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302 MEDIMAGE > 3b. Thorax HAL - Worksheet > Flashcards

3b. Thorax HAL - Worksheet Flashcards

1
Q

what is the first chamber you will see passing left to right in sagittal

A

left ventricle

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2
Q

what is the first chamber you will see passing right to left in sagittal

A

right atrium

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3
Q

what is the last chamber you will see passing front to back in coronal

A

left atrium

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4
Q

what is the first chamber you will see passing front to back in coronal

A

right ventricle

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5
Q

do you encounter the atria or the ventricles first when scrolling top to bottom in axial

A

atria more so than ventricle

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6
Q

what basic architectural feature helps to determine if you are looking at a ventricle or an atrium in an otherwise normal heart

A

thick muscular wall of the left ventricle

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7
Q

how does the right ventricle compare to the left ventricle morphologically? How is this related to their function

A

left ventricle has more muscular walls than the right

left ventricle pumps to the rest of the body which is a higher pressure circuit so needs more muscle to pump

Right ventricle only pumps to the lungs which is lower pressure circuit and requires less power

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8
Q

what important internal structures divides the atria from the ventricle

A

atria-ventricular valves (tricuspid and mitral valves)

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9
Q

what is the key feature that distinguishes the thoracic vertebrae from the cervical and lumbar

A

they have ribs attached to them

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10
Q

on an axial CT how can you tell if you are looking at the disks or the vertebral body

A

IV discs are less dense than bone so an compare to other bony structure to check - will appear darker than bone

bone is denser than cartilage so will be brighter white

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11
Q

how many pairs of ribs are there

A

12

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12
Q

why do we only see partial slices of the ribs when taken in axial cross section

A

ribs descend and then ascend again slightly and this makes it difficult to tell from a single slice

ribs are on different levels in body and don’t travel in one level, they slope down obliquely between different levels

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13
Q

what 3 elements of the vertebral column do typical ribs (2-9) articulate with posteriorly to form the costovertebral joints

A

vertebral body

transverse process of own level and vertebral body of level above

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14
Q

what are the 3 parts of the sternum

A

manubrium

mesosternum

xiphoid process

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15
Q

what is the relation that the 3 parts of the sternum have with the chest wall as a whole

A

it slopes posteriorly from xiphoid to manubrium

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16
Q

why wont you get a complete coronal view of the sternum

A

angled so wont get everything in a vertical slice

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17
Q

how do you tell where the mesosternum, manubrium and sternum are in a sagittal CT chest image

A

mesosternum = beneath aorta and carina of trachea at level of heart

manubrium = anterior to great vessels

xiphi = level of liver/lower ventricles of heart

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18
Q

the trans-thoracic plane sits in line with what joint

A

manubrium sternal joint

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19
Q

what characteristic feature does the trachea have when compared to most of the rest of the soft tissue nearby that might help you locate it on a CT/MRI slice

A

the trachea contains air

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20
Q

at what vertebral level is the trachea said to bifurcate

A

T4/5 transthoracic plane

at sternal angle

21
Q

how many lobes does the right lung have and what are their names

A

superior
middle
inferior

22
Q

how many lobes does the left lung have and what are their names

A

superior inferior

lingula

23
Q

how many fissures does the right lung have and what are their names

A

oblique and horizontal

24
Q

how many fissures does the left lung have and what are their names

A

oblique

25
Q

where is the lingual lobe of the left lung located

A

at the inferior tip of the superior lobe near the medial border

26
Q

ho far superiorly do the apex of the lungs extend normally

A

above rib 1 and behind collar bones into the lower neck region

27
Q

which relationship of the upper lobes to the lower lobes of either lung might you expect to use most on an axial chest CT or MRI slice to differentiate them

A

upper lobes are more anterior to the lower lobes

lower lobes more posterior at some levels, AP association for axial slice - sup as lung fields are small and is tight, lower slice then lower lobe forms more

28
Q

what are the 3 structures entering/exiting the hilum of the lung

A

pulmonary arteries, veins and bronchi

29
Q

which of the 3 structures entering and exiting the lung at the hilum are most superiorly located

A

pulmonary arteries more superior

30
Q

what features of the 3 hilum structures help you differentiate them in practice

A

Pulmonary trunk splits into pulmonary arteries in an upside down Y shape and is the most anterior vessel of the heart

Pulmonary veins are 4 in number and enter the left atrium which is the most posterior part of the heart

Pulmonary trunk and arteries cross beneath the arch of the aorta

31
Q

what does the IVC enter

A

right atrium

32
Q

what does the SVC enter

A

right atrium

33
Q

what does the aorta exit

A

left ventricle

34
Q

what does the pulmonary trunk exit

A

right ventricle

35
Q

what does the pulmonary veins enter

A

left atrium

36
Q

note the ascending aorta’s relative position to the pulmonary trunk in the axial slice - what might be confusing about this orientation considering where the vessels enter and exit from

A

aorta exits the left ventricle but is located on the right side of the pulmonary trunk which leaves the right ventricle

this is due to the twist of the heart so the artery you see on the right in the axial view is actually the aorta leaving the left ventricle

37
Q

once the aorta has left the heart how would you describe its course

how can you use this to determine if you are looking at the ascending or descending portion on the axial slice

A

it arches slightly to the left from anterior to posterior

therefore anterior = ascending and posterior = descending

38
Q

in what cross sectional view might you expect to see the entire length of the aorta from ascending to descending

A

sagittal

depending on how far it travels to the left from the heart

39
Q

when scrolling from superior to inferior in an axial series what order do you expect to come across the following structures

imagine how they look in the axial view

pulmonary arteries/pulmonary trunk/arch of aorta/ascending aorta/pulmonary veins/IVC

A 
1/ arch of aorta 
2/ pulmonary arteries 
3/ ascending aorta (and descending)
4/ pulmonary veins 
5/ IVC
40
Q

in the axial view what is the appearance of the aortic arch

A

appears as straight length of tube

41
Q

in the axial view what is the appearance of the pulmonary trunk

A

appear as Y shape coming off pulmonary trunk

42
Q

in the axial view what is the appearance of the ascending aorta

A

appear as circular cross sections

43
Q

in the axial view what is the appearance of the pulmonary veins

A

1-2 each side entering the left atrium at back of the heart

44
Q

in the axial view what is the appearance of the IVC

A

appears as a ellipsoid structure beneath right atrium at the bottom of the heart

45
Q

the inferior aspect of the arch of the aorta and pulmonary trunk bifurcation lie on what plane at what vertebral level

A

trans-thoracic plane

T4/5 vertebral level

46
Q

how might you expect the airways to appear at or around the trans-thoracic plane on an axial slice

A

variable but should start widening left-right as the trachea bifurcates or appear as 2 separate structures if slightly below the carina (left and right main bronchus)

47
Q

where are the airways in relation to most of the great vessels

A

posterior to them

48
Q

which is usually the most anterior vessel emerging from the heart

A

pulmonary trunk

302 MEDIMAGE (20 decks)

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