Thorax Cont Flashcards
1
Q
What are the primary muscles of inspiration?
A
- Diaphragm
- External intercostals
2
Q
What are the accessory muscles of inspiration?
A
- SCM
- Scalenes
- Pect major and minor
- Serratus anterior
- Serratus posterior superior and inferior
3
Q
What is the primary expirator of the lungs?
A
Elastic recoil of the lungs
wall has tension and wants to expel the air
4
Q
What are the accessory expiration muscles?
A
- Internal intercostals
- Abdominal muscles
5
Q
What is the blood source of the intercostal muscles?
A
-Thoracic Aorta
6
Q
This artery serves the body wall
A
-Lumbar artery
7
Q
This artery branches off of the subclavian and runs along the sternum and supplies blood to the anterior thorax
A
-Internal thoracic artery
8
Q
These are 2 terminal branches off of the internal thoracic
A
- Musculophrenic a
- Superior epigastric a
9
Q
What does the musculophrenic supply?
A
- Lower intercostal spaces and the diaphragm
- On the deep surface of the costal margin
10
Q
What does the superior epigastric a supply?
A
Supplies anterior abdominal wall and musculature
11
Q
Where does all venous blood drain in the thorax?
A
-The azygos vein
12
Q
Describe the Azygos vein
A
- lies along the right side of the posterior thoracic wall
- unpaired
- crosses around T8
- Connects and goes into the superior and inferior vena cava
13
Q
Describe the posterior intercostal veins
A
-Dump into the azygos vein
14
Q
This vein serves the lower left of the thorax
A
Hemiazygos vein
15
Q
This vein serves the upper left and collects blood from the upper intercostal spaces
A
Accessory hemiazygos vein
16
Q
Where does the internal thoracic vein lie?
A
On the left side- opposite of the azygos vein
17
Q
What dumps into the internal thoracic vein
A
The anterior intercostal vein
18
Q
Are there any venous valves in the thorax?
A
NOPERS
19
Q
This is a modified sweat gland and it is more deep and central (of the breast)
A
Glandular tissue
20
Q
What does the glandular tissue secrete?
A
Colostrum
21
Q
What is contained in the connective tissue of the breast?
A
Suspensory ligaments
-fibrous supportive structures
22
Q
What does the breast contain a lot of?
A
Fat
23
Q
These are dilated openings of the ducts in the nipple
A
Lactiferous sinuses
24
Q
What are the layers and components of the breast from outside (nipple) to inside?
A
- Nipple with lactiferous sinuses
- Lactiferous ducts and fat
- Pectoral fascia
- Pectoralis major
- Superficial abdominal fascia
- Ribs/intercostals
25
The breasts typically stretch from ribs ___ to ___
ribs 2-6
26
Describe the axillary tail (of spence)
- Extension of outer upper quadrant
| - Area where the majority of breast cancer occurs
27
There are ___ to ____ lobules
20-25
28
_______ give rise to buds that develop into 20-25 lobules of the mammary gland
Lactiferous ducts
29
What is the functional substance of the mammary gland?
Parenchyma
30
How many quadrants does the breast have?
4
31
What are the 2 main arteries that supply the breast?
- Internal thoracic a
| - Lateral thoracic a
32
What are the 2 branches of the internal thoracic a that supply the breast?
- Perforating branches
| - Medial mammillary branches
33
What are the branches off the lateral thoracic artery that supply the breast?
-Lateral mammary branches
34
What are 3 other arteries that supply the breast? (minorly)
- Anterior intercostal a
- Posterior intercostal a
- Thoracoacromial a- pectoral branch
35
How does breast cancer typically spread?
-Through the lymph nodes and via blood because the breast have many different arterial supplies
36
What are the 2 plexuses of the breast lympatics?
- Superficial plexus
| - Deep plexus
37
Do most nodes drain ispilaterally/contralaterally?
Ipsilaterally
38
What do most fluid drain into?
Axillary Node (75%)
39
What lines the 2 pulmonary cavities
Endothoracic fascia
40
What is continuous with endothoracic fascia
Prevertebral fascia
41
What fascia blends into the pericardial fascia?
Pretrachial
42
T/F- there is a fascial connection between the endothoracic pleural and the diaphragm
True
43
What is the most superficial fascia of the pulmonary cavity?
Endothoracic fascia
44
What are the 2 layers of pleura in the pulmonary cavity?
- Parietal pleura
| - Visceral pleura
45
What part of the lung is not covered by pleura
The root structures
46
This is the space between the ribs and the diaphragm that is not completely filled with the lungs but it has potential to be if the lungs expand
The costodiaphragmatic recess
47
What are the 3 surfaces that are in contact with the lungs
- Costal
- Diaphragmatic
- Mediastinal
48
What is the significance of cervical pleura
- It exists
| - The apexes of the lungs go up and behind the clavicle so there needs to be pleural there as well
49
What rib is the horizontal fissure of the right lung at, and what 2 lobes does that divide?
- 4th rib
| - Separates the superior and the middle lobe
50
If there was fluid in the pericardial space, where would you insert the needle to remove it?
Left side in the intercostal space of the 5th rib
51
If you are on the posterior side, what lobes of the lungs are you really percussing/analyzing?
Inferior lobes
52
How many lobes does the right lung have
3
53
What are the 4 impressions in the right lung?
- Azygos
- Esophageal
- Cardiac
- SVC
54
How many lobes are in the left lung?
2
55
What impressions are in the left lung?
- Cardiac notch
- Cardiac impression
- Groove for arch and thoracic aorta
56
What define a bronchopulmonary segment?
Tertiary bronchus
57
Are the tracheal rings complete rings?
No
58
What airway is larger and more verticle?
The right bronchus
59
Each lobar serves ___ lobe
1
60
Describe the arteries and veins in the lung
- 1 pulmonary artery
- 3 bronchial arteries (1 right and 2 left)
- 2 pulmonary veins
61
What do the pulmonary veins do?
Collect O2 rich blood and deliver it to left atrium
62
Where are the bronchial arteries located?
- On the surface of the airway
| - Very small branches that supply the airway
63
What is another name for bronchopulmonary nodes?
- Hilar nodes
| - Occur where bronchi go into lungs
64
Where does right lymphatics drain
Right lymphatic duct
65
Where does the left lymphatics drain
Thoracic duct
66
What innervates the lungs?
The vagus (parasympathetic) and splentic (sympathetic) nerve
67
What 2 nerves are responsible for providing somatosensory (localized pain) to the costal pleura?
- Intercostal n
| - Phrenic nerve
68
What are the targets for the vagus and splentic nerve
SM, vessels, and mucus glands
69
Sympathetic stimulation causes....
- Bronchodilation
| - vessel vasoconstriction
70
When dividing the mediastinum into superior and inferior, what is the divider and where does it occur
- Transverse thoracic plane
| - Occurs at T4 and 5 (trachea also ends here)
71
What are the 3 divisions of the inferior mediastinum
- Anterior
- Middle
- Posterior
72
What are the contents of the superior mediastinum?
- Thymus
- Great vessels (brachiocephalic veins, SVC, aortic arch and branches)
- Phrenic nerve
- Pericardiophrenic artery
- Vagus nerve
- L. recurrent laryngeal nerve
- Trachea
- Esophagus
- Thoracic duct
73
Where does the thoracic duct sit?
Between the esophagus and the thoracic aorta
| -from the abdomen crosses and goes through the superior mediastinum to left venous angle
74
Where does the vagus nerve sit in relation to the root structures?
Posterior
75
Where does the phrenic nerve sit compared to the root structures?
Anterior
76
What nerve sits between the arch of the aorta and the SVC?
Phrenic nerve
77
What direction does the outflow of the aorta go?
Right
78
What part of the heart sits on either side of the transverse thoracic plane?
Ascending aorta (below plane) and aortic arch (above plane)
79
What is contained in the anterior mediastium
- Thymus
- Lymph nodes
- Fat
- Connective tissue (sternopericardium ligaments)
80
What are the contents of the posterior mediastinum
- Thoracic aorta
- Tracheobronchal lymphnodes
- Azygos vein
- Hemiazygos vein
- Thoracic Splanchnic nerves (greater, lesser, least)
- Vagus nerve
- Esophageal plexus
81
What are the contents of the middle mediastinum?
- Pericardial sac
- Heart
- Cardiac nerve plexus
- Roots of great vessels
- Phrenic nerve
- Pericardiacophrenic artery
82
Describe the cardiac nerve plexus
- Vagal stimulation of the heart
| - On the surface of ascending aorta
83
What are the 2 components of the fibrous pericardium?
- Sternopericardial ligaments
| - Pericardiacophrenic ligaments
84
What are the 2 layers of serous pericardium
Parietal and visceral
85
What is the pericardial space
The potential space between the parietal and visceral pericardium
86
What are the 2 sinuses of the heart?
- Transverse pericardial sinus
| - Oblique pericardial sinus
87
This sinus is between the arteries and the veins
Transverse pericardial sinus
88
This sinus is between the pulmonary veins and the inferior vena cava
Oblique pericardial sinus
89
What is cardiac tamponade?
-Too much pressure on the heart do to too much fast fluid accumulation
90
What are the 3 layers of the blood vessel
- Tunica intima
- Tunica media
- Tunica adventitia
91
What are the 3 layers of the heart
- Endocardium
- Myocardium
- Epicardium
92
This covers the valves and continues with the endothelium of vessels
Endocardium
93
This attaches to great vessels and it is what muscles are attached to
Fibrous pericardium
94
Look over coronary vasculature
GO-NOW!!
