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Clin Anatomy Exam 2-Tomolonis > Thorax > Flashcards

Thorax Flashcards

1
Q

What is the bifurcation of the trachea called?

A

The carina

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2
Q

What is located at the sternal angle?

A

The carina, the beginning and ending of the aortic arch, the 2nd rib

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3
Q

What are the vertical lines of the thorax (front view)?

A

Mid sternal line, and mid clavicular line

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4
Q

What are the lateral vertical lines?

A

anterior axillary line, mid axillary line, posterior axillary line

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5
Q

Where is “auscultation alley” located

A

Posteriorly between vertebral line and scapular line

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6
Q

what are the bones of the thoracic wall?

A

Ribs, thoracic vertebrae and sternum

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7
Q

What is the function of the thoracic wall?

A

Protection of thoracic content

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8
Q

What two parts of the thoracic wall form the sternal angle?

A

the sternum (body) and manubrium

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9
Q

Which ribs are “true ribs”

A

1-7

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10
Q

False ribs?

A

8-10 attach indirectly to sternum

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11
Q

Floating ribs

A

11-12

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12
Q

Typical ribs

A

3-9

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13
Q

atypical ribs

A

1, 2, 10-12

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14
Q

What are the classifications of the typical rib

A

Rib#3-9. Head has facets that articulate with vertebrae, Neck, Tubercle-articulates with transverse process, shaft-thing flat curves costal angle

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15
Q

Where do you find the costal facets on the vertebral bodies

A

Pairs of inferior and superior on vertebrae except lower 4 thoracic and below

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16
Q

Where are the transverse costal facets located on the vertebral bodies?

A

along transverse processes except lower 2 thoracic vertebrae

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17
Q

What are the joints of the posterior thorax?

A

Costovertebral-rib articulation with vertebral body, constotransverse-rib articulation with transverse process, and IV joints (discs and facets )

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18
Q

Joints of the anterior thorax?

A 
Costochondral joints
Sternocostal joints
Sternoclaviuclar going (SC) 
Interchondral joints (between 8-10)
Maubriosternal
Xiphosternal
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19
Q

Normal movement patterns of ventilation?

A

bucket handle motion of ribs-increase in AP and lateral diameter

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20
Q

What is the “continuum” pattern for inspiratory muscular movement?

A

Rest=diaphragm
Exercise=Diaphragm + external intercostals
Extreme exercise=Diaphragm, external intercostals AND accessory muscles (SCM scalenes etc.)

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21
Q

What type of breathing may patients with COPD and other pulmonary disease display?

A

Accessory pattern - shrug shoulders, use of accessory muscle,

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22
Q

What might thoracic asymmetry indicate?

A

Trauma/pathology in one lung, scoliosis

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23
Q

External intercostals role in breathing?

A

Inspiration

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24
Q

Internal intercostals role in breathing?

A

Expiration

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25
Q

What do the innermost intercostals do?

A

elevate

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26
Q

Transverse thoracis action

A

expiration (depress ribs)

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27
Q

Subcostal muscles action

A

Inspiration (elevate ribs)

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28
Q

Levator costarum action

A

insipiration (elevate ribs)

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29
Q

What nerve provides motor sensory components to the diaphragm?

A

Phrenic nerve C3-5

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30
Q

What is the main role of the daiphragm

A

Inspiration

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31
Q

Pathway of intercostal nerves

A

12 thoracic spinal nerves exit the spinal IVF, each nerve braces into anterior and posterior rami, anterior rami supply intercostal spaces, Vein, artery, and nerve bundle enter the intercostal space

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32
Q

What does the anterior rami supply?

A

the intercostal spaces

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33
Q

What are the 3 major sources of circulation to the thoracic wall?

A

Thoracic aorta, axillary artery, subclavian artery

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34
Q

What are the branches of the thoracic aorta?

A

Posterior intercostal arteries and subcostal artery

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35
Q

What does the posterior intercostal arteries supply?

A

the 3rd - 11th intercostal spaces

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36
Q

What does the subcostal artery supply?

A

Inferior to the 12th rib

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37
Q

Where do the upper intercostals on the left dump back into?

A

The brachiocephalic on the L SIDE

38
Q

Where do the upper intercostals on the right dump back into?

A

Azygos vein

39
Q

Where does the azygos vein dump into?

A

heart via the SVC on the Right side

40
Q

What landmark is the nipple indicative of?

A

The 4th intercostal space in a male as well as the apex of the heart

41
Q

Where does the majority of lymph drainage from the breast go?

A

axillary lymph nodes

42
Q

Where do the majority of breast cancers occur?

A

on the outside of the breast

43
Q

Where does the trachea begin?

A

inferior to larynx (cricoid cartilage)

44
Q

Order of bronchial tree

A

trachea>Primary bronchi (R/L)>Lobar bronchi(2 on L 3 on R)>segmental bronchi (10 bronchopulmonary segments)>intersegmental(20-25 generations)>bronchioles>terminal bronchiole>respiratory bronchiole(gas exchange begins)>

45
Q

Where does the acinus begin?

A

at the end of the first terminal bronchiole-this is the start of the respiratory zone

46
Q

Parietal pleura lines what?

A

the thoracic wall and diaphragm

47
Q

The visceral pleura lines what?

A

the lungs

48
Q

What is the parietal cavity?

A

potential space between the pleura

49
Q

What angles to you look for in the lower thorax of a healthy chest-xray

A

Costodiaphragmatic recesses

50
Q

Describe a thoracentesis

A

Fluid accumulation in the plurae-can be removed via hypodermic needle through intercostal space

51
Q

T/F the inferior border of the costodiaphragmatic space on X-ray will be higher on the L than on the R

A

F it will be higher on the R because of the location of the liver-pushing the CDR up

52
Q

What is contained in the Hilum (root)

A 
Primary bronchus
pulmonary veins
pulmonary artery
pulmonary nerves
lymph vessels
53
Q

How many lobes are present on the Right lung?

A

3: superior, middle, inferior

54
Q

What are the lobes on the R lung separated by?

A 
Oblique fissure (sup/mid)
Horizontal fissure (mid/inf)
55
Q

What are the 3 bronchopulmonary segments on the R lung?

A

superior lobe=3
Middle Lobe=2
Inferior lobe=5

56
Q

How many lobes are present in the L lung?

A

2: superior, inferior

57
Q

What are the loves in the L lung separated by

A

Oblique fissure only

58
Q

What are the 2 bronchopulmonary segments on the R lung?

A

Superior lobe=5

Inferior lobe=5

59
Q

Endocardium

A

Inner layer or thin, smooth lining of hear chambers

60
Q

Myocardium

A

cardiac muscle

61
Q

Epicardium

A

outer layer blends into visceral layer of serous pericardium

62
Q

What is the importance of the pericardium?

A

It is a double walled fibrous sac that provides stability but also flexibility in order to allow the heart to contract and relax, but also stabilize

63
Q

Where does the fibrous pericardium attach to? (what ligaments facilitate this)

A

the pericardiophrenic ligament to the diaphragm and the sternopericardial ligament to the sternum

64
Q

What are the two layers of pericardium?

A

Fibrous pericardium -outside sac

serous pericardium - inside sac

65
Q

What are the two layers of serous pericardium

A

Parietal layer-blends with fibrous pericardium

Visceral layer-blends with epicardium

66
Q

Landmarks of R atrium

A

SVC/IVC openings
Opening coronary sinus
Fossa Ovalis
Tricuspid valve

67
Q

Landmarks of R ventricle

A

Tricuspid valve
papillary muscle/cordae tendinae
Pulmonary valve

68
Q

Landmarks of L atrium

A

Foramen ovale
4 openings for pulmonary veins
Bicuspid valve

69
Q

Landmarks of L Ventricle

A

Bicuspid valve
Papillary muscle/chordea tendinae
Aortic valve

70
Q

What is the function of the fibrous skeleton

A

Insulator between top and bottom of the heart

as well as support and provision of attachments for atria, ventricles, and valves

71
Q

What do the chordae tendon and papillary muscles function?

A

Anchor cusps of the tricuspid valve between R atrium and R ventricle

72
Q

Where do you ascultate on the thorax to appreciate the function of the tricuspid valve?

A

Left along sternal border at 5th (or 4th) intercostal space

73
Q

Where is the pulmonary valve located in the heart?

A

Right ventricle and pulmonary trunk

74
Q

Where do you ascultate on the thorax to appreciate the function of the pulmonary valve?

A

the Left 2nd intercostal space

75
Q

Where is the bicuspid valve located in the heart?

A

Between the L atrium and L ventricle (anchored by chordae tendon and papillary muscles)

76
Q

Where do you ascultate to appreciate the function of the bicuspid valve?

A

along apex (L 5th intercostal space)

77
Q

Where is the aortic valve located?

A

Between the L ventricle and the aorta

78
Q

How do you ascultate the aortic valve?

A

Along the Right 2nd intercostal space

79
Q

Where does the superior vena cava go from and dump in to?

A

from superior to diaphragm (except heart and lung) to the Right atrium

80
Q

Where does the IVC go from and dump in to?

A

from inferior to diaphragm to the Right atrium

81
Q

What is the function of the pulmonary trunk

A

sends unoxygenated blood from R ventricle to lungs

82
Q

What is the function of the R/L pulmonary veins

A

returns oxygenated blood back to the Left atrium from the lungs

83
Q

Where does the Aorta come from and go to?

A

aorta sends blood out to the body from L ventricle

84
Q

What is significant about the pressure gradient of the coronary arteries?

A

70ml of blood goes up in to the first part of the Aortic arch. That pressure is so great it forces the valve closed again, what is left gets pushed in to the coronary arteries

85
Q

What is called the Widow Maker? Where does it supply blood?

A

The Left coronary artery (Left anterior descending artery) supplies blood to septum and L ventricle

86
Q

Where can you auscultate the R/L 2nd ICS?

A

Aortic area (on the R side of the sternal line) and the pulmonic area (on the L side of the sternal line).

87
Q

Where is ERb’s point?

A

Left 3rd ICS (S1 and S2)

88
Q

Where is the tricuspid area auscultated?

A

Left sternal border 4th/5th ICS

89
Q

Where is the mitral/apex auscultated?

A

The 5th ICS

90
Q

What is a good way to identify the internal and innermost intercostals?

A

Vessels and nerves run between the innermost and internal intercostals.

91
Q

Where does the subclavian artery supply blood to in the thoracic vasculature?

A

Costalcervical trunk supplies top 2 ICS

92
Q

What artery supplies blood the the anterior portion of the thoracic wall?

A

The internal thoracic artery, Anterior thoracic arteries branch off to supply the anterior 1-9th intercostal spaces

Clin Anatomy Exam 2-Tomolonis (2 decks)

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