Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

M1 Gross Anatomy > Thorax > Flashcards

Thorax Flashcards

1
Q

The bony thorax includes

A

Thoracic vertebrae (12) and intervertebral discs
Ribs (12 pairs) and costal cartilages
Sternum: manubrium sterni, body, xiphopid process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Apertures in the thoracic cage:

A

1) Superior thoracic aperture (inlet) - Clinical outlet

2) Inferior thoracic aperture (outlet)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Sternal angle

A

T4/T5

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Level of xiphoid process

A

T10 or T11

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Superior thoracic aperture

A

1st pair of ribs and cartilages, manubrium sterni, first thoracic vertebra (T1)

Contents:

  • trachea
  • esophagus
  • vagus (CN X)
  • phrenic nerves (C3, 4, 5)
  • apex of lungs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Thoracic outlet (inferior thoracic aperture):

A
  • the 12th thoracic vertebra (T12)
  • the 12th pair of ribs
  • costal margin = costal cartilages 7-10
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Angle of Louis:

A
  • marked the level of the 2nd costal cartilage
  • aortic arch
  • bifurcation of the trachea (carina)
  • T4/T5 intervertebral disc
  • ligamentum arteriosus
  • pulmonary trunk divides into the left and right pulmonary arteries
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Shortest and longest ribs

A

Rib 7 generally the longest

Rib 12 is the shortest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Typical vs atypical ribs

A

Typical ribs: Ribs 3-9

Atypical ribs: Ribs 1, 2, 10, 11, 12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

True, false, and floating ribs

A

True ribs- Ribs 1-7 articulate with the sternum through their own costal cartilages

False ribs- Ribs 8,9,10 share a common costal cartilage

Floating ribs- Ribs 11-12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Costal groove

A

Costal groove- located on the inferior aspect of the ribs, shelters the intercostal Neurovascular bundle (vein, artery, nerve- VAN)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Describe the 1st rib

A

Short and broad
Forms parts of the thoracic inlet
Groove for subclavian vein and artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Functions of the thoracic cage

A
  • protection of internal organs
  • framework for attachment of muscles
  • assists in respiration
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Muscles of the thoracic wall

A
  • diaphragm
  • serratus anterior muscle
  • serratus posterior superior and inferior muscles
  • pectoralis major and minor
  • intercostal muscles- external, internal, innermost (innermost proper, sternocostalis/transversus thoracis, subcostalis)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Intercostal muscles, innervation and action

A

All innervates by corresponding intercostal nerve

External intercostal muscle- elevates the rib cage on inspiration

Internal and innermost intercostal muscles- expiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Describe the diaphragm and its origin

A

Diaphragm- dome shaped structure that separates a the thoracic cavity from the abdomen

Consists of a peripheral muscular part, and a centrally placed tendon

Origin:
Sternal, costal, and vertebral parts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Diaphragm hiatuses and contents:

A

Aortic hiatus (T12)- thoracic aorta, thoracic duct, azygos vein, splanchnic nervecs

Esophagus hiatus (T10)- esophagus, vagus nerves, esophageal branches of left gastric artery and vein

Caval opening (T8)- IVC, phrenic nerves, lymphatic vessels

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Arteries of the thoracic wall

A

Anterior aspect- supplied by internal thoracic artery (branch of subclavian)

  • 1-6 internal thoracic
  • 7,8,9 musculophrenic (branch of internal thoracic)
  • no anterior intercostal arteries in ICS 10-11

Posterior aspect- supplied by 1st posterior intercostal artery or highest intercostal artery (costocervical trunk of the subclavian), posterior intercostal arteries (thoracic aorta)- ICS 2-11, ICS 12 subcostal artery (thoracic aorta)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Veins of the thoracic wall

A

Anterior aspect of thorax- drained by internal thoracic vein into the brachiocephalic vein

Posterior aspect of thorax- drained by azygos vein —> SVC
Right:
- 1st: highest intercostal vein —> Brachiocephalic v
- 2-12: azygos

Left:

  • 1st: highest intercostal vein —> Brachiochephalic v
  • 2nd-4th: accessory hemiazygos —> azygos —> SVC
  • 5th-12th: hemiazygos —> azygos —> SVC
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Thoracic duct

A

Bilateral lower extremity,abdomen, left UE, left head and neck/thorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Layers of penetration - mix-axillary line

A

Skin —> Superficial fascia —> deep fascia —> serratus anterior muscle —> external intercostal muscle —> internal intercostal muscle —> innermost intercostal muscle —> endothoracic fascia —> parietal pleura —> pleural cavity —> visceral pleura —> lungs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Lumbar ribs

A

More common than cervical
May confuse ID of vertebral levels in radiographs
May be erroneously interpreted as a Fx transverse process of L1

23
Q

Flail chest

A

Due to multiple rib fractures leading to paradoxical chest movement (ie inward with inspiration and outward with expiration); it impairs ventilation

24
Q

Rib dislocation

A

Displacement of the costal cartilage from the sternum (2-7); contact sports

25
Q

Rib separation

A

Dislocation of the costochondral joint between the rib and its costal cartilage

26
Q

Pectus excavatum

A

“Funnel chest” body of the sternum projects inferiorly and posteriorly pressing on the heart, which widens it making it look large on AP radiographs

27
Q

Pectus carinatum

A

“Pigeon chest”- sternum projects anteriorly

28
Q

Thoracocentesis

A

Surgical puncture of the chest wall

29
Q

Thoracostomy

A

Needle or tube at ICS 4 or 5

30
Q

Thoracotomy

A

Surgical incision of the chest wall. Over ICS 4 or 5, extending from the lateral margin of the sternum to the anterior axillary line

31
Q

Parietal pleural cavities

A

Parietal pleura: lines the thoracic wall and covers the thoracic surface of the diaphragm and the lateral surface of the mediastinum
- parietal pleura becomes continuous with the visceral pleura at the hilum of each lung

Visceral pleural: covers the outer surfaces of the lungs and extends into the interlobar fissures

32
Q

Cupola

A

Area of parietal pleura reflected over the apex of the lung

33
Q

Pleural recess

A

Potential pleural space that is not occupied by the lungs during quiet respiration
- during deep inspiration the lungs fill the pleural cavities, hence pleural recessed allow for the expansion of the lungs during inspiration

34
Q

Pleural Recesses are:

A

1- Costodiaphragmatic recesses: at the junction of the costal and diaphragmatic parietal pleura, at the mid-axillary line. This is the lowest area of the pleural cavity into which the lungs expand during inspiration. A tap may be performed here at ICS 9. Measures about 5 cm vertically extending from ribs 8-10

2- cosotmediastinal recesses

3- costovertebral recesses

35
Q

Costal parietal pleura extends

A

Anteriorly ICS8
Mid-axillary line to ICS9
Posteriorly to ICS10

36
Q

Blood Supply

A

Parietal pleura- the corresponding intercostal arteries. The internal thoracic artery

Visceral pleura- bronchial arteries (thoracic aorta)

37
Q

Pleural cavity nerve supply

A

Parietal pleura: very sensitive to pain!

  • intercostal nerves 1-11
  • subcostal nerve 12
  • phrenic nerve (CN 3,4,5)

Visceral pleura: insensitive to pain!

38
Q

Lungs are freely suspended and are attached by their _____

A

Roots to the mediastinum.

They are attached to the pericardium by the pulmonary ligaments

39
Q

Lungs borders

A

Anterior- thin, overlaps the heart. It is notched on the left lung= cardiac notch (costal cartilages 4,5,6)

Posterior- thick, lies beside the vertebral column

Inferior

40
Q

Right vs left lung

A

Right lung- superior, middle, inferior

Left lung- superior, inferior, and lingual (modified middle lobe)

41
Q

Lung fissures

A

Oblique fissure- begins 2.5 cm from the apex of the lung and ends at the level of costal cartilage 6

Horizontal fissure- located at the level of costal cartilage 4 (only on right lung)

42
Q

Depressions and grooves of left & right lung

A

Right lung- Tracheal and esophageal areas, a groove for the SVC, groove for the IVC, cardiac depression, a groove for the azygos vein, and a concave diaphragmatic depression

Left lung- large cardiac depression, a groove for the aortic arch, and a groove for the descending aorta, as well as a, concave diaphragmatic depression

43
Q

Blood and nerve supply

A

Arterial supply:

  • bronchial arteries: 2 on left from thoracic aorta, 1 on right from 3rd posterior IC artery
  • pulmonary arteries (deoxygenated blood)

Venous supply:

  • bronchial veins: right bronchial vein drains into the azygos vein. Left into the hemiazygos vein
  • pulmonary veins: oxygenated blood

Lymphatic drainage:
- from the hilum to the pulmonary nodes to the tracheobronchial nodes

Nerve supply:

  • vagus nerve (parasympathetic)- bronchoconstriciton, inhibitory to pulmonary vessels (vasodilation), increase glandular secretion
  • vagus- sensory innervation
  • sympathetic trunk = vasomotor- innervation from T2-T5. Bronchial dilation, vasoconstriction, inhibit glands of bronchial tree
44
Q

Trachea

A

Mobile fibrocartilagenous tube
Continuation fo the larynx at the lower border of the cricoid cartilage (C6)
Descends in the midline of the neck anterior to the esophagus entering the superior mediastinum and deviating slightly to the right of the median plane at the angle of Louis before it divides. Level of IV disks T4-T5

45
Q

Carina angle

A

90 degrees

If it is more, may indicate presence of a mediastinal mass

46
Q

Structures anterior and posterior to trachea

A

Anterior: sternum, thymus, arch of aorta, origins of brachiocephalic trunk and L CC artery

Posterior: esophagus, azygos vein and R vagus (on the right) and pleura, aortic arch, LCC, left subclavian, left subclavian, left phrenic, and pleura (on the left)

47
Q

Trachea blood and nerve supply

A

Blood supply:
Superior thyroid artery (ext carotid artery), inferior thyroid artery (thyrocervical trunk subclavian artery), bronchial arteries (thoracic aorta), internal thoracic artery (subclavian artery)

Nerve:
Vagus nerve and sympathetic chain

48
Q

Bronchi

A

Right: wider, shorter, and more vertical

  • before entering hilum, gives off superior lobar bronchus
  • on entering- middle and inferior
  • 10 bronchopulmonary segments

Left: narrower, longer, and more horizontal

  • passes to the left below the arch of the aorta and in front of the esophagus!!
  • on entering hilum- superior and inferior bronchi
  • 8 bronchopulmonary segments
49
Q

Blood supply bronchi

A

Bronchial arteries- 2 on left from thoracic aorta, and one on right form the 3rd posterior intercostal artery

50
Q

Pleurasy/pleuritis

A

Inflammation fo the pleura
Pain referred to thoracic/abdominal wall
Hear “pleural rub” on auscultation

51
Q

Pleurectomy

A

Surgical obliteration of pleural cavities no appreciable functional consequences
In some cases done to prevent recurrent spontaneous pneumothorax
Done by inducing covering the opposing surfaces with irritating agents

52
Q

Atelectasis

A

Lung collapse

53
Q

Pneumothorax

A

Hemothorax (blood)/hydrothorax/chylothorax (chyle)

Air int he pleural space causes the lung to collapse around the hilus and may push the mediastinal contents toward the other lung

54
Q

Esophageal plexus

A

Anterior branch- left vagus

Posterior- right vagus nerve

M1 Gross Anatomy (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions