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HAO 561: QUIZ 2 > Thorax and Mediastinum > Flashcards

Thorax and Mediastinum Flashcards

(108 cards)

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1
Q

Thoracic wall contains

A

skin

fascia

nerves

vessels

muscles

bone

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2
Q

functions of thoracic wall

A

Protection of the thoracic and abdominal internal organs

Resist the negative internal pressures generated by elastic recoil of the lungs and inspiratory movements

Provides attachment for and support of the weight of the

Provides attachment for muscles of the neck, abdomen, back, upper limbs and muscles of inspiration

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3
Q

thoracic skeleton

A

Forms the osteocartilaginous thoracic cage

Comprised of:
12 pairs of ribs and costal cartilages
12 thoracic vertebrae and IV discs

Sternum

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4
Q

three types of ribs

A

true ribs
false ribs
floating ribs

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5
Q

true ribs

A

(1-7)

Attach directly to the sternum through their own

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6
Q

false ribs

A

(8-10)

Cartilages are joined to that of the rib immediately superior to them

Indirect connections to the sternum

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7
Q

floating ribs

A

Free/Vertebral Ribs (11th and 12th)

Cartilages do not connect to sternum

End in the posterior abdominal musculature

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8
Q

costal cartilages

A

Anterior communication of the ribs to the sternum

Flexible attachment

Made of hyaline cartilage

A synchondrosis is formed between each and the sternal end of the associated rib

Increase in length from ribs 1-7 then gradually decrease

Intercostal spaces (11)
• separation of ribs and cartilage
• Occupied by intercostal muscles, vessels, and nerves
• Named according to the rib forming the superior border of the space
• Subcostal Space: below the 12 rib
• Subcostal Nerve: the anterior ramus of spinal nerve T12

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9
Q

sternum

A

Flat and vertically elongated

Middle of the anterior part of the thoracic cage

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10
Q

manubrium

A

Superior part of the sternum

Trapezoidal

At levels of the bodies of T3 and T4

Jugular notch/suprasternal notch

Indentation on superior border
• Clavicular notch

Articulated with the medial end of the clavicle

Fuses with costal cartilage of 1st rib

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11
Q

Sternal Body

A

T5-T9 vertebral level

Longer, narrower and thinner than the manubrium

Costal notches- articulations with costal cartilages

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12
Q

Xiphoid Process

A

T10 vertebral level

Smallest and most variable part of sternum

Midline marker for the upper limit of the lever, the central tendon of the diaphragm and the inferior border of the heart

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13
Q

Sternal angle

A

At the manubriosternal joint

Palpable landmark opposite 2nd costal cartilages

At level of IV disc between T4 and T5
Where rib counting starts

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14
Q

superior thoracic aperture (thoracic inlet)

A

Superior border of thoracic cavity between 1st ribs

Structures enter and leave cavity via this aperture: trachea, esophagus, vessels & nerves

Slopes downward and forward to the sternum

Borders: posteriorly: T1 vertebra
laterally: 1st pair of ribs
Anteriorly: superior border manubrium

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15
Q

inferior thoracic aperture

A

Large opening

Bounded by T12 vertebrae, 12th rib, costal arch, &

Diaphragm attaches to these structures
• Muscular and tendinous
• Dome shaped, arches up to body of T8

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16
Q

thoracic outlet syndrome

A

Compression of nerves and arteries to the lower neck and upper limb

Costoclavicular Thoracic Outlet Syndrome
•Compression of subclavian artery between clavicle and 1st rib
•Pallor and coldness
• Diminished radial pulse

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17
Q

inspiration

A

Widening of thoracic wall, rib elevation, and diaphragm movements

increase intrathoracic volume and decrease intrathoracic pressure

Negative pressure change causes air to draw into the lungs

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18
Q

expiration

A

Diaphragm and intercostal muscles relax decreasing intrathoracic volume and increasing intrathoracic pressure

Elastic tissue of lungs recoil expelling air

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19
Q

Muscles develop from myotomes

A

Innervated by ventral rami

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20
Q

Muscles that attach to the thoracic cage:

A

Pectoralis major

Pectoralis minor

Serratus anterior

Latissimus dorsi (refer to lecture 2)

Scalenes
• Anterior, medial, and posterior

Intercostal muscles (3 layers of muscles)
   • Externals, internals, and innermost intercostal muscles

Transverse thoracic muscles
• Subcostal muscles
• Levatores costarum
• Serratus posterior sup. And inf. (lecture 2)

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21
Q

origin of pectoralis major

A

Clavicle

Anterior sternum to the 6th rib

Rib cartilage of true ribs except

Aponeurosis of obliquus externus abdominis

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22
Q

insertion of pectoralis major

A

Humerus- intertubercular groove

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23
Q

function of pectoralis major

A

Whole muscle- Adduction, int. rotation of the shoulder & elevation of the thorax

Clavicular portion- int. rotation, flexion, and horizontal adduction of the shoulder

Sternocostal portion- horizontal adduction and extension of the shoulder

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24
Q

innervation of pectoralis major

A

Clavicular fibers- C5-C7 lateral pectoral nerve

Sternocostal fibers- C6-T1 medial and lateral pectoral nerves

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25
origin of pectoralis minor
Ribs 3-5 Aponeurosis of intercostal muscles
26
insertion of pectoralis minor
Scapula- coracoid process, medial border and superior surface
27
function of pectoralis minor
Scapular protraction/abduction Elevation of ribs in forced inspiration
28
innervation of pectoralis minor
C5-T1 Medial and lateral pectoral nerves
29
origin of serratus anterior
Ribs 1-8 Aponeurosis of intercostal muscles
30
insertion of serratus anterior
Ventral surface of scapula
31
function of serratus anterior
Scapular | Upward rotation of the scapula
32
innervation of serratus anterior
C5-C7 Long Thoracic nerve
33
origin of scalenus anterior
C3-C6 vertebrae- transverse processes
34
insertion of scalenus anterior
1st rib- inner border of upper surface
35
function of scalenus anterior
Flexion of cervical spine Elevation of 1st rib during inspiration Rotation of cervical spine to opposite side Lateral bending of C-spine to the same side
36
innervation of scalenus anterior
C4-C6 cervical nerves (ventral rami)
37
origin of scalenus medius
C2-C7 transverse processes
38
insertion of scalenus medius
1st rib
39
function of scalenus medius
Same as Scalenus Anterior
40
innervation of scalenus medius
C3-C8 cervical nerves (ventral rami)
41
origin of scalenus posterior
C4-C6 transverse processes
42
insertion of scalenus posterior
2nd rib
43
function of scaleus posterior
Cervical flexion Elevation of 2nd rib during inspiration Lateral bending of C-spine to same side Cervical rotation to opposite side
44
innervation of scaleus posterior
C6-C8 cervical nerves (ventral rami)
45
external intercostals
- Extends from tubercle of rib to costochondral joint - Fibers run inferior and anteriorly - Anteriorly External Intercostal Membrane continues to sternum from costochondral junction Inferiorly continuous with external abdominal oblique
46
origin of external intercostals
Ribs 1-11 lower borders | Superior costotransverse ligaments
47
insertion of external intercostals
Ribs 2-12 upper borders Sternum
48
function of external intercostals
Elevation of ribs in inspiration Depression of the ribs in expiration Rotation of thoracic spine to opposite side (unilateral) Stabilization of rib cage
49
innervation of external intercostals
T1-T11 intercostal nerves (ventral rami)
50
internal intercostals
- From sternum to angle of rib - Deep to external intercostals m. Visible through external intercostals membrane Fibers run superomedially Continues posteriorly as the Internal Intercostal Membrane Inferiorly continuous with internal abdominal oblique
51
origin of internal intercostals
Ribs 1-11 inner surface Costal cartilages Sternum
52
insertion of internal intercostals
Ribs 2-12 upper border of inferior rib
53
function of internal intercostals
Same as External Intercostals Elevation of ribs in inspiration Depression of the ribs in expiration Rotation of thoracic spine to opposite side (unilateral) Stabilization of rib cage
54
innervation of internal intercostals
T1-T11 intercostal nerves (ventral rami)
55
innermost intercostals
- Deep to internal intercostals - Less well developed than the other two - Runs in the same direction as internal intercostals - Found only in the middle section of the intercostals space - Separated from internal intercostals by the neurovascular plane (blood vessels and nerves)
56
origin of innermost intercostals
Costal groove of rib above the rib of insertion
57
insertion of innermost intercostals
Upper margin of the rib below the rib of origin
58
function of innermost intercostals
Same as External Intercostals Elevation of ribs in inspiration Depression of the ribs in expiration Rotation of thoracic spine to opposite side (unilateral) Stabilization of rib cage
59
innervation of innermost intercostals
T1-T11 Intercostal nerves (ventral rami)
60
transverse thoracis
- on inner surface of - runs from sternum upward to a costal cartilage - helps secure blood vessels in place
61
origin of transverse thoracis
Sternum (caudal 1/3, xiphoid, posterior surface); Ribs 3-6 (inner side)
62
insertion of transverse thoracis
Ribs 2-5 (caudal borders)
63
function of transverse thoracis
Draws ribs downward (narrows chest); Active in forced expiration
64
innervation of transverse thoracis
T2-T11 intercostal nerves (ventral rami)
65
subcostales
- on inner surface of fibers cross 2-3 ribs
66
origin of subcostales
lower ribs
67
insertion of subcostales
surface of two or three ribs below rib of origin
68
function of subcostales
draws adjacent ribs together
69
innervation of subcostales
T7-T11 intercostal nerves (ventral rami)
70
origin of levatores costarum
C7-T11 transverse processes
71
insertion of levatores costarum
Rib immediately below rib of origin
72
function of levatores costarum
Elevation of ribs in inspiration; Lateral bending of spine
73
innervation of levatores costarum
T1-T11 intercostal nerves (dorsal rami)
74
nerves of thoracic wall
12 pairs of thoracic spinal nerves As they leave the IV foramina they divide into anterior and posterior rami Anterior rami of T1-T1= intercostal nerves Anterior rami of T12= subcostal nerves Posterior rami supply the bones, joints, deep muscles and skin of the back in the thoracic region  
75
typical intercostal nerves
Nerves run in the costal grooves anteriorly Branches •Lateral cutaneous branches at midaxillary line •Anterior cutaneous branches near sternum •Pass between costal cartilages and enter subcutaneous tissue •Muscular branches  
76
posterior intercostal arteries
- are branches of thoracic aorta - run in intercostals spaces 3-11 - spaces 1 and 2 are supplied by branches of the subclavian a.
77
internal thoracic arteries
- branches of subclavian - run vertically, deep to costal cartilage, 1” lateral to sternum - give off a pair of anterior intercostal arteries in spaces 1-6 that anastomose with posterior intercostals arteries - at level of 6th costal cartilage, bifurcate into: • musculophrenic artery • superior epigastric artery
78
musculophrenic artery
- helps supply diaphragm | - gives off anterior intercostal aa. to lower spaces
79
superior epigastric artery
- continues into abdominal wall - runs on deep surface of rectus abdominis muscle  
80
posterior intercostal veins
- drain through azygos vein into superior vena cava
81
anterior intercostal veins
- drain into the internal thoracic veins to brachiocephalic veins on each side
82
* Anterior and posterior intercostals arteries run in neurovascular plane between internal intercostals and innermost intercostals muscles under cover of the costal groove along with intercostals nerve and vein.
.
83
thoracic cavity
Space enclosed by the thoracic walls ``` Three compartments • Two pulmonary cavities • Lateral • One Mediastinum • Central • Heart, thoracic parts of great vessels, thoracic part of the trachea, espohagus, thymus, and lymph nodes ```
84
pleurae
serous sac consisting of two membranes that invests and encloses each lung
85
visceral pleura (pulmonary pleura)
Covers the lungs Adherent to all lung surfaces Can not be dissected from the lungs
86
parietal pleural
Lines the pulmonary cavities Adherent to the thoracic wall, the mediastinum and the diaphragm
87
pleural sleeve
Encloses root of the lung Between the visceral and parietal layers
88
pleural ligament
Inferior to the root Continuity between parietal and pleural viscera Between the lung and mediastinum
89
pleural cavity
Potential space between the visceral and parietal layers of pleura Contains a capillary layer of serous pleural fluid that lubricates pleural surfaces and allows sliding between pleural layers during respiration
90
*Surface tension provides cohesion that keeps the lung surface in contact with the thoracic wall Similar to two glass plates with water  
.
91
pulmonary collapse
Sufficient amount of air enters the pleural cavity-surface tension holding visceral to parietal pleura breaks Lungs collapse because of elastic recoil Potential space becomes a real space
92
pneumothorax
Entry of air into the pleural cavity Bullet wound, fractured ribs
93
hydrothorax
Accumulation of fluid in the pleural cavity Result of pleural effusion
94
hemothorax
Accumulation of blood in the pleural cavity
95
chylothorax
Lymph from a torn thoracic duct accumulating in the pleural cavity
96
pleuritis
Inflammation of the pleurae Makes smooth surfaces rough= friction Acute pleuritis
97
function of lungs
To oxygentate the blood by bringing inspired air into close relation with the venous blood in the pulmonary capillaries
98
appearance of lungs
Light, soft and spongy | Elastic- recoil to 1/3 of their size when the thoracic cavity is opened
99
root of the lung
Formed by the structures entering and emerging from the lung at its hilum Connects the lung with the heart and trachea If root is sectioned before branching of main bronchus and pulmonary artery: Pulmonary artery, superior on the left Superior and inferior pulmonary veins, anteriormost and inferiormost, respectively Bronchus, middle of posterior border
100
hilum of lung
- Area on medial surface of each lung | - At the point at which the structures forming the root enter and leave the lung
101
fissues
divide the lungs into lobes; horizontal or oblique Right lung 3 lobes Larger and heavier than left Shorter and wider than left Left lung Cardiac notch on anteroinferior aspect of the superior lobe Lingula- extension below the cardiac notch, slides in and out of the costomediastinal recess during respiration
102
apex
Blunt superior end of the lung Ascends above the level of the 1st rib into the root of the neck
103
costal surface
adjacent to the sternum, costal cartilages and ribs
104
mediastinal surface
medial to the mediastinum and posterior to sides of the vertebrae
105
diaphragmatic surface
resting on the convex dome of the diaphragm
106
anterior border
where the costal and mediastinal surfaces meet anteriorly and overlap the heart
107
inferior border
circumscribes the diaphragmatic surface of the lung
108
posterior border
where the costal and mediastinal surfaces meet posteriorly

HAO 561: QUIZ 2 (2 decks)

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