Thorax: Breast, Lungs, Thoracic Wall

Question 1

breast (8 structures)

Answer 1

Level: ribs 2-6

Features:

1. lactiferous ducs & sinuses
2. nipple-areolar complex
3. lobes
4. lobules
5. alveolar glands
6. suspensory ligaments
7. retromammary space
8. axillary tail

Relations:
2/3 bound to fascia of pectoralis major
1/3 pound to fascia of serratus anterior muscle

Question 2

lactiferous ducs & sinuses

Answer 2

openings of milk glands

Question 3

nipple-areolar complex

Answer 3

the opening of the milk duct and surrounding area of pigmented skin

Question 4

lobes

Answer 4

secretory units

Question 5

lobules

Answer 5

smaller secretory units

Question 6

alveolar glands

Answer 6

milk producing glands. Production occurs through an apocrine mechanism

Question 7

suspensory ligaments

Answer 7

“Cooper’s” Ligaments- fibrous septa that attach the underlying gland to overlying skin

Question 8

retromammary space

Answer 8

a layer of superifical fascia

deep to the breast but superficial to the deep fascia of the muscle

Question 9

axillary tail

Answer 9

the superiolateral region of the breast

Question 10

sternum (parts)

Answer 10

1. manubrium
2. body
3. xiphoid process
4. sternal angle

Question 11

visceral pleura

Answer 11

interior aspect of pleura in contact with organs

Question 12

parietal pleura

Answer 12

superficial aspect of pleura

Question 13

pleura cavity

Answer 13

the area between the pleura. Important for maintaining pleural pressure

Question 14

true ribs

Answer 14

def. attach to sternum directly through costal cartilage

location: ribs 1-7, sometimes also 8

Question 15

false ribs

Answer 15

def. cartilages are joined to rib just superior

location: ribs 8-10

Question 16

floating ribs

Answer 16

def. cartilages ends in posterior abdomen

ribs 11 & 12

Question 17

costal margin

Answer 17

defined by cartilage of ribs 7-10

Question 18

typical ribs

1. features
2. location

Answer 18

1. a. head- posterior aspect, wedge shaped structure, articulates with vertebral body
   b. neck: posterior aspect, separates head and tubercle
   c. tubercle: posterior aspect, articulates with a corresponding transverse process
2. ribs 3-9

Question 19

Rib 1

Answer 19

1. articulates with T1
2. broad and short, the brachial plexus and subclavian artery pass superior. Presence of a “cervical” rib may compress the structures (thoracic outlet syndrome)

Question 20

Rib 2

Answer 20

1. thinner than Rib 1

2. articulates with T1 & T2

Question 21

Rib 10

Answer 21

only on “facet” only articulates with T10

Question 22

Ribs 11&12

Answer 22

short
have a large facet
lack necks and tubercles

Question 23

manubrium

1. level
2. surface features
3. key relations

Answer 23

1. level- T3/T4
2. features
   a. clavicular notch
   b. jugular (suprasternal) notch
   * c. sternal angle: at the level of T4/T5 interverebral disc
3. articulates with clavicle

Question 24

body (sternum)

1. level
2. surface features

Answer 24

1. level: T4-T9

2. not many

Question 25

xiphoid process

Answer 25

cartilagenous, inferior aspect of sternum

Question 26

comminuted sternal fracture

Answer 26

def. the sternal body is usually fractured into several pieces common causes: steering wheel crash

Question 27

superior thoracic apeture (thoracic outlet) 1. borders 2. structures

Answer 27

1 . first thoracic vertebrae, first pair of ribs and cartilages, superior border of manubrium 2. lungs, subclavian artery, brachial plexus

Question 28

inferior thoracic aperture 1. borders 2. structures

Answer 28

1. 12 thoracic vertebrae and ribs, costal cartilages of ribs 7-12, xiphisternal joint 2. diaphragm closes, aorta, vena cava, other structures pass through

Question 29

rib dislocation v. separation

Answer 29

dislocation: detachment from sternum separation: detachment from costal cartilage common causes: contact sports

Question 30

explain thoracocentesis

Answer 30

Goldie Locks: insert a needle just above the inferior part of an intercostal space in the superior part there are intercostal vessles in the inferior part, there tend to be collaterals

Question 31

cervical pleura

Answer 31

parietal pleura that extends above the thoracic outlet

Question 32

costal pleura

Answer 32

parietal pleura in contact with ribs

Question 33

diphragmatic pleura

Answer 33

borders the inferior thoracic oulet

Question 34

costodiaphragmatic reces

Answer 34

?

Question 35

right lung has __ lobes

Answer 35

3, faces away from heart

Question 36

left lung has ___ lobes

Answer 36

2, due to heart

Question 37

carina

Answer 37

site at which trachea divides into two bronchi

Question 38

transverse throacic plane

Answer 38

level: T4-T5 significance:

Question 39

costal surface of lung

Answer 39

adjacent to ribs

Question 40

mediastinal surface of lung

Answer 40

related to mediastinum and posterior aspect of ribs

Question 41

diaphragmatic surface

Answer 41

convex dome of diaphragm

Question 42

base of lung

Answer 42

anatomically: the diaphragm clincally: the inferior part of the posterior costal surface

Question 43

horizontal fissure

Answer 43

only in the right lung, divides superior and middle lobes

Question 44

Thoracic Wall: VAN is a pneumonic for:

Answer 44

Intercostal neurovasculature, from superior to inf Vein Artery Nerve

Question 45

anterior vessels of thoracic wall

Answer 45

arise from: internal thoracic artery | drain into: internal thoracic vein

Question 46

posterior vessels of thoracic wall

Answer 46

arise from: thoracic aorta | drain into: the azygous system

Question 47

endothoracic fascia

Answer 47

thin fibroareolar layer between internal aspect of the thoracic cage and the lining of the pulmonary cavities

Question 48

lymph drainage of breast (2)

Answer 48

1. inferior jugular lymph nodes- above clavicle | 2. axillary lymph nodes- below clavicle (75%)

Question 49

medial mammary branch (artery)

Answer 49

arises from: subclavian artery supplies: breast drains into:

Question 50

internal thoracic branch (artery)

Answer 50

arise from: branch of the axillary artery supply: breast drain into:

Question 51

posterior intercostal arteries

Answer 51

arise from: thoracic aorta supply: breast drain into:

Question 52

subareolar lymphatic plexus

Answer 52

collects: lymph from nipple, areola, and lobules drains into: 1. lateral quadrants: axillary lymph nodes (75%) 2. medial quadrants: parasternal lymph nodes or opposite breast 3. inferior quadrants: inferior phrenic lymph nodes

Question 53

hierarchy: lymphatic drainage, breast axillary nodes> right lymphatic duct or tho. duct parasternal nodes. . . .

Answer 53

axillary nodes< subclavian lymphatic drunks< jugular lymphatic trunk< right lymphatic duct or thoracic duct (left side)