Anatomy of thorax Flashcards
where does the anterior axillary line run from
from fold of muscle at anterior axilla/front of the armpit
which layer does the mammary gland lie in
subcutaneous layer
which muscle forms the anterior axillary fold
lowest n most lateral part of pectoralis major
which ribs does the pectorals minor originate from
3rd
4th
5th
does the medial pectoral supply the pectorals minor
yeeeeeeees
which muscle do the lower ribs give rise to (5th to 8th)
eternal oblique - outer layer of abdominal wall muscles
where does lymph drainage medial to the nipple pass through
intercostal spaces to thorax lymph nodes (internal mamary (thoracic) lymph nodes)
where does lymph from lateral breast drain into
axillary lymph nodes
where is a pacemaker inserted
under skin next to left cephalic vein
which costal cartilage is the sternal angle
2nd
what lies on either side of the centrally placed mediastinum
pleural cavities
how is the lung connected to the mediastinum
only at 1 place - hilum
how does contraction of pectorals major assist in breathing
when ring contracts, thoracic pressure rises to assist exhalation. this only oc
curs in disease n during exercise; normal exhalation is passive
what forms the ring of muscles which encircle the thoracic cage
2 pectoralis muscles
scapula muscles
which bony structures lie subcutaneously in the anterior chest wall
clavicles
sternum
are the ribs subcutaneous
no, they lie beneath muscle
what are the articulations of the clavicle
at the medial end to the manubrium; sternoclavicular joint
at the lateral end to the acromion of the scapula; acromioclavicular joint
what forms the anterior axillary fold
lower edge of the pec major muscle
what lies deep to the pec minor muscle
axilla
which costal cartilage connects to the sternum at the sternal angle
2nd
what is angle of Louis aka
sternal angle
what is in the hilum
- main bronchus
- pulmonary artery
- 2 pulmonary veins
- brachial artery
- lymphatic vessels
- branches of vagus n sympathetic nerves
contraction of the diaphragm causes the dome of diaphragm to ascend, decreasing the pressure in the thoracic cavity. what are the 2 effects?
- if glottis is open, air is drawn into lungs
2. blood is drawn from IVC into RA
which nerves carry sensation from the parietal pleura
parietal lines inside of thoracic wall
- supplied by the same nerves as tissue of thoracic wall
- spinal nerves t1-12
which nerves carry sensation from visceral pleura
visceral covers lung surface
- supplied by same nerves as lung\
- vagus and sympathetic nerves
what is a bronchopulmonary segment
has a feeding artery n bronchus which run together through the centre of the segment n repeatedly branch to reach all parts of segment
how is each bronchopulmonary segment separated
- anatomically and functionally
- layers of connective tissue n fissures
what effect does contraction of diaphragm have on intrathoracic and intraabdominal pressure
decreases intrathoracic
increases intrabadominal
what is intercostal recession
when a patient is having difficulty taking a breath in n having to create very neg pressures in thorax, intercostals get ‘sucked in’
which nerve passes to the left of the aortic arch more posterior than the phrenic nerve
left vagus nerve
where does the vagus nerve pass in relation to the lung
behind the root of the lung to join the oesophagus
where does the vagus nerve pass to give left recurrent laryngeal nerve
over aortic arch
where does the recurrent laryngeal nerve pass back up into the neck
in the gore btwn the trachea anteriorly on oesophagus behind it
what happens if u have a tumour of left lung
- can invade left recurrent laryngeal nerve
- cause paralysis of muscles of left vocal cords
- therefore hoarse voice
if fluid collects in pericardium, what is limited
end diastolic volume
therefore cardiac output
what is the developmental significance of the
remnant of shunt btwn pulmonary artery n aorta
what are the main branches of left common carotid artery (2)
internal and external carotids
what does the internal carotid supply
most of cerebral hemispheres
what does the external carotid supply
left side of face and head
what are the main branches of the left subclavian artery (3)
- vertebral
- thyro-cervical
- axillary
what do the vertebral arteries supply
- cerebellum
- brain step
- occipital lobe
- inferior temporal lobe
what do the thyrocervical artery supply (2)
- thyroid gland
- neck
what does the axillary artery supply
upper limb
what structures are supplied by the vagus nerve
- pharynx
- larynx
- heart
- lungs
- foregut
- midgut
what is the surface marking for the apex of the heart
5th intercostal space
midclavicular line
what is the RCA sometimes known as
right coronary sulcus
where does the circumclfex artery run
grove btwn LA and LV (left coronary sulcus)
what is the coronary sinus
major venous drainage of heart
what are cusps made of
fibrous tissue
covered with endothelium
what are the chord tendinae
tendinous cords that are attached to the free edge of cusps
at which phase of the cardiac cycle do the coronary arteries fill n why
during ventricular diastole
- pressure in aorta is high, pressure in myocardium drops to 0
how many bundles to right and left ventricle
1 for right - right
2 for left - anterior and posterior
what is the blood supply of the SAN and AVN
SAN - RCA (60%), LCA (40%)
AVN - PIVA
where is SAN located
crista terminals where SVC enters RA
what is crista terminalis
ridge of tissue inside btwn RA and right atrial appendage
on a chest x ray, which chambers and vessels form the right and left borders of the cardiac shadow
right heart border - RA
left heart border - left auricular appendage superiorly and LV
which lymph does the thoracic duct drain
from lower half of body n bowel into the confluence of left subclavian and internal jugular (left side of neck)
which vessels run horizontally lying over the vertebral bodies
intercostal vessels
which side are the azygous veins on
right
which side are the semi-azygous veins on
left
what is the sympathetic chain formed from
a series of ganglia (neurone cell bodies) connected by nerve fibres (axons and dendrites)
how many ganglia are in the thorax, neck and abomen/pelvis
thorax - 12 (1 each)
neck - 3
abdomen/pelvis (1 per vertebra also)
from the 5th-12tth thoracic ganglia, there are nerves running forwards over vertebral bodies. what do these form
3 splanchnic nerves
where does all sympathetic nerve supply to head and neck travel through
T1 ganglia of sympathetic chain
what is Horner’s syndrome
pathology damaging ganglia - loss of sympathetic innervation to face n eye
- no facial sweating, drooping eye lid, constricted pupil and an eye slightly drawn in
where does a patient experience pain felt by greater splanchnic nerve
epigastrium
where does patient experience pain felt by lesser splanchnic nerve
umbilicus area
where does a patient experience pain felt by least splanchnic nerve
suprapubic area
which structure lies immediately behind LA in lower thorax
oesophagus
which structures drain blood into azygous system
lateral and posterior chest/abdominal wall
why is the left recurrent laryngeal at risk from thoracic disease but not right
left passes into thorax, around aortic arch and back into next
right doesn’t pass through thorax
where do sympathetic nerves attach to CNS
thoacic 1-12
lumbar 1-2 spinal segment nerves
