumbar, costal and sternal
104
Where do the 2 crura of the lumbar component of the diaphragm arise from? what is formed?
the first 3 vertebrae and form an arch to allow the aorta to pass through
105
Where are the medial and lateral arcuate ligaments
lateral to the crura of the lumbar portion of the diaphragm
106
Which abdominal muscles do the medial and lateral arcuate ligaments bridge across?
the quadratus lumborum and the psoas
107
Where does the costal origin of the diaphragm travel from and to?
the costal origin continues from the lateral arcuate ligament along rib 12 and onto the lower 6 costal cartilages and then passes onto the xyphoid process (sternal origin)
108
What is formed as the diaphragm rises from the sternal origin?
a dome on each side of the thorax
109
How high does the right dome rise?
1 cm below the right nipple (in the male)
110
Where do the fibers of the dome insert?
central tendon
111
What happens to the diaphragm during inspiration?
The fibers of the dome contract, pulling the central tendon (dome) downward, thus flattening the diaphragm and expanding the vertical 'diameter' of the thoracic cavity
112
Where is the costodiaphragmatic recess
lateral to the dome of the diaphragm
113
Where does the aorta peirce the diaphragm
between the crura at level T12
114
Where does the esophagus and vagi (vagus nerve) pierce the central tendon?
T10
115
Where does the inferior vena cava pierces the central tendon?
T8
116
Inferior vena cava
117
Esophagus
118
Aorta
119
Right crus
120
Quadratus lumborum
121
Psoas
122
Lateral arcuate ligament
123
Medial arcuate ligament
124
Left crus
125
Central tendon
126
What is the job of the circulatory system? (4)
- bring oxygenated blood to all regions of the body - deliver hormones for the endorine system - transport nutrients from the GI tract to the liver - carry carbon dioxide to the lungs and oxygen from the lungs
127
Systemic circulation
is the totality of the vessels serving the organs and tissues of the body except the lungs and the liver
128
Pulmonary circulation
delivers deoxyganted blood to the lungs and returns oxygenated blood to the heart
129
What is the portal system made up of and what does it do?
The portal system is made up of the portal vein and its tributaries delivering nutrients from the GI tract to the liver
130
What drives the circulatory system
the heart
131
Where is the heart located
in the middle mediastinum
132
What type of tissue is the heart made of?
cardiac muscle (a unique contractile tissue) and connective tissue
133
Pathway of blood through the heart to lungs
1. Venous blood enters right atrium from superior and inferior vena cava 2. Blood passes through the tricuspid valve into the right ventricle 3. The right ventricle contracts, sending blood through the pulmonary valve into the pulmonary trunk 4. The pulmonary trunk bifurcates into the left and right pulmonary arteries, which deliver blood to the left and right lungs
134
Pathway of blood through the heart from the lungs
1. The oxygenated blood returns from the lungs in the pulmonary veins which empty into the left atrium 2. The blood passes through the mitral valve into the left ventricle 3. The left ventricle contracts and blood passes by the aortic valve into the aorta
135
The 3 regions of the aorta in order
arch of the aorta, descending (thoracic) aorta, and the abdominal aorta
136
3 major branches of the arch of the aorta
1. brachiocephalic artery 2. left common carotid artery 3. left subclavian artery
137
the brachiocephalic artery bifuractes into
- right common carotid | - right subclavian artery
138
the right common carotid supplies
the head and neck
139
the right subclavian arteries supply
the right upper limbs
140
When does the descending aorta become the abdominal aorta
when it passes through the diaphragm
141
The abdominal aorta bifurcates into the
left and right common iliac arteries
142
The left and right common iliac artieries supply
the pelvis and lower limbs
143
The pericardium
a 3 layered protective sac around the heart
144
3 layers of the pericardium
1. Fibrous pericardium 2. Parietal layer 3. Visceral layer
145
The parietal layer and visceral layer are what type of pericardium
serous pericardium
146
The fibrous pericardium is made up of
dense connective tissue
147
The fibrous pericardium surrounds
- the heart - serous pericardia - roots of the great vessels
148
The base of the fibrous pericardium is fused with
the central tendon of the diaphragm
149
How many layers is the fibrous pericardium
1
150
The serous pericardium is fused with
the inside of the fibrous pericardium
151
How many layers is the serous pericardium
2
152
The parietal layer is fused with the
fibrous pericardium
153
The visceral layer is fused to
the myocardium (muscle of the heart)
154
Epicardium
the outer layer of the heart between the pericardium and the heart
155
What allows for the free movement of the two serous layers during contraction of the heart
Between the serosa is a lubricating fluid manufactured by the serous pericardium
156
Fibrous pericardium
157
Pericardial space
158
Serous pericardium
159
Epicardium
160
From the front, the right border formed by
forms a verticle line with the vene cavae, and is largely formed by the right atrium
161
From the front, the inferior border formed by
the right ventricle
162
From the front, the left border formed by
left ventricle and the left atrial apendage (auricle)
163
From the front, the apex is formed by
the tip of the left ventricle
164
From the front, the superior border formed by
the base of the heart, where the roots of the great vessels arise
165
Atrioventricular sulcus is seen
anterior face of the heart
166
Interventricular sulcus is seen
anterior face of the heart
167
From the back, the left border formed by
the left ventricle
168
From the back, the right border formed by
the right ventricle and right atrium
169
Where are the atriums in respect to the atrioventricular sulcus?
above it
170
What separates the ventricles?
the interventricular sulcus
171
Pulmonary veins enter the
left atrium
172
The right atrium is formed by the
venae cavae and the smooth surface between them
173
Where is the right atrioventriculuar orifice
it is contained in both the interatrial septum and the right atrioventricular septum, which are within the right atrium
174
Where do the venae cavae empty
they empty toward each other into a smooth walled section of the atrium
175
Where is the crista terminalis
it is located on the anterior wall of the right atrium, separating the smooth from muscular wall
176
Pectinate muscles
a set of parallel ridges apart of the crista terminalis, which run into the atrial appendage or auricle
177
Pectinate muscles
a set of parallel ridges apart of the crista terminalis, which run into the atrial appendage or auricle
178
Where and what are the auricles
they are vestigial flaps that project forward around the root of the aorta
179
Where is the opening to the coronary sinus
at the left of the IVC opening
180
Function of the coronary sinus
to drain the myocardium
181
Fossa ovalis
a prominent depression in the interatrial septum
182
The fossa ovalis used to be
the foramen ovale as a feature of the fetal circulation
183
Are the walls thicker in the ventricle or atrium
ventricle
184
How does blood enter the right ventricle
blood enters via the atrioventricular orifice and passes the tricuspid valve
185
Where does the blood go once the right ventricle contracts
the tricuspid valve closes and the blood rushes up the smooth infundibulum and passes the pulmonary valve into the pulmonary trunk
186
How come the flaps of the tricuspid valve don't flip inside out
cords called the chordae tendinae prevent the flaps from evaginating
187
What controls the chordae tendinae
these cords are held down and controlled by papillary muscles
188
Trabeculae carnae
ridges of muscle that augment the thickened walls of the right ventricle
189
Moderator band
a round bundle of muscle fibres that link the interventricular septum with the ventricular wall
190
The lower portion of the septum is _______, which the upper part is ________
- muscular | - membranous
191
The base of the heart is formed by the
left atrium
192
the left atrium is supplied by
various pulmonary veins (on average 2 per side)
193
The left atrium feeds the
left ventricle
194
Where is the left auricle
in the left atrium and it points around the left side of the aortic arch
195
The left atrium empties into the ___________ via the __________
- left ventricle | - left atrioventricular orifice
196
What is thicker, the left or right ventricle
The left ventriculalr wall is 3 times as thick as the of the right ventricle
197
Where is the highest pressure in the systemic circulation
left ventricle
198
Main difference between left and right ventricle
The left venticule has the bicuspid/mital valve, which only has 2 flaps, and its chordae tendinae, papillary muscles, and trabeculae carnae are more robust
199
In which ways are the aortic valves and pulmonary valves similar
they both have three semilunar, sac-like cusps which fill upon relaxation of the heart (diastole) and close onto each other thus preventing regurgitation of the blood with the help of nodules in the centre of each cusp
200
Where are the roots of the great vessels located
they lie within the fibrous pericardium, lined with serous pericardium
201
Where does the pulmonary trunk rise from
the top of the right ventricle
202
The pulmonary trunk divids into
the left and right pulmonary arteries
203
Where is the ascending aorta
to the right of the pulmonary trunk, it rises several centimeters and then turn backwards becoming the arch of the aorta
204
Where do the coronary arteries arise
from two of the aortic sinuses
205
Where are the pulmonary and aortic sinuses
at the root of the pulmonary trunk and the aorta there are 3 sinuses each located above the cusps of the pumlonary and aortic valves
206
Where do the coronary arteries arise and where do they go
the left and right coronary arteries arise from their aortic sinuses and run forwards under the cover of the left and right auricles
207
Where does the right coronary artery run to
it runs to find the anterior atrioventricular sulcus, then runs backwards in the atrioventricular sulcus as far as the posterior interventricular sulcus in which it descends as the posterior descending artery
208
Right marginal branch
a branch of the posterior descending artery which supplies part of the right ventricular wall
209
The left coronary artery branches into the
anterior descending artery
210
Where does the anterior descending artery run
it runs down the anterior interventricular sulcus and the left circumflex artery
211
Where is the left circumflex artery
is passes behind the anterior decending artery in the atrioventricular sulcus
212
The circle and loop scheme is formed by
the anterior descending artery and the left circumflex artery anastomosing with each other
213
Pathway of the great cardiac vein
It passes the interventricular sulcus where it goes around the left border and then as it passes to the back of the heart it enlarges and becomes the coronary sinus
214
The coronary sinus empties into the
right atrium
215
The coronary sinus is supplied by
the middle cardiac vein for the posterior interventricular sulcus
216
Pathway of the small cardiac vein
it runs up the right border of the heart and passes around the back in the atrioventricular sulcus to join the coronary sinus just before it enters the right atrium
217
Innervation of the heart
the heart is innervated by efferent autonomic fibres via the cardiac plexus
218
Where is the cardiac plexus
it lies posterior to the heart and anterior to the bifurcation of the trachea
219
Sympathetic innervation of the heart is derived from
T1-4
220
Two specialized nodes that control the contraction of the heart
Sinoatrial node and the atrioventricular node
221
Location of the sinoatrial node
located in the right atrium near the superior caval opening
222
What supplies the sinoatrial node
supplied by the autonomic nervous system
223
Location of the atrioventricular node
located in the lower part of the interatrial septum
224
Location of the Atrioventricular bundle (of His)
The atrioventricular node sends fibers down the interventricular septum and around to the ventricular walls
225
Does the atrioventriculr bundle (of His) bifurcates
Yes, into the left and right bundle branches, which supply each of the ventricles
226
What is the pleura
a double walled serous membranous sac that contains each of the lungs
227
Each lung invaginated the pleural sac early on in the embryo and finally gives rise to 2 layers:
the parietal and visceral pleura
228
the parietal and visceral pleura surround:
the lungs, except for the area called the hilus
229
What is the hilus
the root of the lung where the airways and blood vessels enter and leave
230
Pleural sac (cavity)
the space between the parietal and visceral pleura
231
type of fluid in the pleural sac (cavity)
serous exudate
232
The parietl pleura cover the:
three surfaces of the lung
233
The costal pleura covers the:
large, curved lung-surface defined by the rib cage
234
The mediastinal surface covers the:
medial surface of the lungs, the mediastinum being the space between the lungs
235
The diaphragmatic pleura covers the:
base of the lungs
236
The visceral pleura is attached to:
the lung surface including those inside the fissures
237
The right and left lungs are separated by the:
mediastinum
238
Oblique fissure
divides the left lung into a superior and inferior lobe
239
Cardiac notch
an indentation in the left lung which the heart occupies
240
Lingula
a flap of lung tissue that wraps anteriorly around the front of the heart
241
Cupola
The top, dome-shaped, part of the lung which extends up into the root of the neck
242
Why is the right lung bigger than the left?
The right lung has an extra fissure, the horizontal fissure
243
Lobes of the right lung
superior, middle, and inferior
244
Hilus location
medial surface of the lung
245
The hilus contains branches of:
- the pulmonary artieries (superior) - the pulmonary veins (inferior) - bronchi (posterior)
246
The trachea splits in the chest into
The left and right primary bronchi
247
The right primary bronchi splits into
3 secondary bronchi, one for each lobe
248
The left main bronchus splits into
2 secondary bronchi, one for each lobe
249
Each secondary bronchi bifurcates into
2-3 tertiary bronchi
250
the tertiary bronchi supply
a subdivision of each lobe called a bronchopulmonary segment
251
Bronchial arteries function
deliver blood supply to the connective tissue of the lungs
252
What effect do the phrenic nerves have on the diaphragm
the phrenic nerves cause the diaphragm to contract
253
What happens to blood in the alveoli
the blood is oxygenated and decarbonated
254
Primary muscle of respiration
the diaphragm
255
The primary muscle of respiration is assisted by the
intercostal scalene (in the neck) and pectoral muscles
256
Pulmonary sympathetic outflow arises from:
T2-4
257
Pulmonary sympathetic outflow synapses at:
T2-4
258
Pulmonary innervation travels through the
pulmonary plexus
259
The pulmonary parasympathetic innervation is via ______, which synapses in the _______
- the vagus (CN 10) | - pulmonary plexus
260
The vagi effect on the bronchioles
constriction
261
The sympathetic nerves effect on the bronchioles
dilation
262
The mediastinum
central part of the thorax, defined as the space between the lung
263
The mediastinum is divided into the 4 parts:
superior, anterior, middle and posterior portions
264
Which portions comprise the inferior mediastinum
the anterior, middle, and posterior portions
265
Where is the superior medistinum
This region is above the level of T4/5
266
The superior mediastinum
- superior vena cava + its tributaries - aortic arch + its branches - trachea - esophagus - left and right vagus - phrenic nerves
267
Where is the anterior mediastinum
This is the area below T4/5, and anterior to the heart
268
The anterior mediastinum contains
fat and the thymus
269
Where is the middle mediastinum
behind the anterior mediastinum
270
The middle mediastinum contains the
- heart and its pericardia - ascending aorta - pulmonary trunk - lower superior vena cava
271
The posterior mediastinum contains the
- descending aorta - lower esophagus - the root of the lungs - the posterior thoracic wall structures
272
The great veins of the thorax are formed as follows:
the left and right jugular veins descend from the neck and join the left and right subclavian vein to form the left and right brachiocephalic veins
273
The left and right brachiocephalic veins come together to form the
superior vena cava
274
The superior vena cava is joined by the ______________ as it descends into the right atrium
arch of the azygos vein
275
The ascending aorta arises from
the left ventricle
276
The ascending aorta has two branches:
coronary arteries
277
When does the ascending aorta become the arch of the aorta
as it leaves the pericardium
278
The first branch of the arch of the aorta
brachiocephalic artery
279
The brachiocephalic artery bifurcates into
the right common carotid and right subclavian arteries
280
The second branch of the arch of aorta
left common carotid arteries
281
The third branch of the arch of the aorta
left subclavian arteries
282
Where do the common carotids enter
the base of the neck on either side
283
The common carotid arteries supply
the head and, with the vertebral arteries, the brain
284
The subclavian arteries supply
the upper limbs
285
Lingammentum arteriosum location
runs down from beneath the arch of the aorta to the top of the "T" of the pulmonary trunk
286
The ligamentum arteriosum used to be the
ductus arteriosus
287
Descending aorta location
runs down the thorax to the left of the vertebral bodies in close proximity to the trachea and esophagus which are situated to the right of it
288
The descending aorta gives off 3 sets of arteries:
- Intercostal arteries (most posterior pair) - Bronchial arteries (anterior to above) - Esophageal arteries
289
The bronchial arteries supply the:
connective tissue of the lungs
290
The esophageal arteries supply
the esophagus
291
Esophagus
muscular tube carrying food from the pharynx to the stomach
292
Location of the esophagus
lies behind the trachea and to the right of the aorta
293
The esophagus penetrates the diaphragm at
T10
294
Which nerves surround the esophagus
On its left is the left vagus nerve, on its right is the right vagus nerve
295
Thoracic duct location
sits posteriorly and to the right of the esophagus
296
Where does the trachea enter in the throax
through the inlet anterior to the esophagus
297
What is the trachea made up of
horseshoe shaped cartilages and connective tissue
298
Where does the trachea bifurcate
T4/5
299
carina
The underside of the trachea bifurcation
300
The main nerves in the mediastinum
the two vagi and the paired phrenic nerves
301
Where does the left vagus enter the thorax
anterior to the left subclavian artery
302
Left reccurent laryngeal nerve (is a branch of what?, where does it lead?)
branch of the left vagus which goes up the neck to the larynx, wraps around the arch of the aorta, and continues to the esophagus
303
Which nerve loops around the arch of the aorta an the ligamentum ateriosum
the left recurrent laryngeal nerve
304
Where does the right vagus enter the thorax
in front of the right subclavian artery
305
Right reccurent laryngeal (what is it a branch of, where does it go to?)
branch of the right vagus which recurs around the subclavian artery and acends on the right side of the esophagus to the larynx
306
Where do the phrenic nerves arise
in the neck from roots C3, 4, 5
307
Where do the phrenic nerves enter the thorax
lateral to the vagi
308
Where do the phrenic nerves attach when on their way to the diaphragm
they attach to each side of the pericardium
309
3 important structures of the posterior wall of the thorax
- the unpaired thoracic duct - the paired sympathetic trunks - the sort of paired azygos and hemi-azygos veins
310
The largest lymphatic vessel in the body
thoracic duct
311
Where does the thoracic duct arise from
arises in the upper abdomen from a 'hoding-tank,' the cisterna chyli
312
Where does the thoracic duct enter the thorax
through the aortic hiatus
313
The thoracic duct enters which vein at T1/2
enters subclavian vein and joins the internal jugular vein
314
Where are the paired sympathetic trunks
each trunk is situated on each side of the vertebral column
315
What type of nerves originate from the sympathetic trunks
greater, lesser, and least splanchnic nerves
316
The greater, lesser, and least splanchnic nerves supply the input to:
the celiac, superior, and renal ganglia
317
The azygos and hemi-azygos veins drain into the:
superior vena cava via the arch of the azygos vein
318
The azygos vein drains into:
the right intercostal veins as it rises
319
What level does inferior vena cava penetrate the diaphragm
T8
320
What level does esophagus penetrate the diaphragm
T10
321
What level does descending aorta penetrate the diaphragm
T12
322
What is the first branch of aorta
coronary arteries
323
Apex
324
Superior lobe
325
Oblique fissure
326
Pulmonary arteries
327
Bronchi
328
Pulmonary veins
329
Inferior lobe
330
Diaphragmatic surface
331
Cardiac impression
332
Lingula
333
Horizontal fissure
334
Middle lobe
335
Diaphragmatic surface
336
Inferior lobe
337
Pulmonary veins
338
Bronchi
339
Pulmonary arteries
340
Oblique fissure
341
Superior lobe
342
Apex
343
Right internal jugular vein
344
Right subclavian vein
345
Right brachiocephalic vein
346
Superior vena cava
347
Inferior vena cava
348
Left brachiocephalic vein
349
Left subclavian vein
350
Entry of the thoracic duct
351
Left internal jugular vein
352
Pulmonary trunk
353
Descending aorta
354
Left pulmonary artery
355
Ligamentum arteriosum
356
Left subclavian artery
357
Left common carotid artery
358
Brachiocephalic artery
359
Arch of aorta
360
Ascending aorta
361
Sinoatrial node
362
Atrioventricular node
363
Right bundle branches
364
Left bundle branches
365
Atrioventricular bundle of His
366
Esophagus
367
Carina
368
Trachea
369
Arch of the aorta
370
Left subclavian artery
371
Left common carotid artery
372
Right common carotid artery
373
Brachiocephalic artery
374
Esophagus
375
Ligamentum arteriosum
376
Aorta
377
Left recurrent nerve
378
Left vagus nerve
379
Right vagus nerve
380
Right recurrent nerve
381
Right subclavian artery
382
Pulmonary artery
383
Superior vena cava
384
Jugular veins
385
Thoracic duct
386
Arch of aorta
387
Left branchiocephalic vein
388
Thoracic duct
389
Diaphragm
390
Cisterna chyli
391
Brachiocephalic veins
392
Superior vena cava
393
Jugular veins
394
Left subclavian vein
395
Intercostal veins
396
Hemi-azygos veins
397
Left renal vein
398
Lower vena cava
399
Azygos vein
400
Arch of the azygos
401
Intercostal veins
402
Azygos vein
403
Inferior vena cava
404
Superior vena cava
405
Subclavian veins
406
Internal jugular veins