ALL THE THINGS Flashcards
When making a transverse cut of the thoracic cavity, how many sub cavities are visible?
3 sub cavities
What are the 3 sub cavities of the anterior thoracic wall?
two pleural cavities on either side of the mediastinum in the middle
The pleural cavities extend above —
the first rib and clavicle into the root of the neck
Inferiorly, above the costal margin and medially the pleural cavities are connected to what by what?
to the mediastinum by veins, arteries, nerves and ducts
What kind of membrane is the pleura?
serous membrane lined with mesothelium and supporting connective tissue
What are the two major layers of the pleura?
parietal or wall pleura
visceral or organ pleura
Each pleural sac is invaginated by what?
a lung
What is the visceral pleura adherent to?
to the lung
What is the parietal pleura adherent to?
the wall
What 4 parts is the parietal pleura described in?
cervical, costal, mediastinal, diaphragmatic
What does the visceral pleura form around the lung root?
a cuff acting as a pulmonary ligament
The space between the parietal and visceral layers is what?
pleural cavity (completely closed)
Where is the inferior margin of the visceral pluera layer?
draw a line on the suface of the body passing along rib 6 (MCL), rib 8 (MAL), and rib 10 (VL/SL)
How many ribs inferior to the visceral layer does the parietal layer run?
2 ribs
e.g rib 8 (MCL) rib 10 (MAL) rib 12 (VL/SL)
The space between the two inferior margins of the pleural layers is called
costodiaphragmatic/costophrenic recesses (near the spinal cord area posterior)
Region is below the level of the lungs
The visceral pleura is nourished by what?
the bronchial arteries
What is the parietal pleura innvervated by?
phreic and intercostal nerves
(intercostal for the costo-vertebral part)
(Phrenic for the cervical, mediastinal, and diaphragmatic parts)
The pleural recesses are potential spaces for what?
the expansion of the lungs during deep inspriation
Where are the right and left costomediastinal recesses located? Which is larger?
located near the front (anterior side) where the ribs are. the left recess is much bigger
What are some common pathologies and clinical applications for the pleura?
pleural effusion and thoracocentesis
injuries to cervical pleura and lung apex
pneumothroax/hydrothorax
insertion of a chest tube
pleurectomy/pleurodesis
A thoracocentesis for pleural effusion at the midaxillary line is best performed in which intercostal spaces?
8th and 9th spaces
What kind of sac is the pericardium?
fibro-serous sac
What does the pericardium enclose?
the heart and the roots of the great vessels
Where is the pericardium situated?
in the middle mediastinum
What are the 2 sacs of the pericardium?
outer single layered fibrous pericardium and the inner double layered serous pericardium
The fibrous and serous pericardium together form how many layers of the pericardium?
3
1 fibrous + 2 serous = 3 layers
How is the fibrous pericardium shaped?
conical shaped
What does the apex of the fibrous pericardium fuse with?
roots of the great vessels and pre-tracheal fascia
Describe the base of the fibrous pericardium?
broad and inseparably blended with the central tendon of the diaphragm
What 2 ligaments does the fibrous pericardium form?
superior and inferior sternopericardial ligaments
What is the serous pericardium lined with?
mesotheium
What is the outer parietal layer of the serous pericardium fused with?
inseparably fused with the fibrous pericardium
What does the inner visceral layer of the serous pericardium form?
the epicardium of the heart
What does the serous pericardium have within it that allows the heart to move?
a thin film of fluid
What is the pericardium nourished by?
branches of the internal thoracic artery, thoracic and abdominal aorta
What innervates the pericardium?
the phrenic nerve (C3-5)
What is the clinical application of the transverse pericardial sinus?
useful in open heart surgery
What is the oblique pericardial sinus clinically significant for?
along with the esophagus, is utilized in trans-esophageal echocardiography (heart ultrasound)
What are 3 common diseases of the pericardium?
acute pericarditis/chronic pericarditis
pericardial effusion
cardiac tamponade
What is characteristically visible on a chest x-ray for someone with pericardial effusion?
water bottle shape
Where will you enter in order to perform a pericardiocentesis procedure?
at the left infasternal angle
The left 5th an 6th intercostal space is called what?
the bare area
it is the area of the cardiac notch of the left lung
When making your incision at the left infrasternal angle, how will the needle pass through and where will you aim?
passed supero-posteriorly aiming at the left shoulder
