Anatomy Flashcards
1
Q
sternoclavicular joints
A
saddle joints where the clavicles articulate with the manubrium at its superolateral angles
2
Q
vertebral level of the sternomanubrial joint
A
T4
3
Q
vertebral level of the xiphoid process
A
T9
4
Q
the 2nd costal cartilage articulates with
A
the manubrium and the sternal body
5
Q
the 7th rib articulates with
A
the sternal body and the xiphoid process
6
Q
costochondral joint
A
synchrondosis between the rib and the costal cartilage
7
Q
sternocostal joint
A
synovial plane joint between the costal cartilage and the sternum
1st = primary cartilagenous (synchrondosis)
8
Q
true ribs
A
ribs 1-7 (vertebrosternal)
9
Q
false ribs
A
ribs 8-10 (vertebrochondral)
10
Q
floating ribs
A
ribs 11-12 (vertebral)
11
Q
subclavian vein and artery function
A
supply the upper limb
12
Q
costovertebral joint
A
synovial plane joint between the head of the rib and the vertebral body of the same number and the one above it
13
Q
function of the tubercle of the rib
A
articulates with the articular facet on the tip of the transverse process of the vertebra with the same number
The costotransverse joint
14
Q
dermatome of the sternal angle
A
T2
15
Q
dermatome of the nipples
A
T4
16
Q
inferior border of the deflated lung at the midclavicular line
A
rib 6
17
Q
inferior border of the deflated lung at the midaxillary line
A
rib 8
18
Q
inferior border of the deflated lung at the midscapular line
A
rib 10
19
Q
inferior border of the parietal pleura at the midclavicular line
A
rib 8
20
Q
inferior border of the parietal pleura at the midaxillary line
A
rib 10
21
Q
inferior border of the parietal pleura at the midscapular line
A
rib 12
22
Q
rib level of the cardiac notch
A
ribs 4-6
Here a needle can enter the heart without penetrating the lungs or pleura
23
Q
the oblique fissure follows…
A
rib 6
24
Q
the horizontal fissure follows…
A
rib 4
25
vertebral level of the superior point of the lung
C7
26
when inflated, the posterior border of the lung extends to...
rib 12
27
muscle fibre orientation of the external intercostal muscles
infero-anteriorly (\\//)
28
muscle fibre orientation of the internal intercostal muscles
infero-postereorly (//\\)
29
muscle fibre orientation of the innermost intercostal muscles
infero-posteriorly (//\\)
30
external intercostal muscles fill the intercostal space...
from the vertebrae to the costochondral junction.
| the front is filled by external intercostal membrane
31
internal intercostal muscles fill the intercostal space...
from the sternum to the costal angle.
| the back is filled by internal intercostal membrane
32
intercostal membrane
a thin aponeurosis
33
innermost intercostal muscles fill...
only the central half of the intercostal space.
the front is filled by the transvursus thoracis muscles.
the back is filled by the subcostalis muscles
34
contents of the neurovascular bundle (superior to inferior)
intercostal Vein
intercostal Artery
intercostal Nerve
35
location of the neurovascular bundle
in the costal groove/ sulcus below each rib, between the internal and innermost intercostal muscles
36
collateral branch of the neurovascular bundle
a small branch given off by each structure in the neurovascular bundle, located just above each rib
37
shape of the thoracic diaphragm
consists of a left dome and a (higher up due to the liver) right dome.
a clover shaped central tendon in the middle
38
attachments of the thoracic diaphragm
the xiphisternum
costal cartilages 7-12
vertebra T12
The central tendon is attached to the fibrous pericardium
39
The left and right crura (singular = crus)
tendons which bind the diaphragm to vertebral bodies L1-2
40
major openings (hiatuses) in the thoracic diaphragm, and their vertebral levels
inferior vena cava - T8 (through the central tendon*)
oesophagus - T10
aorta - T12
*so it cannot be compressed by contracting muscle
Due to the dome shape, more anterior structures are more superior
41
minor openings in the thoracic diaphragm are for...
```
azygous vein
thoracic duct
sympathetic trunks
phrenic nerves
vagus nerves
```
42
Phrenic nerves
motor and sensory nerves supplying the diaphragm (left and right domes, inferior and superior surfaces)
43
spinal level of origin of phrenic nerves
| + results of injury
C3-5
injury to the spinal cord above these levels will result in paralysis of the diaphragm (+ need for artificial ventilation)
Injury below these levels may result in quadriplegia (inability to move all limbs)
44
anterior and posterior axillary folds
the ridges of skin covered muscle on either sides of the arm pit
45
muscles for forced inspiration
accessory muscles, e.g.
- muscles of the neck attaching to the sternum and upper ribs
- muscles of the abdomen that attach to the lower ribs
- upper limb and back muscles with rib attachments
46
Larynx
the "voice box"
| a set of cartilages, membranes and ligaments which produce sound from expired air
47
attachments of the larynx
superiorly - to the hyoid bone
| inferiorly - to the trachea at C6
48
function of the epiglottus
prevents solids and liquids entering the pharyngeal outlet
49
laryngeal prominence
the "adam's apple"
| in the middle of the thyroid cartilage
50
cricoid cartilage
a ring of cartilage below the thyroid cartilage and above the tracheal cartilages
51
motor innervation of the lower respiratory tract
| sympathetic + parasympathetic
1. sympathetic fibres from upper thoracic spinal levels via the pulmonary plexuses (located at the termination of the primary bronchi)
2. parasympathetic fibres from the vagus nerve
* Sensory fibres travel in both
52
blood supply (+drainage) of the lower respiratory tract
- The bronchial arteries arising from the thoracic aorta
- intercostal ateries
the bronchial vein drains into the azygous venous system
53
spinal levels of the trachea
C6 - T4 (where it bifurcates)
54
cartilage rings of the trachea
15-20 C shaped hyaline cartilage rings, completed at the back by the trachealis muscle
55
Carina
the cartilage ring at the bifurcation of the trachea
56
right bronchi
the right main bronchus bifurcates just before entering the lung.
the superior branch is the superior lobar (eparterial) bronchus
the main bronchus then becomes the hypartrial bronchus
57
tracheobronchial lymph nodes
exist around the bifurcation of the trachea and alongside the two main bronchi
58
Hilum of the lungs
the area on the mediastinal surface of the lungs where the lung root enters and exits
59
root of the lung
```
consists of...
the bronchus/ bronchi (posteriorly)
the pulmonary artery (superiorly)
the superior pulmonary vein
the inferior pulmonary vein
```
60
bronchopulmonary/bronchomediastinal lymph nodes
surround the pulmonary veins at the hilum of the lung
61
parts of the parietal pluera
mediastinal pleura
diaphragmatic/phrenic pleura
costal pleura
apical/cervical/cupola pleura
62
pleural reflections
where the pleura changes direction to be on another surface
e.g.
costomediastinal
costophrenic
sternal pleural reflection (btw mediastinal and phrenic)
63
pleural angles/ recesses
spaces that occur between the pleura at pleural reflections
e.g.
costomediastinal
costophrenic
64
the thoracic inlet is surrounded by
1st ribs + their costal cartilages
superior border of the manubrium
T1 vertebra
65
the thoracic outlet is surrounded by
11th and 12th ribs
costal cartilages of ribs 7-10
vertebta T12
xiphisternal joint
66
intercostal space numbering
each space has the same number as the rib above it
67
normal location for a chest drain
5th intercostal space
in the midaxillary line
between the neurovascular bundle and the collateral branch
68
the fascial membrane covering the apex of the lung
suprapleural membrane
69
nerve supply to the parietal pleura
mediastinal and diaphragmatic parietal pleura is supplyed by the phrenic nerve
the rest is supplied by the intercostal nerves
only the parietal pleura is sensitive to pain
70
vagus nerve function
parasympathetic control of the heart, lungs and digestive tract.
sympathetic function (vasoconstriction) via peripheral chemoreceptors in response to hypoxaemia.
71
PA chest x-ray
posterior --> anterior
patient stands with front against film and holds a deep inspiration
patient close to x-ray film so more accurate picture
72
AP chest X-ray
used if a patient can't stand
patient sits with back to x-ray film
bigger distance btw patient and film so less accurate. cannot be used to determine heart size
73
supine x-ray
patient lies down
74
position clavicles on CXR
should be equidistant from the spinous processes of the thoracic spine
75
appearance of ribs on CXR
posterior rib is more horizontal than anterior
with proper inspiration, 9-10 posterior ribs / 5-7 anterior ribs should be visible
76
heart shadow on CXR
occupies up to 50% of maximum internal thoracic diameter
remember to check the lung hidden behind the heart
77
mediastinum on CXR
hiliar vascular structures should be clearly defined
| should be no widening
78
trachea on CXR
should be central
79
diaphragm on CXR
costophrenic and cardiophrenic angles should be sharp
80
The ectoderm forms the...
epidermis of skin
| neural tube
81
The neural tube forms the...
brain and spinal cord
82
the paraxial mesoderm forms...
somites which each form a...
dermatome --> dermis of skin
myotome --> muscle
sclerotome --> bones
83
the intermediate plate mesoderm forms the...
urogenital system
84
the somatic lateral plate mesoderm forms the...
parietal pleura
85
the splanchnic lateral plate mesoderm forms the...
visceral pleura
86
the intra-embryonic coelom forms the...
pericardioperitoneal cannals --> intrapleural cavity
87
the endoderm forms the...
gut and respiratory system
88
the notochord forms the...
nucleus pulposus
89
the laryngotracheal groove forms the...
trachea and lung buds
90
the foregut forms the...
oesophagus
91
the septum transversum forms the...
central tendon of the diaphragm
| migrates from C3-5
92
the pleuroperitoneal membranes form the...
primitive diaphragm
93
the dorsal mesentery of the oesophagus forms the...
median portion and the crura of the diaphragm
94
the peripheral parts of the diaphragm are formed by...
muscular in-growth from lateral body walls
95
Function of the thoracic wall
To protect the contents of the pleural and pericardial sacs, yet permit movements for respiration
96
The thoracic wall comprises of
The sternum
Vertebrae T1 - T12
Ribs 1 - 12
97
Location of the jugular notch
Superior border of the manubrium
98
Clinical use of the sternal angle
To locate positions from which to auscultate the heart + define pleural/ lung boundaries
99
Typical rib shape
Rounded superior border
| Sharp inferior border
100
The fist rib articulates with...
T1 (only one vertebra)
101
Scalene tubercle
Tubercle on the 1st rib
| Attaches to the anterior scalene muscle of the neck (an accessory respiratory muscle)
102
arrangement of grooves and scalene tubercle on the 1st rib
```
ANTERIOR
Groove for subclavian vein
Scalene tubercle
Groove for subclavian artery
POSTERIOR
```
103
Path of the subclavian vessels
Subclavian artery and vein pass from the neck to the axilla, sandwiched between the clavicle and 1st rib
104
The costal margin/ subcostal angle is formed by...
ribs/ costal cartilages 7-10
105
Orientation of the ribs in an adult
Anteroinferior
106
Function of the intercostal muscles
1. respiratory movement
| 2. prevent the lungs and pleura from ballooning out between the ribs during respiratory movements
107
Layers of the chest wall (superficial to deep)
```
Skin
Superficial fascia
endothoracic/ deep fascia
external intercostal muscle
internal intercostal muscle
innermost intercostal muscle
parietal pleura
pleural cavity
visceral pleura
```
108
Dermatome
An area of skin supplied by a single spinal nerve
109
Major groups of lymph nodes (+ location)
Axillary - root of upper limb
Superficial + deep inguinal - root of lower limb
Pectoral - around the pectoralis major muscle
Tracheobronchial - bifurcation of trachea
Lumbar/ pelvic - around the root of arteries in the abdomen + pelvis
Superficial + deep cervical - superficial and deep groups in head and neck
110
The axillary lymph nodes lie around...
The axillary vein and its branches in the axilla
111
Lymph channels (function)
connect groups of lymph nodes
112
Location of the base (glandular part) of the breast
between ribs 2 - 6
between the lateral border of the sternum and the
anterior axillary line
113
Structure of the breast
The glandular part is divided into 16-20 lobes and smaller lobules and is surrounded by extensive adipose tissue
the axillary tail (of spence) of the breast, extends superolaterally into the floor of the axilla where it lies close to the axillary lymph nodes.
114
Purpose of the diaphragm
The main muscle of respiration
Also assists in raising intra-abdominal pressure during coughing, vomiting and defecation
115
The diaphragm is made of
Skeletal muscle
116
Difference between the phrenic and vagus nerves on a specimen
Phrenic = thinner, looser, more anterior, more lateral + can be seen all the way to the diaphragm
The vagus nerve lies immediately lateral to the trachea on both sides and soon passes posteriorly out of sight to lie on the oesophagus
117
Hiatus hernia
The abnormal protrusion (herniation) of a structure
e.g. the upper part of the stomach protruding into the thorax due to a tear/ weakness in the diaphragm
118
Spinal level of pulmonary artery bifurcation
T4
119
Rib level of the top of the domes of the diaphragm in quiet expiration
Rib 5
| Therefore penetrating woulds below the nipples may damage the diaphragm
120
The upper respiratory tract consists of...
Nasal cavity
Pharynx
Larynx
121
Nerve supply of the larynx
Branches of the vagus nerve
| for motor and sensory innervation
122
The lower respiratory tract consists of...
Trachea
Main/principal/primary bronchi + their branches
Lungs
Pleurae
123
Tracheo-oesophageal grooves
Grooves lying between the trachea and the oesophagus on both sides
124
Difference between the left and right main bronchi
Right is shorter, wider and more vertical
The left pulmonary artery and the aorta arch over the left main bronchus
125
Change in airway histology from bronchi -- > alveoli
Gradually lose their cartilage and increase their elastic fibre content
126
Name of the corner of the left lung, below the cardiac impression
Lingula
127
Division of the bronchi
Principal bronchi
Lobar bronchi (2 on the left. 3 on the right.)
Segmental bronchi
128
Bronchopulmonary segment
A segment of the lung supplied by a tertiary (segmental) bronchus
Separated by layers of connective tissue
Can be surgically removed
129
Bronchial circulation function
Supplies blood to the tissue of the larger airways of the lung
130
Mediastinal pleura
Lines the structures situated between the two pleural cavities (in the mediastinum)
131
Site for pleural aspiration
9th intercostal space, midaxillary line
| as the lung and parietal pleura are not co-extensive inferiorly
132
Cartilage found in the respiratory tract
Hyaline cartilage
133
Main connective tissue fibre in the respiratory tract
Elastin
134
Respiratory epithelium
Pseudostratified ciliated collumnar epithelium with goblet cells
135
Cells comprising the respiratory epithelium
Cilia (protrude into lumen)
Goblet cells - large, pale
Basal cells - small, dark staining
136
Goblet cell function
Secrete mucous
| all pale staining cells secrete mucous
137
Mucosa
Respiratory epithelium
Basement membrane - smooth
Lamina propria
138
Lamina propria
Loose connective tissue
extracellular substance > cells
Can contain blood vessels
139
Submucosa
Contains mixed serous mucous glands
(appears grainy at low magnification)
Pale staining = mucous secreting
Dark staining = serous
140
Function and composition of the trachealis
Allows the oesophagus to expand
| Smooth muscle
141
Layers of the trachea
```
Respiratory epithelium \
Basement membrane l -> Mucosa
Lamina propria /
Submucosa
Cartilage
Adventitia
```
142
Adventitia function + composition
Anchors the airway to surrounding structures
| Loose connective tissue
143
Arrangement in hyaline cartilage in airways
Continuous in trachea
Irregular plates in bronchi
Disappears completely in bronchioles
144
Size of bronchioles
1mm or less
145
Composition of bronchiole wall
Collumnar/ cuboidal epithelium
SMOOTH MUSCLE
NO: cartilage, glands, goblet cells
146
Cells found in alveolar walls
Type I pneumocytes - smaller
Type II pneumocytes - larger
Macrophages - huge!
147
Main connective tissue fibres in alveoli
Reticular fibres
| Elastin
148
Histological changes from bronchioles to alveoli
Smooth muscle slowly disappears
| Epithelial cells flatten to form simple squamous epithelium
149
typical ribs
3 - 9
150
Intercostal nerves
The anterior rami of spinal nerves T1 - T11
151
Lung borders
Anterior border: where costal and mediastinal surfaces meet anteriorly
Inferior border: surrounds the diaphragmatic surface
Posterior border: where costal and mediastinal surfaces meet posteriorly
152
Lymphatic drainage of the breast
1.
Subareolar plexus
2.
75% (esp from lateral quadrants) --> axillary lymph nodes
From medial quadrants --> parasternal lymph nodes/ opposite breast
From inferior quadrants --> abdominal lymph nodes
