Anatomy Flashcards

1
Q

sternoclavicular joints

A

saddle joints where the clavicles articulate with the manubrium at its superolateral angles

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2
Q

vertebral level of the sternomanubrial joint

A

T4

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3
Q

vertebral level of the xiphoid process

A

T9

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4
Q

the 2nd costal cartilage articulates with

A

the manubrium and the sternal body

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5
Q

the 7th rib articulates with

A

the sternal body and the xiphoid process

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6
Q

costochondral joint

A

synchrondosis between the rib and the costal cartilage

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7
Q

sternocostal joint

A

synovial plane joint between the costal cartilage and the sternum

1st = primary cartilagenous (synchrondosis)

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8
Q

true ribs

A

ribs 1-7 (vertebrosternal)

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9
Q

false ribs

A

ribs 8-10 (vertebrochondral)

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10
Q

floating ribs

A

ribs 11-12 (vertebral)

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11
Q

subclavian vein and artery function

A

supply the upper limb

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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

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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

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14
Q

dermatome of the sternal angle

A

T2

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15
Q

dermatome of the nipples

A

T4

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16
Q

inferior border of the deflated lung at the midclavicular line

A

rib 6

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17
Q

inferior border of the deflated lung at the midaxillary line

A

rib 8

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18
Q

inferior border of the deflated lung at the midscapular line

A

rib 10

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19
Q

inferior border of the parietal pleura at the midclavicular line

A

rib 8

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20
Q

inferior border of the parietal pleura at the midaxillary line

A

rib 10

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21
Q

inferior border of the parietal pleura at the midscapular line

A

rib 12

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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

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23
Q

the oblique fissure follows…

A

rib 6

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24
Q

the horizontal fissure follows…

A

rib 4

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25
Q

vertebral level of the superior point of the lung

A

C7

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26
Q

when inflated, the posterior border of the lung extends to…

A

rib 12

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27
Q

muscle fibre orientation of the external intercostal muscles

A

infero-anteriorly (\//)

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28
Q

muscle fibre orientation of the internal intercostal muscles

A

infero-postereorly (//\)

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29
Q

muscle fibre orientation of the innermost intercostal muscles

A

infero-posteriorly (//\)

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30
Q

external intercostal muscles fill the intercostal space…

A

from the vertebrae to the costochondral junction.

the front is filled by external intercostal membrane

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31
Q

internal intercostal muscles fill the intercostal space…

A

from the sternum to the costal angle.

the back is filled by internal intercostal membrane

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32
Q

intercostal membrane

A

a thin aponeurosis

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33
Q

innermost intercostal muscles fill…

A

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

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34
Q

contents of the neurovascular bundle (superior to inferior)

A

intercostal Vein
intercostal Artery
intercostal Nerve

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35
Q

location of the neurovascular bundle

A

in the costal groove/ sulcus below each rib, between the internal and innermost intercostal muscles

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36
Q

collateral branch of the neurovascular bundle

A

a small branch given off by each structure in the neurovascular bundle, located just above each rib

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37
Q

shape of the thoracic diaphragm

A

consists of a left dome and a (higher up due to the liver) right dome.
a clover shaped central tendon in the middle

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38
Q

attachments of the thoracic diaphragm

A

the xiphisternum
costal cartilages 7-12
vertebra T12

The central tendon is attached to the fibrous pericardium

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39
Q

The left and right crura (singular = crus)

A

tendons which bind the diaphragm to vertebral bodies L1-2

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40
Q

major openings (hiatuses) in the thoracic diaphragm, and their vertebral levels

A

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

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41
Q

minor openings in the thoracic diaphragm are for…

A
azygous vein
thoracic duct
sympathetic trunks
phrenic nerves
vagus nerves
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42
Q

Phrenic nerves

A

motor and sensory nerves supplying the diaphragm (left and right domes, inferior and superior surfaces)

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43
Q

spinal level of origin of phrenic nerves

+ results of injury

A

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)

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44
Q

anterior and posterior axillary folds

A

the ridges of skin covered muscle on either sides of the arm pit

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45
Q

muscles for forced inspiration

A

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
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46
Q

Larynx

A

the “voice box”

a set of cartilages, membranes and ligaments which produce sound from expired air

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47
Q

attachments of the larynx

A

superiorly - to the hyoid bone

inferiorly - to the trachea at C6

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48
Q

function of the epiglottus

A

prevents solids and liquids entering the pharyngeal outlet

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49
Q

laryngeal prominence

A

the “adam’s apple”

in the middle of the thyroid cartilage

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50
Q

cricoid cartilage

A

a ring of cartilage below the thyroid cartilage and above the tracheal cartilages

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51
Q

motor innervation of the lower respiratory tract

sympathetic + parasympathetic

A
  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
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52
Q

blood supply (+drainage) of the lower respiratory tract

A
  • The bronchial arteries arising from the thoracic aorta
  • intercostal ateries

the bronchial vein drains into the azygous venous system

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53
Q

spinal levels of the trachea

A

C6 - T4 (where it bifurcates)

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54
Q

cartilage rings of the trachea

A

15-20 C shaped hyaline cartilage rings, completed at the back by the trachealis muscle

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55
Q

Carina

A

the cartilage ring at the bifurcation of the trachea

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56
Q

right bronchi

A

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

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57
Q

tracheobronchial lymph nodes

A

exist around the bifurcation of the trachea and alongside the two main bronchi

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58
Q

Hilum of the lungs

A

the area on the mediastinal surface of the lungs where the lung root enters and exits

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59
Q

root of the lung

A
consists of... 
the bronchus/ bronchi (posteriorly)
the pulmonary artery (superiorly)
the superior pulmonary vein
the inferior pulmonary vein
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60
Q

bronchopulmonary/bronchomediastinal lymph nodes

A

surround the pulmonary veins at the hilum of the lung

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61
Q

parts of the parietal pluera

A

mediastinal pleura
diaphragmatic/phrenic pleura
costal pleura
apical/cervical/cupola pleura

62
Q

pleural reflections

A

where the pleura changes direction to be on another surface
e.g.
costomediastinal
costophrenic
sternal pleural reflection (btw mediastinal and phrenic)

63
Q

pleural angles/ recesses

A

spaces that occur between the pleura at pleural reflections
e.g.
costomediastinal
costophrenic

64
Q

the thoracic inlet is surrounded by

A

1st ribs + their costal cartilages
superior border of the manubrium
T1 vertebra

65
Q

the thoracic outlet is surrounded by

A

11th and 12th ribs
costal cartilages of ribs 7-10
vertebta T12
xiphisternal joint

66
Q

intercostal space numbering

A

each space has the same number as the rib above it

67
Q

normal location for a chest drain

A

5th intercostal space
in the midaxillary line
between the neurovascular bundle and the collateral branch

68
Q

the fascial membrane covering the apex of the lung

A

suprapleural membrane

69
Q

nerve supply to the parietal pleura

A

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
Q

vagus nerve function

A

parasympathetic control of the heart, lungs and digestive tract.

sympathetic function (vasoconstriction) via peripheral chemoreceptors in response to hypoxaemia.

71
Q

PA chest x-ray

A

posterior –> anterior
patient stands with front against film and holds a deep inspiration

patient close to x-ray film so more accurate picture

72
Q

AP chest X-ray

A

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
Q

supine x-ray

A

patient lies down

74
Q

position clavicles on CXR

A

should be equidistant from the spinous processes of the thoracic spine

75
Q

appearance of ribs on CXR

A

posterior rib is more horizontal than anterior

with proper inspiration, 9-10 posterior ribs / 5-7 anterior ribs should be visible

76
Q

heart shadow on CXR

A

occupies up to 50% of maximum internal thoracic diameter

remember to check the lung hidden behind the heart

77
Q

mediastinum on CXR

A

hiliar vascular structures should be clearly defined

should be no widening

78
Q

trachea on CXR

A

should be central

79
Q

diaphragm on CXR

A

costophrenic and cardiophrenic angles should be sharp

80
Q

The ectoderm forms the…

A

epidermis of skin

neural tube

81
Q

The neural tube forms the…

A

brain and spinal cord

82
Q

the paraxial mesoderm forms…

A

somites which each form a…

dermatome –> dermis of skin
myotome –> muscle
sclerotome –> bones

83
Q

the intermediate plate mesoderm forms the…

A

urogenital system

84
Q

the somatic lateral plate mesoderm forms the…

A

parietal pleura

85
Q

the splanchnic lateral plate mesoderm forms the…

A

visceral pleura

86
Q

the intra-embryonic coelom forms the…

A

pericardioperitoneal cannals –> intrapleural cavity

87
Q

the endoderm forms the…

A

gut and respiratory system

88
Q

the notochord forms the…

A

nucleus pulposus

89
Q

the laryngotracheal groove forms the…

A

trachea and lung buds

90
Q

the foregut forms the…

A

oesophagus

91
Q

the septum transversum forms the…

A

central tendon of the diaphragm

migrates from C3-5

92
Q

the pleuroperitoneal membranes form the…

A

primitive diaphragm

93
Q

the dorsal mesentery of the oesophagus forms the…

A

median portion and the crura of the diaphragm

94
Q

the peripheral parts of the diaphragm are formed by…

A

muscular in-growth from lateral body walls

95
Q

Function of the thoracic wall

A

To protect the contents of the pleural and pericardial sacs, yet permit movements for respiration

96
Q

The thoracic wall comprises of

A

The sternum
Vertebrae T1 - T12
Ribs 1 - 12

97
Q

Location of the jugular notch

A

Superior border of the manubrium

98
Q

Clinical use of the sternal angle

A

To locate positions from which to auscultate the heart + define pleural/ lung boundaries

99
Q

Typical rib shape

A

Rounded superior border

Sharp inferior border

100
Q

The fist rib articulates with…

A

T1 (only one vertebra)

101
Q

Scalene tubercle

A

Tubercle on the 1st rib

Attaches to the anterior scalene muscle of the neck (an accessory respiratory muscle)

102
Q

arrangement of grooves and scalene tubercle on the 1st rib

A
ANTERIOR
Groove for subclavian vein
Scalene tubercle
Groove for subclavian artery
POSTERIOR
103
Q

Path of the subclavian vessels

A

Subclavian artery and vein pass from the neck to the axilla, sandwiched between the clavicle and 1st rib

104
Q

The costal margin/ subcostal angle is formed by…

A

ribs/ costal cartilages 7-10

105
Q

Orientation of the ribs in an adult

A

Anteroinferior

106
Q

Function of the intercostal muscles

A
  1. respiratory movement

2. prevent the lungs and pleura from ballooning out between the ribs during respiratory movements

107
Q

Layers of the chest wall (superficial to deep)

A
Skin
Superficial fascia
endothoracic/ deep fascia
external intercostal muscle
internal intercostal muscle
innermost intercostal muscle
parietal pleura
pleural cavity
visceral pleura
108
Q

Dermatome

A

An area of skin supplied by a single spinal nerve

109
Q

Major groups of lymph nodes (+ location)

A

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
Q

The axillary lymph nodes lie around…

A

The axillary vein and its branches in the axilla

111
Q

Lymph channels (function)

A

connect groups of lymph nodes

112
Q

Location of the base (glandular part) of the breast

A

between ribs 2 - 6
between the lateral border of the sternum and the
anterior axillary line

113
Q

Structure of the breast

A

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
Q

Purpose of the diaphragm

A

The main muscle of respiration

Also assists in raising intra-abdominal pressure during coughing, vomiting and defecation

115
Q

The diaphragm is made of

A

Skeletal muscle

116
Q

Difference between the phrenic and vagus nerves on a specimen

A

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
Q

Hiatus hernia

A

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
Q

Spinal level of pulmonary artery bifurcation

A

T4

119
Q

Rib level of the top of the domes of the diaphragm in quiet expiration

A

Rib 5

Therefore penetrating woulds below the nipples may damage the diaphragm

120
Q

The upper respiratory tract consists of…

A

Nasal cavity
Pharynx
Larynx

121
Q

Nerve supply of the larynx

A

Branches of the vagus nerve

for motor and sensory innervation

122
Q

The lower respiratory tract consists of…

A

Trachea
Main/principal/primary bronchi + their branches
Lungs
Pleurae

123
Q

Tracheo-oesophageal grooves

A

Grooves lying between the trachea and the oesophagus on both sides

124
Q

Difference between the left and right main bronchi

A

Right is shorter, wider and more vertical

The left pulmonary artery and the aorta arch over the left main bronchus

125
Q

Change in airway histology from bronchi – > alveoli

A

Gradually lose their cartilage and increase their elastic fibre content

126
Q

Name of the corner of the left lung, below the cardiac impression

A

Lingula

127
Q

Division of the bronchi

A

Principal bronchi
Lobar bronchi (2 on the left. 3 on the right.)
Segmental bronchi

128
Q

Bronchopulmonary segment

A

A segment of the lung supplied by a tertiary (segmental) bronchus
Separated by layers of connective tissue
Can be surgically removed

129
Q

Bronchial circulation function

A

Supplies blood to the tissue of the larger airways of the lung

130
Q

Mediastinal pleura

A

Lines the structures situated between the two pleural cavities (in the mediastinum)

131
Q

Site for pleural aspiration

A

9th intercostal space, midaxillary line

as the lung and parietal pleura are not co-extensive inferiorly

132
Q

Cartilage found in the respiratory tract

A

Hyaline cartilage

133
Q

Main connective tissue fibre in the respiratory tract

A

Elastin

134
Q

Respiratory epithelium

A

Pseudostratified ciliated collumnar epithelium with goblet cells

135
Q

Cells comprising the respiratory epithelium

A

Cilia (protrude into lumen)
Goblet cells - large, pale
Basal cells - small, dark staining

136
Q

Goblet cell function

A

Secrete mucous

all pale staining cells secrete mucous

137
Q

Mucosa

A

Respiratory epithelium
Basement membrane - smooth
Lamina propria

138
Q

Lamina propria

A

Loose connective tissue
extracellular substance > cells
Can contain blood vessels

139
Q

Submucosa

A

Contains mixed serous mucous glands
(appears grainy at low magnification)

Pale staining = mucous secreting
Dark staining = serous

140
Q

Function and composition of the trachealis

A

Allows the oesophagus to expand

Smooth muscle

141
Q

Layers of the trachea

A
Respiratory epithelium   \
Basement membrane     l   ->  Mucosa
Lamina propria               /
Submucosa
Cartilage
Adventitia
142
Q

Adventitia function + composition

A

Anchors the airway to surrounding structures

Loose connective tissue

143
Q

Arrangement in hyaline cartilage in airways

A

Continuous in trachea
Irregular plates in bronchi

Disappears completely in bronchioles

144
Q

Size of bronchioles

A

1mm or less

145
Q

Composition of bronchiole wall

A

Collumnar/ cuboidal epithelium
SMOOTH MUSCLE

NO: cartilage, glands, goblet cells

146
Q

Cells found in alveolar walls

A

Type I pneumocytes - smaller
Type II pneumocytes - larger
Macrophages - huge!

147
Q

Main connective tissue fibres in alveoli

A

Reticular fibres

Elastin

148
Q

Histological changes from bronchioles to alveoli

A

Smooth muscle slowly disappears

Epithelial cells flatten to form simple squamous epithelium

149
Q

typical ribs

A

3 - 9

150
Q

Intercostal nerves

A

The anterior rami of spinal nerves T1 - T11

151
Q

Lung borders

A

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
Q

Lymphatic drainage of the breast

A

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