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JKC Anatomy- Spring '24 > Thorax > Flashcards

Thorax Flashcards

1
Q

What part of the sternum ossifies with age?

A

Xyphoid process

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2
Q

_____ attach to the sternum through individual costal cartilages

A

Ribs 1-7

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3
Q

_____ attach to the costal cartilages of rib 7

A

Ribs 8-10

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4
Q

_____ do not attach to the sternum but are tipped by cartilage

A

Ribs 11 and 12

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5
Q

What is the purpose of the subclavius muscle?

A

Stabilizes clavicle

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6
Q

______ connects the ribs to vertebral facets/demifacets

A

Radiate ligament of head of the rib

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7
Q

______ connect from neck of rib to transverse process at same level and one level above

A

costotransverse ligaments

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8
Q

During expansion of the thorax during inspiration:

The 1st and 2nd ribs _____

A

elevate

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9
Q

During expansion of the thorax during inspiration:

The 3rd-10th ribs _____

A

Open laterally in a bucket handle motion

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10
Q

During expansion of the thorax during inspiration:

The 11th and 12th ribs _____

A

Swing laterally in a pincers motion

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11
Q

During expansion of the thorax during inspiration:

The ribs movements ???

A

push the sternum anteriorly

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12
Q

What is the function of the serratus posterior inferior?

A

proprioception

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13
Q

_____ muscle protracts the scapula and attaches to the lateral aspect of the ribs.

A

Serratus anterior

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14
Q

What artery supplies the serratus anterior?

A

Lateral thoracic artery

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15
Q

The serratus anterior is innervated by the ____

A

Long thoracic nerve

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16
Q

________ muscles have an inferomedial direction (hands in pocket).

A

External intercostal

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17
Q

The ______extend from vertebrae, around thorax, and become the ______ membrane before reaching the sternum.

A

External intercostal muscles

External intercostal membrane

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18
Q

______ muscles run in a superomedial direction, extending from the sternum, around the thorax, and become the ______ before reaching vertebrae

A

Internal intercostal muscle

Internal intercostal membrane

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19
Q

______ muscles run parallel to the internal intercostal and are only present in the lateral region between the ribs.

A

Innermost intercostal

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20
Q

On the inside of the thorax, the _______ muscles extend from the sternum towards the ribs and costal cartilages.

A

transversus thoracis

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21
Q

The _____ forms the floor of the thoracic cavity

A

diaphragm

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22
Q

The diaphragm attaches ???

A

bilaterally from the xyphoid process around the costal arch to the twelfth thoracic and upper lumbar vertebrae.

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23
Q

What three things travel through the diaphragm to reach the abdomen?

A

Inferior vena cava, aorta and esophagus

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24
Q

When the diaphragm contracts what happens?

A

It flattens

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25
Q

The diaphragm, external intercostals, internal intercostals (parasternal portion) and scalene muscles are involved with ??

A

Inspiration

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26
Q

Internal intercostals (lateral portion), innermost intercostals, abdominal obliques, rectus abdominis and transversus thoracis are involved with ??

A

Expiration

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26
Q

Relaxed expiration is largely a result of ___ of the soft tissues

A

Recoil

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27
Q

When a patient has COPD or emphysema ______, ______ and _____ will fix the scapula so that other muscles can then work on the ribcage

A

Trapezius, levator scapulae and rhomboids

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28
Q

During inspiration/expiration ______ works to elevate the 1st and 2nd rib

A

Scalenes (**anterior, middle and posterior)

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29
Q

What muscles work to elevate the anterior ribcage if the scapula is fixed?

A

Pectoralis major and minor

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30
Q

_____ elevates the lateral ribcage if scapula is fixed

A

Serratus anterior

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31
Q

The blood supply of the thoracic wall is largely via the ______, which run within each intercostal space.

A

intercostal arteries

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32
Q

Where do the intercostal arteries originate from?

A

Internal thoracic artery and aorta

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33
Q

The skin and muscles of the thoracic wall are innervated via _____

A

intercostal nerves

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34
Q

The intercostal nerves are extension of _____ from each spinal level T1-T12

A

anterior rami

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35
Q

Both intercostal nerves and arteries have ______ branches and _____ branches.

A

lateral cutaneous

anterior cutaneous

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36
Q

Anterior intercostal arteries come from ??

A

Internal thoracic artery

37
Q

Posterior intercostal arteries comes from ??

A

Aorta

38
Q

the _____ and ____ form an anastomoses in the ribcage

A

Anterior and posterior intercostal arteries

39
Q

Anteriorly the intercostal veins drain into ____

A

Internal thoracic veins

40
Q

Posteriorly the intercostal veins drain into ____

A

azygos system

41
Q

The _____ on the right side of the vertebral bodies receives the ___ intercostal veins and _____ ascending lumbar vein. It drains to the _______.

A

azygos vein

Right

Right

Superior Vena Cava

42
Q

On the left are _____ that receives blood from LOWER ____ intercostal veins and ____ ascending lumbar vein.

A

hemiazygos vein

Left

Left

43
Q

_____ which receives UPPER left intercostal veins and connects to the left brachiocephalic vein

A

accessory hemiazygos vein

44
Q

What three things are protected by the costal groove of the superior rib?

A

Intercostal Vein, Artery and Nerve

VAN in that order

45
Q

_____ arteries and _____ nerves run in the plane between the internal intercostal and innermost intercostal muscles.

A

Posterior intercostal

intercostal

46
Q

Each nerve and artery also gives off a very small branch that runs ______ within the intercostal space.

A

Inferiorly

47
Q

If you are trying to do a nerve block in the intercostal space, where would you put the needle?

A

Aim for the UPPER part of the intercostal space

48
Q

If you are trying to take a sample of the fluid, where do you put the needle?

A

aim for the middle of the intercostal space

49
Q

Inside of the thorax is subdivided into two ____ and the midline _______

A

pleural cavities

mediastinum

50
Q

The superior mediastinum contains what 10 things:

A
  1. Superior vena cava
  2. Brachiocephalic vein
  3. Arch of aorta
  4. Vagus
  5. Phrenic
  6. Left recurrent laryngeal
  7. Thoracic duct
  8. Trachea
  9. Esophagus
  10. Thymus
51
Q

What level does the superior and inferior mediastinum split between?

A

T4-5

52
Q

The inferior anterior mediastinum contains what 3 things?

A
  1. Thymus
  2. Lymph nodes
  3. Fat and connective tissue
53
Q

The middle anterior mediastinum contains what 4 things?

A
  1. Pericardium and heart
  2. Roots of great vessels
  3. Arch of azygos vein
  4. Primary bronchi
54
Q

The posterior anterior mediastinum contains what 7 things?

A
  1. Esophagus
  2. Aorta
  3. Azygos and hemiazygos veins
  4. Thoracic duct
  5. Vagus nerve
  6. Sympathetic trunk
  7. Splanchnic nerve
55
Q

The ______ is an important immune organ where T lymphocytes mature and become active.

A

thymus gland

56
Q

Where does T lymphocytes mature and become active?

A

Thymus gland

57
Q

What gland is quite large in children but is small and atrophies in adults?

A

Thymus gland

58
Q

The breast is a modified sweat gland with multiple ____ that can produce milk, which drains through _____, to _______ that then empty at the ____. Fat fills spaces between lobules

A

lobules

lactiferous ducts

lactiferous sinuses

nipple

59
Q

There is a ______ between the breast and pectoralis major muscle.

A

retromammary space

60
Q

Between lobules are ______ that extend from the thoracic wall and attach to the skin of the breast.

A

suspensory ligaments (of Cooper)

61
Q

A fixed breast to the body wall with “orange peel” skin is a sign of ?

A

breast cancer

62
Q

What is the primary blood supply to the breasts? What else contributes?

A

Internal thoracic and lateral thoracic

lateral cutaneous branches of the intercostal artery and vein

63
Q

The majority (3/4) of lymphatic flow travels in what direction? Towards what lymph nodes? but first pass through _____ before reaching ______.

A

Laterally

Axillary lymph nodes

interpectoral nodes- between pectoralis major and minor

Pectoral axillary nodes

64
Q

Medial breast lymph drains where? What 2 other places can they go?

A

parasternal nodes

mediastinum or cross into the opposite breast

65
Q

The right border is composed of ?

A

Superior vena cava
Right atrium
Inferior vena cava

66
Q

The Inferior border of the heart is composed of ?

A

Right ventricle

67
Q

The superior border of the heart is composed of ?

A

Left atrium
Right atrium

68
Q

The left border of the heart is composed of ?

A

left ventricle
Left auricle

69
Q

What is the reminisce when the right and left atrium were connected?

A

Fossa ovalis

70
Q

Where is the SA node located?

A

Crista terminalis

71
Q

______: The outer lining of the heart

A

Epicardium

72
Q

_______: The actual heart muscle

A

myocardium

73
Q

_____: The inner lining of the heart

A

Endocardium

74
Q

The ______ has a serous lining that releases lubricating fluid

A

epicardium

75
Q

In the epicardium deep to the serous layer there is a layer of ______. What does it contain?

A

Loose connective tissue and adipose tissue

contains coronary blood vessels and nerves

76
Q

What is a difference between heart and skeletal muscle?

A

The cardiac muscle branches and connects to other cardiac muscles

77
Q

______ are the “spot welds” that connect it to its neighbors

A

intercalated discs

78
Q

Where are the nucleus located in myocardium?

A

located centrally

79
Q

______ layer prevents clots from happening

A

endothelium layer of endocardium

80
Q

_____ layer or endocardium that is dense irregular CT

A

Subendothelial Connective Tissue

81
Q

_____ layer of endocardium, connective tissue layer next to myocardium that contains small vessels and nerves to the myocardium.

A

Subendocardium

82
Q

Reminder to look at this slide

A

Look at this slide

83
Q

The fibrous skeleton of the heart is a layer of insulating _____ that electrically isolates ____ from _____

A

connective tissue

atria from ventricles

84
Q

What is contracting during systole?

A

Ventricles

85
Q

What is contracting during diastole?

A

Atria

86
Q

Atroventricular valves are _____ during systole

A

Closed

87
Q

Semilunar valves are _____ during diastole

A

closed

88
Q

When listening to the valves, where do you position your stethoscope for the aortic semilunar?

A

right 2nd intercostal space next to the sternum

89
Q

When listening to the valves, where do you position your stethoscope for the pulmonary semilunar?

A

left 2nd intercostal space next to sternum

90
Q

When listening to the valves, where do you position your stethoscope for the tricuspid?

A

left 5th intercostal space next to sternum

91
Q

When listening to the valves, where do you position your stethoscope for the bicuspid?

A

left 5th intercostal space in midaxillary line

JKC Anatomy- Spring '24 (14 decks)

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