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Flashcards in Thorax, Snell Deck (144):
1

3 parts of sternum

1) Manubrium
2) Body
3) Xiphoid process

2

Manubrium articulates with

1) Body of sternum
2) Clavicles
3) First costal cartilage
4) Upper part of 2nd costal cartilage

3

Landmark formed by articulation of manubrium with body of sternum

Sternal angle of Louis

4

5 structures at the level of sternal angle of Louis

1) 2nd costal cartilage
2) Junction of superior and inferior mediastinum
3) Bifurcation of trachea
4) Junction of ascending aorta and aortic arch and aortic arch and descending aorta
5) IV disc between T4 and T5

5

Body of sternum articulates with on each side with

2nd to 7th costal cartilages

6

T/F Xiphoid process is ossified at birth

No, plate of cartilage that becomes ossified at proximal end during adult life

7

T/F No ribs or costal cartilages are attached to the xiphoid process

T

8

T/F Sternum possesses red hemopoietic marrow throughout life

T

9

Ribs, #

12

10

Categories of ribs

1) True
2) False
3) Floating

11

True ribs

Attached to the sternum by their costal cartilages (1st-7th)

12

False ribs

Attached anteriorly to each other and to the 7th rib by their costal cartilages and small synovial joints (8th-10th)

13

Floating ribs

No anterior attachment (11th-12th)

14

Atypical rib

1st rib

15

Superior vs inferior: Costal groove

Inferior

16

Costal groove accomodates

Intercostal vessels and nerves

17

Typical rib: Parts

1) Head
2) Neck
3) Tubercle
4) Shaft
5) Angle

18

Head of rib: How many facets

2

19

Head of rib: Superior facet articulates with

Vertebra immediately above it

20

Head of rib: Inferior facet articulates with

Numerically corresponding vertebral body

21

Tubercle of rib: How many facets

1

22

Tubercle of rib: Facet articulates with

Transverse process of the numerically corresponding vertebra

23

Part of rib where the shaft bends forward sharply

Angle

24

Important structures related to the first rib (2)

1) Brachial plexus
2) Subclavian artery and vein

25

T/F The first rib is flattened anteroposteriorly

F, superoinferiorly

26

First rib: Muscle attached to its upper surface and inner border

Scalenus anterior

27

Crosses first rib anterior to the scalenus anterior

Subclavian vein

28

Lie in contact with 1st rib posterior to the scalenus anterior attachment

1) Subclavian artery
2) Brachial plexus

29

A cervical rib occurs in ~ ___% of persons

0.5

30

Cervical rib: Arises from

Transverse process of C7

31

Cervical rib: Possible anterior attachments

1) Free
2) Connected to first rib by fibrous band
3) Articulate with 1st rib

32

Thoracic outlet syndrome is brought about by compression of what structures by the cervical rib

1) Brachial plexus
2) Subclavian artery

33

T/F Costal cartilages of eighth, ninth, and tenth ribs connect to the cartilage immediately above them

T

34

T/F 11th and 12th ribs do not have costal cartilages

F, cartilages of the eleventh and twelfth ribs end in the abdominal musculature

35

Rib #s: Head articulates by a synovial joint with the corresponding vertebral body and that of the vertebra above it

2nd-9th

36

Rib #s: Heads have a simple synovial joint with the corresponding vertebral body

1st, 10th-12th

37

Type of joint: Manubriosternal joint

Cartilaginous

38

Type of joint: Xiphisternal joint

Cartilaginous

39

Type of joint: Costovertebral joint

Synovial

40

Articulation of rib tubercle with transverse process of corresponding vertebra is absent in which ribs

11th-12th

41

Type of joint: Costochondral

Cartilaginous

42

Movement in the costochondral joint

NONE

43

Type of joint: Articulation of first costal cartilage with manubrium

Cartilaginous

44

Articulation of first costal cartilage with manubrium: Movement

NONE

45

Type of joint: Articulation of second to the seventh costal cartilages articulate with the lateral border of the sternum

Synovial joints

46

Type of joint: Articulation of sixth, seventh, eighth, ninth, and tenth costal cartilages with one another

Small synovial joints

47

Movement that rotates the neck of rib around its own axis

Respiration

48

Brachial plexus, subclavian artery, and subclavian vein can be compressed between which bones

1) First rib
2) Clavicle

49

Muscles of respiration within intercostal spaces

1) External intercostal
2) Internal intercostal
3) Innermost intercostal

50

Thoracic muscles are lined internally by

Endothoracic fascia and parietal pleura

51

Intercostal nerves and blood vessels run between what muscles

1) Internal intercostal muscles
2) Innermost intercostal muscles

52

Intercostal nerves and blood vessels: Arrangement from superior to inferior

VAN
Intercostal vein
Intercostal artery
Intercostal nerve

53

Needle thoracostomy: Indications

1) Tension pneumothorax
2) Large hemothorax

54

Most important muscle of respiration

Diaphragm

55

Diaphragm: Insertion

Central tendon

56

Diaphragm: Nerve supply

Phrenic

57

Raise ribs during inspiration and lower ribs during expiration

External intercostals

58

Thoracic muscle: Elevate ribs

1) Levatores costarum
2) Serratus posterior superior

59

Thoracic muscle: Lowers ribs

Serratus posterior inferior

60

Diaphragm: Origins

1) Sternal
2) Costal
3) Vertebral

61

Diaphragm: Sternal part arises from

Posterior surface of xiphoid

62

Diaphragm: Costal part arises from

Deep surfaces of lower 6 ribs and their costal cartilages

63

Diaphragm: Vertebral part arises from

Crura and arcuate ligaments

64

Diaphragm: Encloses the esophagus

Right crus

65

Diaphragm: Right crus arises from

Bodies and IV discs of L1-3

66

Diaphragm: Left crus arises from

Sides and IV discs of L1-2

67

Diaphragm: Supports the heart

Central tendon

68

Weight-lifting muscle

Diaphragm

69

Thoracoabdominal pump

Diaphragm

70

As the thoracoabdominal pump, the diaphragm helps in

1) Return of blood to right atrium
2) Passage of lymph through thoracic duct

71

Diaphragm: Aortic opening, level

T12

72

Diaphragm: Aortic opening, transmits

1) Aorta
2) Azygos vein
3) Thoracic duct

73

Diaphragm: Esophageal opening, level

T10

74

Diaphragm: Esophageal opening, transmits

1) Esophagus
2) Right and left vagus
3) Esophageal branches of left gastric vessels
4) Lymphatic vessels from lower 3rd of esophagus

75

Diaphragm: Caval opening, level

T8

76

Diaphragm: Caval opening, through what part of diaphragm

Central tendon

77

Diaphragm: Caval opening, transmits

1) IVC
2) Terminal branches of right phrenic

78

Diaphragm: Sympathetic trunk passes posterior to

Medial arcuate ligament on each side

79

T/F Any penetrating wound to the chest below the level of the nipples should be suspected of causing damage to the diaphragm until proved otherwise

T

80

Diaphragm: Arching domes of diaphragm can reach level of ___ rib

5th, right dome can reach a higher level

81

Intercostal arteries per intercostal space, #: Posterior intercostal

1 large

82

Intercostal arteries per intercostal space, #: Anterior intercostal

2 small

83

Intercostal veins: Posterior drain into

Azygos or hemiazygos

84

Intercostal veins: Anterior drain into

Internal thoracic and musculophrenic veins

85

Posterior intercostal arteries: First 2 are branches of

Superior intercostal artery from costocervical trunk of subclavian artery

86

Posterior intercostal arteries: Lower 9 are branches of

Thoracic aorta

87

Anterior intercostal arteries: First 6 are branches of

Internal thoracic

88

Anterior intercostal arteries: Lower 3 are branches of

Musculophrenic from internal thoracic

89

Internal thoracic artery arises from

1st part of subclavian

90

Internal thoracic artery: Descends directly behind

1st 6 costal cartilages

91

Internal thoracic artery: ___ cm lateral to sternum

About a fingerbreadth

92

Internal thoracic artery: Terminates in the

6th ICS

93

Internal thoracic artery: Divides into

1) Superior epigastric
2) Musculophrenic

94

Trachea: Continuation of

Larynx

95

Trachea: Begins at

Lower border of cricoid, C6

96

Trachea: Divides into right and left main bronchi at level of

Sternal angle of Louis

97

Trachea: Length

~ 13cm

98

Trachea: Diameter in adults

2.5 cm

99

Trachea: Shape of supporting cartilage

U

100

Trachea: Posterior relations

1) Esophagus
2) Left recurrent laryngeal nerve

101

Levels of the airway

1) Trachea
2) Main bronchi
3) Lobar bronchi
4) Segmental bronchi
5) Terminal bronchiole
6) Respiratory bronchiole
7) Alveolar duct
8) Alveolar sac
9) Alveolus

102

Trachea, relations: Right

1) Azygos
2) Right vagus
3) Pleura

103

Trachea, relations: Left

1) Left vagus
2) Left phrenic
3) Pleura
4) Arch of aorta
5) Left common carotid
6) Left subclavian

104

Right vs left main bronchus: Wider, shorter, more vertical

Right

105

Right main bronchus: Branch given off before entering the hilum of right lung

Superior lobar bronchus

106

Right main bronchus: Branches given off upon entering the hilum of right lung

Middle and inferior lobar bronchi

107

Left main bronchus: Related structures

1) Aortic arch above
2) Esophagus behind

108

Left main bronchus: Branches given off on entering the hilum of left lung

Superior and inferior lobar bronchi

109

Foreign bodies that lodge into the right main bronchus usually pass into

Middle or lower lobar bronchus

110

2 parts of the pleura

1) Parietal
2) Visceral

111

Lowest area of the pleural cavity

Costodiaphragmatic recess

112

Parietal vs visceral pleura: Sensitive to pain, temperature, touch and pressure

Parietal pleura

113

Parietal pleura: Costal parietal pleura is supplied y

Intercostal nerves

114

Parietal pleura: Mediastinal parietal pleura is supplied by

Phrenic nerve

115

Parietal pleura: Diaphragmatic parietal pleura is supplied by

Phrenic nerve

116

Visceral pleura: Nerve supply

Autonomic from pulmonary plexus

117

Visceral pleura: Sensitive only to

Stretch

118

Thin layer of loose connective tissue that separates the parietal pleura from thoracic wall

Endothoracic fascia

119

Lower margins of pleural reflections

1) 8th rib MCL
2) 10th rib MAL
3) 12th rib paravertebral

120

Lower margins of lungs

1) 6th rib MCL
2) 8th rib MAL
3) 10th rib paravertebral

121

Intrapleural pressure

-4 mmHg

122

Visceral pleura is derived from

Visceral mesoderm

123

Parietal pleura is derived from

Somatic mesoderm

124

Lungs: Main function

Oxygenation of blood

125

# of lobes: Right lung

3

126

# of lobes: Left lung

2

127

Fissure/s: Right lung

Horizontal and oblique

128

Fissure/s: Left lung

Oblique

129

Right vs left lung: Larger and heavier

Right

130

Right vs left lung: Shorter and wider

Right

131

Lung: Apex extends ___ cm above ___

2.5 cm, clavicle

132

Where parietal and visceral pleura meet

Root of lung

133

Root of lung: Contents

1) Bronchi
2) Pulmonary artery and vein
3) Bronchial vessels
4) Lymph vessels

134

Right vs left lung: Hyparterial and eparterial bronchi

Right

135

Left lung: Hyparterial vs eparterial

Hyparterial

136

Largest subdivision of a lung lobe

Bronchopulmonary segment

137

Bronchopulmonary segment: Shape

Pyramidal

138

Bronchopulmonary segment: Apex directed towards

Lung root

139

Bronchopulmonary segment: Named according to

Segmental bronchus supplying it

140

Bronchopulmonary segment: Separated from adjacent segments by

Connective tissue

141

Bronchopulmonary segment: Has its own

1) Bronchus
2) Arterial supply
3) Venous drainage
4) Lymphatic drainage

142

Anatomic and surgical unit of the lung

Bronchopulmonary segment

143

Bronchopulmonary segment: Right lung

10
1) Superior lobe: Apical, anterior, posterior
2) Middle lobe: Lateral, medial
3) Inferior lobe: Superior, anterior basal, lateral basal, medial basal, posterior basal
IMAGE at DOWNLOADS

144

Bronchopulmonary segment: Left lung

10
1) Superior lobe: Apico-posterior, anterior, superior lingular, inferior lingular
2) Inferior lobe: Superior, anterior basal, lateral basal, medial basal, posterior basal