Thorax 3

Question 1

Changes, such as branching of the _______ ducts, occur in the breast tissues during menstrual periods and pregnancy.

Answer 1

lactiferous

Question 2

Although __________ are prepared for secretion by mid-pregnancy, they do not produce milk until shortly after the baby is born.

Answer 2

mammary glands

Question 3

A creamy white to yellowish premilk fluid that may secrete from the nipples during the last trimester of pregnancy and during initial episodes of nursing.

Answer 3

Colostrum

Question 4

Colostrum is believed to be especially rich in _______, immune agents, and a growth factor affecting the infant’s intestines.

Answer 4

protein

Question 5

In ___ women, the breasts often become large and pendulous.

Answer 5

multiparous

Question 6

The breasts in elderly women are usually small because of the decrease in fat and the atrophy of _______ tissue.

Answer 6

glandular

Question 7

For the anatomical location and description of tumors and cysts, the surface of the breast is divided into four quadrants:

Answer 7

Superior lateral, superior medial, Inferior lateral, inferior medial

Question 8

The ___ breast is more affected breast for cancer compared to the ____ breast because it is usually larger and is composed of more granular tissue.

Answer 8

Left, right

Question 9

What quadrant of the breast has the greatest percentage of cancer?

Answer 9

Superior lateral

Question 10

The arterial supply of the breast derives from the:

Answer 10

• Medial mammary branches of perforating branches - Anterior intercostal branches of the internal thoracic artery - Lateral thoracic and thoracoacromial arteries - Posterior intercostal arteries

Question 11

Medial mammary branches of perforating branches and anterior intercostal branches of the internal thoracic artery originate from the ___________ artery.

Answer 11

subclavian

Question 12

Lateral thoracic and thoracoacromial arteries are branches of the ______ artery

Answer 12

axillary

Question 13

Posterior intercostal arteries are branches of the thoracic aorta in these three intercostal spaces:

Answer 13

2nd, 3rd, and 4th

Question 14

In breast cancer, cancer mostly spreads to the ____. However, for prostate cancer, the cancer spreads to the venous blood and bones.

Answer 14

brain

Question 15

The venous drainage of the breast is mainly to the axillary vein, but there is some drainage to the _____________

Answer 15

internal thoracic vein.

Question 16

The _______ of the breast is important because of its role in the metastasis of cancer cells.

Answer 16

lymphatic drainage

Question 17

Lymph passes from the nipple, areola, and lobules of the gland to the _______

Answer 17

subareolar lymphatic plexus.

Question 18

Most lymph (> 75%), especially from the lateral breast quadrants, drains to the axillary lymph nodes, initially to the ___ or _____nodes for the most part.

Answer 18

anterior or pectoral

Question 19

Some lymph may drain directly to other ____ nodes or even to interpectoral, deltopectoral, supraclavicular, or inferior deep cervical nodes.

Answer 19

axillary

Question 20

Most of the remaining lymph, particularly from the medial breast quadrants, drains to the _____lymph nodes or to the opposite breast.

Answer 20

parasternal

Question 21

Lymph from the inferior quadrants may pass deeply to ____ lymph nodes (subdiaphragmatic inferior phrenic lymph nodes).

Answer 21

abdominal

Question 22

Lymph from the skin of the ____, except the nipple and areola, drains into the ipsilateral axillary, inferior deep cervical, and infraclavicular lymph nodes and also into the parasternal lymph nodes of both sides.

Answer 22

breast

Question 23

Lymph from the axillary nodes drains into clavicular (infraclavicular and supraclavicular) lymph nodes and from them into the ______ lymphatic trunk, which also drains lymph from the upper limb.

Answer 23

subclavian

Question 24

Lymph from the _____ nodes enters the bronchomediastinal lymphatic trunk, which also drains lymph from the thoracic viscera.

Answer 24

parasternal

Question 25

When the viscera of the thoracic cavity is sectioned transversely, it is apparent that the thoracic cavity is ____ shaped: a transversely ovoid space deeply indented posteriorly by the thoracic vertebral column and the posteromedial parts of the ribs (heads and necks), which articulate with it.

Answer 25

kidney

Question 26

The thoracic cavity is divided into 3 compartments:

Answer 26

1. Right and left pulmonary cavities 2. Bilateral compartments 3. A central mediastinum

Question 27

The ____ of the thoracic cavity contain the lungs and pleurae (lining membranes) and occupy the majority of the thoracic cavity.

Answer 27

Bilateral compartments

Question 28

The \_\_\_\_\_\_is a thoracic cavity compartment intervening between and completely separating the two pulmonary cavities, which contains essentially all other thoracic structures - the heart, thoracic parts of the great vessels, thoracic part of the trachea, esophagus, thymus, and other structures (e.g., lymph nodes).

Answer 28

Mediastinum

Question 29

The mediastinum extends vertically from the superior thoracic aperture to the ____ and anteroposteriorly from the thoracic vertebral bodies to the \_\_\_\_

Answer 29

diaphragm, sternum

Question 30

The pulmonary cavities are lined by _________ that also reflect onto and cover the external surface of the lungs contained within the cavities.

Answer 30

pleural membranes (pleurae)

Question 31

The inner pleural membrane is called the \_\_\_\_\_\_

Answer 31

visceral pleura

Question 32

The outside pleural membrane is called the\_\_\_\_

Answer 32

parietal pleura

Question 33

During the embryonic period, the developing lungs invaginate (grow into) the _______ canals, the primordia (beginnings) of the pleural cavities.

Answer 33

pericardioperitoneal

Question 34

The invaginated coelomic epithelium covers the primordia of the lungs and becomes the \_\_\_\_\_\_\_.

Answer 34

visceral pleura

Question 35

The epithelium lining the walls of the pericardioperitoneal canals forms the\_\_\_\_\_\_\_

Answer 35

parietal pleura.

Question 36

During embryogenesis, the ______ cavities become separated from the pericardial and peritoneal cavities; however, a congenital diaphragmatic defect results in a diaphragmatic hernia connecting the peritoneal cavity with one of the pleural cavities (usually the left one), and the herniation of abdominal viscera into the thorax.

Answer 36

pleural

Question 37

Each lung is invested by and enclosed in a serous pleural sac that consists of two continuous membranes:

Answer 37

visceral and parietal pleura

Question 38

the \_\_\_\_\_\_pleura invests all surfaces of the lungs forming their shiny outer surface.

Answer 38

visceral

Question 39

the ____ pleura lines the pulmonary cavities.

Answer 39

parietal

Question 40

The pleural cavity - the potential space between the layers of pleura - contains a capillary layer of ______ \_\_\_\_\_\_\_ \_\_\_\_\_\_, which lubricates the pleural surfaces and allows the layers of pleura to slide smoothly over each other during respiration.

Answer 40

serous pleural fluid

Question 41

The surface tension of the pleural cavity also provides the _____ that keeps the lung surface in contact with the thoracic wall; consequently, the lung expands and fills with air when the thorax expands while still allowing sliding to occur.

Answer 41

cohesion

Question 42

The visceral pleura (pulmonary pleura) closely covers the lung and is adherent to all its surfaces, including the surfaces within the _______ and ______ fissures; it cannot be dissected from their surfaces.

Answer 42

horizontal and oblique

Question 43

The visceral pleura provides the lung with a smooth slippery surface, enabling it to move freely on the \_\_\_\_\_.

Answer 43

parietal pleura.

Question 44

The visceral pleura is continuous with the parietal pleura at the _____ of the lung, where structures making up the root of the lung (e.g., the bronchus and pulmonary vessels) enter and leave the lung.

Answer 44

hilum

Question 45

The parietal pleura lines the ______ cavities, thereby adhering to the thoracic wall, the mediastinum, and the diaphragm.

Answer 45

pulmonary

Question 46

The parietal pleura consists of four parts:

Answer 46

costal part mediastinal part diaphragmatic part cervical pleura

Question 47

The ______ part of the parietal pleura covers the internal surfaces of the thoracic wall.

Answer 47

costal

Question 48

The ____ part of the parietal pleura covers the lateral aspects of the mediastinum - the mass of tissues and organs separating the pulmonary cavities and their pleural sacs.

Answer 48

mediastinal

Question 49

The ________ part of the parietal pleura covers the superior or thoracic surface of the diaphragm on each side of the mediastinum.

Answer 49

diaphragmatic

Question 50

The ______ pleura of the parietal pleura extends through the superior thoracic aperture into the root of the neck, forming a cup-shaped pleural dome over the apex of the lung (the part extending above the 1st rib).

Answer 50

cervical

Question 51

\_\_\_\_\_ pleura can be damaged easily, especially in children.

Answer 51

cervical

Question 52

The costal part of the parietal pleura (costovertebral or costal pleura) is separated from the internal surface of the thoracic wall (sternum, ribs and costal cartilages, intercostal muscles and membranes, and sides of thoracic vertebrae) by \_\_\_\_\_\_\_\_

Answer 52

endothoracic fascia.

Question 53

The endothoracic fascia is an extrapleural layer of loose connective tissue that forms a natural cleavage plane for the surgical separation of the _______ from the thoracic wall.

Answer 53

costal pleura

Question 54

The ______ part of the parietal pleura covers the lateral aspects of the mediastinum, the partition between the pulmonary cavities.

Answer 54

mediastinal

Question 55

The mediastinal part of the parietal pleura (mediastinal pleura) continues superiorly into the root of the neck as \_\_\_\_\_\_

Answer 55

cervical pleura

Question 56

The mediastinal part of the parietal pleura (mediastinal pleura) is continuous with costal pleura anteriorly and posteriorly and with the _____ pleura inferiorly.

Answer 56

diaphragmatic

Question 57

Superior to the root of the lung, the mediastinal pleura is a continuous sheet passing anteroposteriorly between the sternum and the \_\_\_\_\_\_\_

Answer 57

vertebral column.

Question 58

At the ______ of the lung, the mediastinal pleura reflects laterally onto the structures making up the root of the lung and becomes continuous with the visceral pleura.

Answer 58

hilum

Question 59

Inferior to the root of the lung, this continuity between parietal and visceral pleura is an ‘empty’double layer of pleura, the \_\_\_\_\_\_\_, extending between the lung and the mediastinum, immediately anterior to the esophagus.

Answer 59

pulmonary ligament

Question 60

The \_\_\_\_\_\_\_covers the superior surface of the diaphragm, except along its costal attachments (origins) and where the diaphragm is fused to the pericardium, the fibroserous membrane surrounding the heart.

Answer 60

diaphragmatic part of the parietal pleura (diaphragmatic pleura)

Question 61

A thin, more elastic layer of endothoracic fascia, the \_\_\_\_\_fascia, connects the diaphragmatic pleura with the muscular fibers of the diaphragm.

Answer 61

phrenicopleural

Question 62

The _______ pleura is the dome-shaped cap of the pleural sac and is the superior continuation of the costal and mediastinal parts of the parietal pleura

Answer 62

cervical

Question 63

The cervical pleura covers the _____ of the lung that extends superiorly through the superior thoracic aperture into the root of the neck.

Answer 63

apex

Question 64

The summit of the cervical pleura is ______ cm superior to the level of the medial third of the clavicle at the level of the neck of the 1st rib.

Answer 64

2 - 3 cm

Question 65

The cervical pleura is reinforced by a fibrous extension of the endothoracic fascia - the \_\_\_\_\_\_\_\_\_, which attaches to the internal border of the 1st rib and the transverse process of C7 vertebra.

Answer 65

suprapleural membrane (Sibson fascia)

Question 66

The _____ do not occupy the pulmonary cavities completely during expiration; thus the peripheral diaphragmatic pleura is in contact with the lowermost parts of the costal pleura.

Answer 66

lungs

Question 67

The potential pleural spaces here are the \_\_\_\_\_\_\_\_, pleura-lined grooves, which surround the upward convexity of the diaphragm inside the thoracic wall.

Answer 67

costodiaphragmatic recesses

Question 68

Smaller pleural ____ are located posterior to the sternum where the costal pleura is in contact with the mediastinal pleura.

Answer 68

recesses

Question 69

The potential pleural spaces here are the costomediastinal recesses; the left recess is potentially larger (less occupied) because of the ______ in the left lung.

Answer 69

cardiac notch

Question 70

The inferior borders of the lungs move farther into the pleural recesses during deep ______ and retreat from them during expiration.

Answer 70

inspiration

Question 71

Because of the inferior slope of the 1st pair of ribs and the superior thoracic aperture they form, the cervical pleura and apex of the lung project through this opening into the neck, posterior to the inferior attachments of the ______ muscles.

Answer 71

sternocleidomastoid

Question 72

The lungs and pleural sacs may be injured in wounds to the base of the neck resulting in a \_\_\_\_\_, the presence of air in the pleural cavity.

Answer 72

pneumothorax

Question 73

The cervical pleura reaches a relatively higher level in ______ because of the shortness of their necks.

Answer 73

infants and young children

Question 74

The \_\_\_\_\_\_\_is especially vulnerable to injury during the first few years after birth.

Answer 74

cervical pleura

Question 75

The pleurae descend inferior to the costal margin in three regions, where an abdominal incision might accidentally enter a pleural sac: the \_\_\_\_\_\_\_and right and left costovertebral angles.

Answer 75

right part of the infrasternal angle

Question 76

The small areas of pleura exposed in the costovertebral angles inferomedial to the 12th ribs are posterior to the superior poles of the \_\_\_\_\_

Answer 76

kidneys

Question 77

The pleura is in danger (i.e., a ______ may occur) from an incision in the posterior abdominal wall when surgical procedures expose a kidney, for example.

Answer 77

pneumothorax

Question 78

Entry of air into the pleural cavity (pneumothorax), resulting from a penetrating wound of the parietal pleura from a bullet, for example, or from rupture of a pulmonary lesion into the pleural cavity (bronchopulmonary fistula), results in \_\_\_\_\_\_\_of the lung.

Answer 78

collapse

Question 79

\_\_\_\_ ribs may also tear the visceral pleura and lung, thus producing pneumothorax.

Answer 79

Fractured

Question 80

The accumulation of a significant amount of fluid in the pleural cavity (\_\_\_\_\_\_\_\_) may result from ______ (escape of fluid into the pleural cavity).

Answer 80

hydrothorax, pleural effusion

Question 81

With a chest wound, blood may also enter the pleural cavity (\_\_\_\_\_\_\_\_).

Answer 81

hemothorax

Question 82

Hemothorax results more commonly from injury to a major intercostal or internal thoracic ______ than from laceration of a lung.

Answer 82

vessel

Question 83

If both air and fluid (\_\_\_\_\_\_\_\_, if the fluid is blood) accumulate in the pleural cavity, an air-fluid level or interface (sharp line, horizontal regardless of the patient's position, indicating the upper surface of the fluid) will be seen on a radiograph.

Answer 83

hemopneumothorax

Question 84

During inspiration and expiration, the sliding of normally smooth, moist pleurae makes no detectable sound during auscultation of the lungs (listening to breath sounds); however, inflammation of the pleura, \_\_\_\_\_\_\_, makes the lung surfaces rough.

Answer 84

pleuritis or pleurisy

Question 85

Friction (pleural rub) is detectable with a \_\_\_\_\_\_\_

Answer 85

stethoscope

Question 86

\_\_\_\_\_\_ sounds like a clump of hair being rolled between the fingers.

Answer 86

Pleuritis (pleurisy)

Question 87

The __________ of pleura may also cause the parietal and visceral layers of pleura to adhere (pleural adhesion).

Answer 87

inflamed surfaces

Question 88

\_\_\_\_ pleuritis is marked by sharp, stabbing pain, especially on exertion, such as climbing stairs, when the rate and depth of respiration may be increased even slightly.

Answer 88

Acute