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Thorax Flashcards

1
Q

How is the mediastinum divided into 2 parts

A

By an imaginary line running between the sternal angle and T4
Divides the mediastinum into superior and inferior

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2
Q

Where does the superior mediastinum extend to

A

Upwards, terminating at the superior thoracic arpeture

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3
Q

Where does the inferior mediastinum extend to

A

Downwards, terminating at the diaphragm

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4
Q

What is the inferior mediastinum further divided into

A

Anterior, middle and posterior mediastinum

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5
Q

What are the borders of the superior mediastinum

A

Superior - thoracic inlet
Inferior - Continuous with the inferior mediastinum at the level of the sternal angle
Anterior - manubrium of the sternum
Posterior - vertebral bodies of T1-4
Lateral - pleural of the lungs

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6
Q

Which vessels are found within the superior mediastinum

A

Arch of aorta and the following branches:
-Brachiocephalic a
- Left common carotid a
- Left subclavian

SVC and the following tributaries
- Brachiocephalic veins
- Left superior intercostal vein
- Supreme intercostal vein
- Azygos vein

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7
Q

Which nerves are found within the superior mediastinum

A

Phrenic nerve
Vagus nerve
Cardiac nerves
Sympathetic trunk

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8
Q

Which organs and muscles are found in the superior mediastinum

A

Thymus
Trachea
Oesophagus
Thoracic duct
Muscles - sternohyoid and sternothyroid

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9
Q

What is the borders of the anterior mediastinum

A

Lateral - mediastinal pleura
Anterior - body of sternum and transversus thoracis muscles
Posterior - pericardium
Roof - continuous with superior mediastinum at the level of the sternal angle
Floor - diaphragm

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10
Q

In which part of the mediastinum is there no major structures

A

Anterior mediastinum

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11
Q

What are the borders of the middle mediastinum

A

Anterior - Anterior margin of the pericardium
Posterior - posterior margin of the pericardium
Laterally - Mediastinal pleura of the lungs
Superiorly - imaginary line between the angle of mandible and T4
Inferiorly - surface of diaphragm

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12
Q

What are the contents of the middle mediastinum

A

Heart and pericardium
Tracheal bifurcation into left and right bronchi
Ascending aorta
Pulmonary trunk
SVC
Cardiac plexus
Phrenic nerves
Tracheobronchial lymph nodes

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13
Q

What are the borders of the posterior mediastinum

A

Lateral - mediastinal pleura
Anterior - pericardium
Posterior - T5-T12 vertebrae
Roof - imaginary line between the angle of mandible and T4
Floor - diaphragm

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14
Q

What is contained within the posterior mediastinum

A

Thoracic aorta
Oesophagus
Thoracic duct
Azygous system of veins
Sympathetic trunks

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15
Q

What are the 3 major veins of the azygous system of veins

A

Azygos vein
Hemiazygos vein
Accessory hemiazygos vein

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16
Q

What does the thoracic duct originate from and where does it enter the thorax

A

Cisterna Chylii
Enters the thorax via the aortic hiatus (T12)

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17
Q

What arteries branch from the aorta in the posterior mediastinum

A

Posterior intercostal arteries
Bronchial arteries
Oesophageal arteries
Superior phrenic arteries

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18
Q

What can the aorta be divided into

A

Ascending aorta
Aortic arch
Descending aorta
Abdominal aorta

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19
Q

What are the branches of the ascending aorta

A

Left and right aortic sinuses which give rise to the right and left coronary arteries

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20
Q

At what level does the aortic arch end

A

T4

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21
Q

What connects the aortic arch to the pulmonary trunk

A

Ligamentum arteriosus

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22
Q

What are the branches of the aortic arch

A

Left common carotid
Left subclavian
Brachiocephalic trunk

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23
Q

At what point does coarctation of the aorta usually occur

A

At the insertion of the ligamentum arteriosus

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24
Q

From which vertebral levels does the descending aorta span

A

T4 - T12

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25
What are the paired branches of the descending aorta
Bronchial arteries Mediastinal arteries Oesophageal arteries Pericardial arteries Superior phrenic arteries Intercostal and subcostal arteries
26
What are the paired branches of the abdominal aorta
Inferior phrenic arteries Middle suprarenal arteries Renal arteries Gonadal arteries Lumbar arteries
27
What are the unpaired branches of the abdominal aorta
Coeliac axis SMA IMA Medial sacral artery
28
What are the unpaired branches of the descending aorta
Bronchial arteries Mediastinal arteries Oesophageal arteries Pericardial arteries
29
What does the abdominal aorta bifurcate to form
right and left common iliac
30
What does the SVC form from
The union of the left and right brachiocephalic trunks
31
Through which part of the mediastinum does the SVC pass
Superior mediastinum
32
At which level does the SVC receives the azygos vein
T4
33
Which pharyngeal pouch is the thymus developed from
Third
34
Where is the thymus located
In the superior mediastinum, immediately posterior to the manubrium of the sternum
35
What is the blood supply of the thymus
Anterior intercostal arteries and small branches of the internal thoracic arteries Venous drainage - left brachiocephalic and internal thoracic veins
36
In which syndrome does thymic aplasia occur
DiGeorge Syndrome
37
The breast can be considered in 2 regions, what are these
Circular body Axillary tail
38
What are the anatomical structures of the breast
Mammary glands Connective tissue stroma Pectoral fascia
39
What forms the suspensory ligaments of Cooper and what are their function
Fibrous stroma condenses down to form the suspensory ligaments of Cooper Function - Attach and secure the breast to the dermis and underlying pectoral fascia. Separate the secretory lobules of the breast.
40
What does the base of the breast lie on and what attaches here
Pectoral fascia Suspensory ligiaments of Cooper attach here
41
What is the blood supply of the breast
60% - internal mammary artery (internal thoracic) Lateral thoracic and thoracoarcromial Lateral mammary branches Mammary branch
42
What is the venous drainage of the breast
Axillary and internal thoracic veins
43
What is the lymph drainage of the breast
Axillary nodes - 75% Parasternal nodes - 20% Posterior intercostal nodes - 5%
44
What is the nervous innervation of the breast
Anterior and lateral cutaneous branches of the 4th-6th intercostal nerves
45
At what level does the pulmonary trunk split into the right and left pulmonary arteries
T5-T6
46
How does the anatomy of the right and left inferior pulmonary veins differ
Inferior left pulmonary vein - found at the hilum of the lung Inferior right pulmonary vein - runs posteriorly to the SVC and the right atrium
47
At what level does the IVC enter the thorax
T8
48
What are the 2 parts of the right atrium and what separates them
Sinus venarum Atrium proper Separated by the crista terminalis
49
Which part of the right atrium has smooth walls and receives blood from the SVC and IVC
Sinus Venarum
50
Which ventricle forms the majority of the anterior border of the heart
Right
51
What divides the right ventricle into an inflow and outflow portion
Supraventricular crest
52
What are trabeculae carnae
A series of irregular muscular elevations which are found in the ventricles of the heart
53
What is the conus arteriosus
The outflow portion of the right ventricle - it is smooth
54
What is the aortic vestibule
The outflow portion of the left ventricle
55
Where does the coronary sinus open into
the right atrium between the inferior vena cava orifice and the right atrioventricular orifice.
56
Where is the SAN found
The upper wall of the right atrium, at the junction where the superior vena cava enters
57
What is the fibrous pericardium continuous with
The central tendon of the diaphragm
58
What are the layers of the pericardium
Fibrous layer Parietal layer of serous pericardium Serous fluid Visceral layer of serous pericardium
59
Where is the transverse pericardial sinus found
Posterior to the ascending aorta and pulmonary trunk Anterior to the SVC Superior to the left atrium
60
What is the innervation of the pericardium
Phrenic nerve
61
What is the anterior surface of the heart
Right ventricle
62
What is the posterior surface of the heart
Left atrium
63
What is the inferior surface of the heart
Left and right ventricles
64
What are the 3 main sulci of the heart
Coronary sulcus Anterior interventricular sulcus Posterior interventricular sulcus
65
What is found in the coronary sulcus of the heart
The right coronary artery Circumflex branch of the left coronary artery Small cardiac vein Coronary sinus
66
What is found in the anterior interventricular sulcus of the heart
Anterior interventricular artery (also known as the left anterior descending artery) Great cardiac vein
67
What is found in the posterior interventricular sulcus of the heart
posterior interventricular artery Middle cardiac vein.
68
What are the branches of the left coronary arteries
Left anterior descending Left marginal artery Left circumflex artery
68
What structures support the mitral and tricuspid valves
Chordae tendinae which are attached to the papillary muscles on the inferior surface of the ventricles
69
What are the branches of the right coronary arteries
Right marginal artery In 80-85% branches to give posterior interventricular artery
70
Where does the coronary sinus drain into
Right atrium
71
What are the tributaries of the coronary sinus
Great cardiac vein Small cardiac vein Middle cardiac vein Posterior cardiac vein
72
What structures are related to the right lung
Oesophagus Heart Inferior vena cava Superior vena cava Azygous vein
73
What structures are related to the left lung
Heart Arch of aorta Thoracic aorta Oesophagus
74
What does the lung root contain
bronchus pulmonary artery two pulmonary veins bronchial vessels pulmonary plexus of nerves and lymphatic vessels
75
How does the drainage of the right and left bronchial veins differ
Right bronchial vein - drains into the azygos vein Left bronchial vein - drains into the hemiazygos vein
76
What level does the horizontal fissure of the right lung run at
T4
77
What epithelium lines the trachea and bronchi
Ciliated pseudostratified columnar epithelium, interspersed by goblet cells
78
Which nerve provides sensory innervation of the trachea
Recurrent laryngeal nerve
79
What is the arterial supply of the trachea
Inferior thyroid artery
80
What is the left main bronchus related to
Aortic arch - passes inferiorly Thoracic aorta - passes anteriorly Oesophagus
81
Which nerve innervates the bronchi
Vagus nerve
82
Where are the 2 pleural recesses
Costodiaphragmatic – located between the costal pleurae and the diaphragmatic pleura Costomediastinal – located between the costal pleurae and the mediastinal pleurae, behind the sternum.
83
What are the 3 peripheral attachments of the diaphragm
Lumbar vertebrae and arcuate ligaments Costal cartilages of ribs 7 -10 Ribs 11 - 12 Xiphoid process of sternum
84
Where does the right crus of the diaphragm arise from
Arises from L1-L3 and their intervertebral discs
85
Where does the left crus of the diaphragm arise from
Arises from L1-L2 and their intervertebral discs.
86
What passes through the hiatus in the diaphragm at T8
IVC Terminal branches of the right phrenic
87
What passes through the hiatus of the diaphragm at T10
Oeosphagus Right and left vagus nerve Oesophageal branches of the left gastric artery/vein
88
What passes through the hiatus of the diaphragm at T12
Aorta Thoracic duct Azygous vein
89
Which muscle is the primary muscle of inspiration
Diaphragm
90
What is the arterial supply of the diaphragm
Inferior phrenic artery
91
Describe the attachment of the intercostal muscles
Originate at the lower border of the first rib inserts into the superior aspect of the rib below
92
What is the innervation of the intercostal muscles
Intercostal nerves (T1-T11)
93
The internal intercostal muscles are continuous with which muscle of the abdominal wall
Internal oblique muscle
94
What are the 3 layers of muscles between the ribs
Intercostal muscles Internal intercostal muscles Innermost intercostals
95
Where does transversus thoracis attach
From the posterior surface of the inferior sternum to the internal surface of costal cartilages 2-6.
96
Which ribs are considered typical ribs
Ribs 3- 9
97
Which ribs are considered atypical ribs
Ribs 1,2, 10, 11, 12
98
What are the posterior articulations of the ribs
Costotransverse joint - between the tubercle of the rib and the transverse costal facet of the corresponding vertebrae Costoverterbal joint - Between the head of the rib, superior costal facet of the corresponding vertebra, and the inferior costal facet of the vertebra above.
99
What are the anterior articulations of the ribs
Ribs 1-7 attach to the sternum Ribs 8-10 attach to costal cartilage Ribs 11 -12 do not have an anterior attachment
100
Which are the 'free floating' ribs
11 and 12
101
What are the 3 parts of the sternum
Manubrium Body Xiphoid process
102
The fossa at either side of the jugular notch of the manubrium articulate to form which joint
Sternoclavicular joint
103
The sternal angle marks the level of what ribs
CC of 2nd rib
104
The tip of the xiphoid process is found at which level
T10
105
In which part of the spine are the spinous processes of the vertebrae long and slanting
Thoracic spine
106
From superficial to deep what are the ligaments of the spine
Supraspinous ligament Interspinal ligament Ligamentum flavus Posterior longitudinal ligament Anterior longitudinal ligament
107
The superficial muscles of the back are associated with movements of what
Shoulders
108
The intermediate muscles of the back are associated with movements of what
Thoracic cage
109
The deep muscles of the back are associated with movements of what
Movements of the vertebral column
110
What are the superficial back muscles
Trapezius Latissimus dorsi Levator scapulae Rhomaboid major and minor
111
What are the intermediate back muscles
Serratus posterior superior Serratus posterior inferior
112
What is the function of serratus posterior superior and what innervates it
Elevates ribs 2-5 Intercostal nerves
113
What is the function of serratus posterior inferior and what innervates it
Depresses ribs 9-12 Intercostal nerves
114
What are the superficial deep back muscles
Splenius capitus Splenius cervicis
115
What are the intermediate deep back muscles
Erector spinae Iliocostalis Longissimus Spinalis
116
What are the 3 groups of the deep layer of the deep back muscles
semispinalis, multifidus and rotatores.

MRCS (17 decks)

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