Anatomy Flashcards
Where can the trachea be palpated?
Jugular notch (of manubriun)
Where does the lower respiratory tract start?
Level of C6 - trachea
What lies just superior to the trachea in the jugular notch?
Isthmus of the thyroid (anterior to tracheal cartilages 2-4)
How many lobes are in each lung?
Right - 3
Left - 2
How do ribs articulate with the vertebrae?
Via the rib head - with body of vertebrae of same number and with superior vertebrae
Via the rib tubercle - with transverse process of same number vertebrae
What is the purpose of the costal groove?
For the NVB
What blood vessels supply the intercostal spaces?
Anterior aspect
- Branches of the internal thoracic artery
Posterior aspect
- Posterior intercostal arteries (paired branches of the thoracic aorta)
What are the drainage vessels for the intercostal spaces?
Anterior aspect
- Paired internal thoracic veins
Posterior aspect
- Posterior intercostal veins drain to the azygous vein on the right and the hemiazygous vein on the left (drains to azygous)
What arteries supply the lung tissue?
Brachial arteries (from thoracic aorta)
What nerves supply the intercostal spaces?
Anterior rami of thoracic spinal nerves T1-T11 (intercostal nerves)
What is the name of the T12 anterior rami?
Subcostal nerves
What are the branches of the intercostal nerves?
Lateral and anterior cutaneous
What do the posterior rami of the thoracic spinal nerves supply?
Bones, joints, deep back muscles and skin
What is the function of the rami communicantes?
Connect intercostal and subcostal nerves to sympathetic trunk
What are the names of the apertures in the diaphragm?
Caval opening (for IVC)
Oesophageal hiatus
Aortic hiatus
Where does the diaphragm connect to?
Sternum
Lower six ribs
L1-L3 vertebral bodies
What is the phrenic nerve made of?
C3, C4 and C5 anterior rami
What is the route of the phrenic nerve?
Passes over anterior surface of scale is anterior
Descends over lateral aspect of fibrous pericardium
The subclavian artery is anterior to the subclavian vein. True or false?
False. The vein is anterior to the artery.
Where does the cephalic vein pass?
In the deltopectoral groove
What is the role of the latissimus dorsi?
Shoulder movement
Which muscle anchors the medial borders of the scapula to ribs 1-8?
Serrated anterior
Paralysis of which nerve results in a “winged scapula”?
Long thoracic nerve (branch of the brachial plexus)
Where do we auscultate the middle lung lobe?
Between ribs four and six in mid-clavicular and mid-axillary lines on the right side of the chest
Where is the oblique fissure situated?
Anteriorly - rib 6
Posteriorly - T3
At what vertebral level is the lung base?
T11
What is the sequence of events in coughing?
- Deep inspiration
- Adduction of vocal cords
- Anterolateral abdo wall muscle contraction
- Vocal folds abduct
- Soft palate tense and elevates
What cranial nerves are stimulated in coughing?
ix and x
What are the accessory muscles of deep inspiration?
Pectoralis major
Pectoralis minor
Sternocleidomastoid
Scalenus anterior, medium and posterior
What structures are contained in the carotid sheath?
Vagus nerve
Internal carotid artery
Common carotid artery
Internal jugular vein
What are the anterolateral abdominal wall muscles?
Rectus abdominis External obliques Internal obliques Transverse abdominus Seratus anterior
What is the linea alba?
The midline communication of the aponeurosis of each external oblique
Where do the aponeuroses begin?
Linea semilunaris
Which aponeuroses form the rectus sheath?
Both obliques
Transverse abdominus
Which intercostal nerves become thoracoabdominal nerves?
7th-11th
Which nerve does the subcostal nerve communicate with?
Iliohypogastric nerve of the lumbar plexus
What is the name for the internal tracheal bifurcation?
Carina
How can a pneumothorax be distinguished from a tension pneumothorax?
A tension pneumothorax will show mediastinal shift on CXR
Management of large pneumothorax?
Thoracentesis
Describe the location of the safe triangle for a chest tube
Anterior border of latissimus dorsi
Posterior border of pectoralis major
Axial lines sup. to nipple
What is VATS?
Video Assisted Thorascopic Surgery
What is chemical pleurodesis?
Talc slurry added to cavity of produce adhesion
Where do the inguinal ligaments attach?
Between ASIS and pubic tubercle
Where do lateral chest quadrants drain (lymph)?
Unilaterally to axillary nodes
Where do the medial chest quadrants drain to (lymph)?
Bilaterally to the parasternal nodes
