12 - Thoracic Walls, Lungs, Middle Mediastinum Flashcards

1
Q

Manubrium – has

A

clavicular notch for sternoclavicular joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Body – joins manubrium at

A

sternal angle (of Louis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Head – articulates with

A

2 vertebral bodies & 1 disc

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Tubercle – articulates with

A

1 transverse process

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Body – region of greatest curve =

A

= angle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Costal groove – formed by

A

intercostal v., a. & n.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Thoracic Wall: Pectoral Region: Breasts are

A

superficial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Thoracic Wall: Pectoral Region: Composed of

A

secretory glands & superficial fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Thoracic Wall: Pectoral Region: Internal thoracic a. & v.

A

– 2nd to 4th intercostal space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Thoracic Wall: Pectoral Region: Lymphatics – drain to

A

parasternal nodes & axillary nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Thoracic Wall: Pectoral Region: Lat. & ant. nn. of 4th to

A

6th intercostal nn. carry cutaneous (GS) innervation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Thoracic Wall: Pectoral Region: Region of

A

m. attachment between UL & anterior chest

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Thoracic Wall: Pectoral Region: Composed of

A

Pectoralis major & minor muscles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Thoracic Wall: Pectoral Region: Pectoralis major

A

–divided into clavicular & sternocostal heads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Thoracic Wall: Pectoral Region: Pectoralis minor –

A

enveloped in clavipectoral fascia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Intercostal Muscles

A

external
internal
innermost

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Intercostal Vein, Artery, & Nerve

in

A

costal groove along inferior border of rib (ICS superiorly)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Collateral nerve, artery & vein

A

another intercostal structure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Pleura

A

Serous secreting membranes that reduce friction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Parietal pleura

A

covers thoracic walls
very sensitive to pain
-intercostal and phrenic nerves

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Visceral pleura

A

covers lungs
NOT sensitive
no sensory n. supply

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Note: both pleural layers are continuous at the

A

root of the lung

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Clinical Notes: Pleural cavities: potential cavities can

A

can become actual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Clinical Notes: Pleural cavities: potential cavities can

pathological fluid =

A

effusion; may fill space

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Clinical Notes: Pleural cavities: potential cavities can | may compress
lungs difficulty breathing
26
Clinical Notes: Pleural cavities: potential cavities: pleural effusions visible on
chest films
27
Clinical Notes: Pleural cavities: potential cavities can
can obsure lung in film
28
Pneumothorax
accumulation of air in pleural cavity | collapse of lung due to its own elasticity
29
Hemothorax
accumulation of blood in pleural cavity | may cause adhesions & infection if not removed
30
Pleurisy
Inflammation of pleura
31
Pleurisy usually leads to formation of
pleural adhesions
32
Pleurisy between
between parietal and visceral pleura
33
Pleurisy can produce
exquisite pain relative to parietal pleura
34
Pleurisy can be caused by:
Infections (viral or bacterial or fungal), autoimmune disorder (rheumatoid arthritis), certain medications, rib fracture, tuberculosis (TB), congestive heart failure, cancer (pulmonary – adjacent to pleura), pulmonary embolism, collagen vascular disease, or certain inherited diseases (such as sickle cell disease).
35
Pleurisy symptoms:
Symptoms include: pain in the chest – aggravated by breathing in (pain may be in the back or shoulder regions as well), shortness of breath, local tenderness, in some cases also a cough and fever.
36
Clinical Notes: Pleural tap(Thoracentesis)
Aspiration of fluids | \Midaxillary line or slightly posterior
37
Clinical Notes: Pleural tap(Thoracentesis): ICS 6 or 7
if needle inserted in ICS 8 or 9, may pierce diaphragm, liver or spleen needle position to avoid intercostal n. & vessels
38
L Lung
: 2 lobes | upper & lower
39
Oblique (major) fissure
both lungs
40
R Lung :
3 lobes | upper, middle, lower
41
Horizontal (minor) fissure
R lung only
42
Occasionally one can find an extra or an absent
fissure
43
Root of the Lungs: Connects lung to
mediastinum
44
Root of the Lungs: covered in
sleeve of pleura
45
Root of the Lungs: consists of
bronchi & pulmonary vessels
46
Root of the Lungs: Inferiorly sleeve mostly
empty & collapsed, contains only a few lymph vessels = pulmonary ligament
47
Middle Mediastinum
Pericardium & heart Phrenic nn. applied to pericardium Pericardiacophrenic vessels Roots of great vessels to & from heart
48
The pericardium, a double fibroserous membrane, forms the
pericardial sac that surrounds the heart and the origins of the great vessels
49
The pericardium is composed of two layers:
an outer fibrous layer and an inner serous layer.
50
1. The outer fibrous pericardium is composed of
tough in-elastic connective tissue. It is attached inferiorly to the diaphragm and is continuous superiorly with the tunica adventitia (outer layer) of the great vessels.
51
2. The thin serous pericardium consists of a
parietal part and a visceral part.
52
The parietal layer (part) of serous pericardium lines the
inner surface of the fibrous pericardium.
53
The visceral layer (part) of serous pericardium firmly adheres to the
outer surface of the heart as the epicardium.
54
Trachea
splits into 2 primary (main) bronchi
55
Primary bronchi
split into 2 or 3 secondary (lobar) bronchi
56
Secondary bronchi
split into 8 or 10 tertiary (segmental) bronchi
57
Secondary bronchi: Supplied by
single branch of pulmonary a.
58
Secondary Bronchi; Smallest
functionally independent region
59
Sympathetic trunks | lungs
Paravertebral contribute to anterior & posterior pulmonary plexuses dilates bronchioles
60
Vagus nn. : pass posteriorly to
roots of lungs
61
vagus nn: closely applied to
trachea, esophagus & aorta
62
Vagus nn: contribute to
anterior & posterior pulmonary plexuses
63
Vagus n: constrict the
bronchioles
64
Phrenic nn. | pass anteriorly to
roots of lungs
65
Phrenic nn. | closely applied to
pericardial sac
66
Pericardiacophrenic vessels | run with the
phrenic nn.
67
Pericardiacophrenic vessels : branches of
internal thoracic aa. & brachiocephalic vv.
68
Bronchial aa.
supplies nutrients to bronchi & lungs
69
Lymph vessels & nodes | drain lymph from
lungs via tracheobronchial nodes & R/L bronchomediastinal trunks
70
Mediastinum – broad central partition separating
2 pleural cavities
71
The mediastinum is subdivided into 4 smaller regions:
``` Superior Inferior -Anterior -Middle -Posterior ```
72
Mediastinum: Extends from the
thoracic inlet to diaphragm & from sternum to 12th thoracic vertebra
73
Pericardium: Fibrous portion –
attached to diaphragm inferiorly
74
Pericardium: Serous portion –
divided into parietal and visceral layers
75
Pericardium: Encloses
heart & pierced by roots of 8 vessels | SVC, IVC, aorta, Pulm. trunk & 4 pulm. vv.
76
Pericardial Sac
complete inner pericardial membrane (parietal & visceral layers)
77
Pericardial Cavity
inside pericardial sac potential space between serous & parietal layers contains only a small amount of serous fluid
78
Pericardial Effusion: accumulation of
excess fluid in pericardial cavity compresses heart
79
Pericardial Effusion: common in conjunction with
congestive heart failure
80
Pericardial Effusion: Hemopericardium: accumulation of blood in
pericardial cavity
81
Pericardial Effusion: Hemopericardium: associated with
penetrating heart wounds or perforated heart m. following MI
82
Pericardial Effusion: Hemopericardium: Arterial bleeding into cavity leads to
cardiac tamponade = compression of the heart and roots of great vessels
83
Rest and digest =
vagus n
84
Fascia layer between pec minor and major
reduces friction
85
Subcostals cover
2 intercostal spaces rather than 1
86
Rib neurovasculature runs between
internal and innnermost intercostals
87
Intercostal
vein, artery, nerve
88
Collateral
nerve, artery, vein (bottom of intercostal space)
89
Posterior intercostals directly from
aorta
90
Collaterals are
branches off posterior intercostal
91
Pleurisy
adherence of parietal and visceral pleura from inflammation
92
Pulmonary ligament
lymphatics reside here - also provides for room for movement (redundancy in case of failure as well)