Thorax Cardiovascular Flashcards

(40 cards)

1
Q

Surface projection of sternum

A

Description:
• Flat bone with three parts: manubrium, body, and xiphoid process
• Characteristic features include jugular notch and sternal angle (angle of Louis)
• Articulates with upper seven costal cartilages and clavicles

Also known as:
• Sternum also known as the “breastbone”

Comment:
• Provides attachment for pectoralis major muscle

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2
Q

Cephalic v.

A

Cephalic v.
Drainage:
• Skin and subcutaneous structures of lateral and dorsal hand, forearm, and arm

Course:
• Ascends from dorsum of hand to anterolateral forearm and arm
• Passes into deltopectoral triangle

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3
Q

Pectoralis major m.

A
Action:
• Adduction of arm
• Medial rotation of arm
• Clavicular head: flexion of arm
• Sternocostal head: extension of arm (from flexed position)

Innervation:
• Lateral pectoral nerve (C5-7)
• Medial pectoral nerve (C8-T1)

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4
Q

Pectoralis minor m.

A

Action:
• Stabilizes scapula (holds it against thoracic wall)
• Protraction (abduction) of scapula (assists serratus anterior)
• Lateral rotation of scapula (e.g., depresses the acromion)

Innervation:
• Medial and lateral pectoral nerves

Comment:
• Pectoralis major and minor muscles also known as “pecs”
• Pectoralis minor active during forced inspiration

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5
Q

Sternum

A

Description:
• Flat bone with three parts: manubrium, body, and xiphoid process
• Characteristic features include jugular notch and sternal angle (angle of Louis)
• Articulates with costal cartilages of true ribs (1-7), combined costal cartilages of false ribs (8-10), and clavicles

Also known as:
• “Breastbone”

Comment:
• Floating ribs (ribs 11-12): not attached to sternum
• Provides for attachment of sternocleidomastoid, pectoralis major, sternohyoid, and sternothyroid muscles

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6
Q

Costal cartilages

A

Description:
• Attaches rib to sternum
• True ribs (ribs 1-7): attached directly to sternum by costal cartilages
• False ribs (ribs 8-10): attach indirectly to sternum via a shared costal cartilage
• Costal margin created by costal cartilages of ribs 7-10

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7
Q

Internal thoracic a.

A

Course:
• Descends adjacent to sternum within thoracic cavity

Distribution:
• Intercostal spaces
• Breast
• Pericardium
• Diaphragm
• Anterior abdominal wall
Branches:
• Anterior intercostal
• Pericardiacophrenic
• Superior epigastric
• Musculophrenic

Also known as:
• Internal mammary artery

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8
Q

Internal thoracic v.

A
Drainage:
• Anterior thoracic wall, including breast
• Anterior abdominal wall
• Diaphragm
• Pericardium
Tributaries:
• Musculophrenic
• Superior epigastric
• Pericardiacophrenic
• Anterior intercostal

Course:
• Ascends posterior to costal cartilages, just lateral to sternum

Also known as:
• Internal mammary vein

Comment:
• Formed by union of superior epigastric and musculophrenic veins

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9
Q

Thyroid gland

A

Description:
• Bilobed endocrine gland
• Normally composed of left and right lateral lobes connected across midline by isthmus of gland

Function:
• Follicular cells: synthesize and secrete thyroid hormones T3 (triiodothyronine) and T4 (thyroxine)
• Parafollicular cells: synthesize and secrete calcitonin

Comment:
• Lobes lie lateral to trachea and larynx
• Enlarged thyroid gland known as a goiter, typically due to insufficient dietary iodine

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10
Q

Parietal pleura

A

Description:
• Thin, serous membrane
• Lines pulmonary cavity
• Fused to internal walls of thoracic cavity and lateral surface of mediastinum
• Continuous with visceral pleura at root of lung
• Regions include mediastinal, cervical, diaphragmatic, and costal

Comment:
• Pleural cavity created by narrow space between parietal and visceral layers of pleura
• Thorax has three subdivisions: mediastinum and right and left pulmonary cavities
• Costal and peripheral diaphragmatic pleura innervated by intercostal nerves

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11
Q

Right lung

A

Description:
• Three lobes: upper (or superior), middle, and lower (or inferior), separated by two fissures - oblique and horizontal
• Medial surface has hilum with airway and pulmonary vessels
• Surface of lung covered with visceral pleura

Function:
• Primary organ of respiration

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12
Q

Visceral pleura

A

Description:
• Thin, serous membrane
• Fused to surface of lung
• Continuous with parietal pleura at root of lung
• Separated from parietal pleura by pleural cavity

Comment:
• Thoracic cavity divided into midline mediastinum and right and left pulmonary cavities

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13
Q

Phrenic nerve

A

Contributions:
• Ventral rami of C3-5 spinal nerves

Motor:
• Diaphragm

General sensation:
• Parietal layer of pleura and peritoneum over central diaphragm
• Mediastinal pleura
• Parietal pericardium

Comment:
• Supplies all motor innervation to diaphragm (hint: remember C3, 4, 5 “keeps the diaphragm alive”)

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14
Q

Thymus Gland

A

Description:
• Large, bilobed gland in children
• Atrophies during adolescence
• Remnant in adults consists primarily of fibrous and adipose tissue

Function:
• Secretes thymopoietin and thymosins that stimulate and promote differentiation, growth and maturation of T-lymphocytes
• Site for maturation and differentiation of T-lymphocytes (primarily in young individuals)

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15
Q

Fibrous pericardium

A
Description:
• Forms fibrous sac enclosing heart
• External to serous pericardium
• Fused to diaphragm
• In contact with parietal (mediastinal) pleura
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16
Q

Left lung

A

Description:
• Two lobes: upper (or superior) and lower (or inferior), separated by oblique fissure
• Medial surface has hilum with airway and pulmonary vessels
• Surface of lung covered with visceral pleura

Function:
• Primary organ of respiration

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17
Q

Axillary v.

A

Drainage:
• Pectoral, shoulder, and scapular regions

Course:
• Passes through axilla with axillary artery surrounded by cords and branches of brachial plexus

Termination:
• Continues as subclavian vein at lateral border of rib 1

Comment:
• Single, large, deep vein that accompanies axillary artery
• Axillary vein formed by continuation of basilic vein, with contribution of paired brachial veins

18
Q

Right brachiocephalic v.

A

Drainage:
• Head and neck (right side)
• Upper limb (right)

Tributaries:
• Internal jugular
• Subclavian

Course:
• Descends vertically from junction of internal jugular and subclavian veins
• Posterior to right sternoclavicular junction
• Does not cross midline

Also known as:
• Right innominate vein (Latin: innominatus = nameless)

Comment:
• Lacks valves

19
Q

Superior vena cava

A
Drainage:
• Head
• Upper limbs
• Posterior thoracic walls
• Mediastinal structures

Tributaries:
• Formed by union of right and left brachiocephalic veins
• Arch of azygos vein

Course:
• Descends in mediastinum from level of right 1st costal cartilage

Termination:
• Right atrium

20
Q

Pulmonary a.

A

Course:
• Left: laterally, inferior to arch of aorta and anterior to left main bronchus
• Right: laterally, posterior to ascending aorta and superior vena cava
• Through root and hilum of respective lungs

Distribution:
• Lung

Branches:
• Lobar arteries to lung lobes

Comment:
• Conveys oxygen-poor blood to lung

21
Q

Right auricle

A

Description:
• Small, conical, pouch-like extension of right atrium
• Thin, rough wall (pectinate muscles)

22
Q

Right atrium

A

Description:
• One of four heart chambers
• Thin, smooth, posterior wall
• Thin, rough anterior wall (pectinate muscles)
• Receives superior and inferior venae cavae and coronary sinus
• Internal features include interatrial septum, fossa ovalis, and crista terminalis

Comment:
• Forms right surface of heart
• Separated from right ventricle by atrioventricular (tricuspid) valve

23
Q

Ascending aorta

A

Origin:
• Left ventricle (aortic vestibule)

Distribution:
• Heart (via coronary arteries)

Branches:
• Right and left coronary arteries
• Continues as arch of aorta

Comment:
• Has aortic valve at origin
• Large arteries do not by themselves supply structures, but do so through their branches

24
Q

Arch of aorta

A

Course:
• Arches diagonally and posteriorly to the left

Distribution:
• Head, including brain
• Neck
• Upper extremities

Branches:
• Brachiocephalic trunk 
• Left common carotid 
• Left subclavian 
• Continues as descending (thoracic) aorta 

Comment:
• Ligamentum arteriosum attached to concave surface of arch
• Large arteries do not by themselves supply structures, but do so through their branches

25
Left brachiocephalic v.
Drainage: • Head and neck (left side) • Upper limb (left) Course: • Descends obliquely to the right from junction of internal jugular and subclavian veins • Posterior to manubrium • Crosses midline Termination: • Superior vena cava Also known as: • Left innominate vein (Latin: innominatus = nameless) Comment: • Lacks valves
26
Subclavian v.
Drainage: • Upper limb • Superficial back and neck Course: • Begins at lateral border of rib 1 • Arches over rib 1 to enter thoracic cavity Termination: • Joins internal jugular vein posterior to sternum to form brachiocephalic vein Comment: • Lies anterior to anterior scalene muscle • Access point to large veins for insertion of electrical leads for heart pacemaker or tubes to administer chemotherapeutic agents to cancer patients
27
Pulmonary trunk
Origin: • Right ventricle Course: • Ascends within pericardium • Initially anterior to ascending aorta and then to its left and slightly posterior Distribution: • Lungs Branches: • Right pulmonary artery • Left pulmonary artery Comment: • Conveys oxygen-poor blood from right ventricle of heart • Has pulmonary (semilunar) valve at its origin • Large arteries do not by themselves supply structures, but do so through their branches
28
Internal jugular v.
Drainage: • Cranial cavity, including brain • Face • Neck Course: • Formed in jugular foramen of skull • Descends through neck in carotid sheath • Enters thorax Termination: • Posterior to sternum unites with subclavian vein to form brachiocephalic vein Comment: • Enclosed in carotid sheath
29
Left recurrent laryngeal n.
Contributions: • Branch of vagus nerve (CN X) in thorax Motor: • Intrinsic laryngeal muscles, except cricothyroid Sensory: • Mucous membranes of trachea and larynx (inferior to vocal fold) Comment: • In thorax, left recurrent laryngeal nerve loops inferior to arch of aorta • In thorax, right recurrent laryngeal nerve loops inferior to right subclavian artery • Recurrent laryngeal nerves ascend in neck to larynx • Terminal part (within larynx) is termed inferior laryngeal nerve
30
Ligamentum arteriosum
Ligamentum arteriosum Origin: • Left pulmonary artery Course: • Ascends to attach to arch of aorta on its concave surface Comment: • A fibrous cord • Remnant of ductus arteriosus in fetus • Ductus arteriosus shunts blood in fetus from pulmonary artery to aorta, thereby bypassing lungs
31
Right ventricle
Location: • Heart Description: • One of four heart chambers • Rough, muscular walls (trabeculae carneae) • Muscle wall thicker than either atrium, and thinner than left ventricle • Internal features include papillary muscles, chordae tendineae, interventricular septum, and conus arteriosus Comment: • Separated from right atrium by atrioventricular (tricuspid) valve • Separated from pulmonary trunk by pulmonary valve • Responsible for pumping oxygen-poor blood to lungs
32
Heart
Description: • Conical, muscular organ with four chambers: two atria and two ventricles Function: • Pumps blood to body • Modified cardiac muscle cells in right atrium secrete the hormone atriopeptin (atrial natriuretic peptide) in response to distension (stretching) of the atrial wall • Atriopeptin reduces blood volume by causing water loss and sodium excretion into urine (with less blood volume, blood pressure is reduced)
33
Left Ventricle
Description: • One of four heart chambers • Thick, muscular walls • Internal features include papillary muscles, chordae tendineae, trabeculae carneae, interventricular septum, and aortic vestibule Comment: • Separated from left atrium by left atrioventricular (bicuspid or mitral) valve • Separated from aorta by aortic valve • Walls twice as thick as right ventricle • Forms apex of heart • Responsible for pumping oxygen-rich blood to body (except lungs)
34
Apex of Heart
Location: • Heart (inferolateral point) Description: • Blunt tip of left ventricle Comment: • Surface projection at left 5th intercostal space in mid-clavicular line
35
Left common carotid a.
Course: • Exits thorax and ascends in neck Branches: • Internal and external carotid arteries (at level of C4 vertebra) Comment: • Has no branches before terminal branches • Enclosed in carotid sheath • Carotid sheath is a fascial sleeve which contains common and internal carotid arteries, internal jugular vein, vagus nerve (CN X), and lymphatic channels • Large arteries do not by themselves supply structures, but do so through their branches
36
Left main bronchus
Description: • Formed at bifurcation of trachea • Longer, more narrow, and less vertical than right main bronchus • Component of root and hilum of left lung Comment: • Foreign bodies that enter trachea tend to pass to right main bronchus
37
Right main bronchus
Description: • Formed at bifurcation of trachea • Shorter, wider, and more vertical than left main bronchus • Component of root and hilum of right lung Also known as: • Right primary bronchus Comment: • Foreign bodies that enter trachea tend to pass to right main bronchus
38
Pulmonary vv.
Drainage: • Lungs Course: • Two veins pass through root of each lung (i.e., four pulmonary veins in total) and directly into left atrium Comment: • Pulmonary veins carry oxygen-rich blood
39
Parietal layer of serous pericardium
Description: • Thin, serous membrane fused to inner surface of fibrous pericardium • Outer limit of pericardial cavity • Continuous with visceral layer of serous pericardium Comment: • Pericardial cavity created by narrow space between parietal and visceral layers of serous pericardium
40
Inferior vena cava
Drainage: • Everything inferior to diaphragm, except posterior abdominal wall, which drains into azygos system Course: • Ascends from level of L4 vertebral body, through diaphragm, to heart Termination: • Right atrium of heart Comment: • Largest vein of body