Anatomy[THORAX] Flashcards
How many lobes in the rt and lft lung?
- Rt: 3 lobes by the fissures(upper lobe above the horizontal fissure-middle lobe between horizontal and oblique fissures - lower lobe below the oblique fissure)
- Left : 2 lobes(the upper above the oblique fissure and the lower is below it)
The blood supply of the lung?and from where ut derives ?
- Right lung: bronchial Ā from rt post intercostal Ā
- left lung: 2 bronchial arteries branch from descending aorta
- right: to the azygos
- left : to superior hemiazygos
7th rib articulate with sternum at
Xipho sternal joint
Whats the anterior relation of the esophagus?
- ant gastric N
- diaphragm
- pericardium oblique acinus
- right pulmonary A & left bronchi
- trachea and left recurrent lareyngeal N
Whats the atypical features of 11 and 12 thoracic vertebrae?
11-complet upper facet(between body and pedicile ), no inferior facet , no costal facet
12-complete upperfacet(in the pedicle) no inferior facet,short and thick spine,larg body, inferior artecular processes faces laterally
Whats the manibruisternal joint and its type?
- secondary cartilaginous joint
- between the manibruim and the body
The azygos vein pass behind the right root of
Lung
Post intercostal arteries number? And they derives?
11 one in each space
- 1-2 from superior intercos Ā>costo cervical trunck>2nd part of subclivian Ā
- from3-11 branch of descending thoracic aorta
- subcostal 12 from descending aorta
Whats the atypical ribs? And they distinguished by?
1-2-10-11-12
1-1st (no costal groove 2surfaces(upper lower) 2borders(ant and post) tubricle for scaleneus muscle)(its upper surface have ant grove for subclivian V and post groove for subclivian Ā)
2-2nd (oblique shaft - short costal groove)
3-10th( its head is one facet not seperated)
4-11-12th (only head no shaft nech or tubricle or costal groove)
Ant and post relation of the apex of the lung?
Ant:subclivian groove
Post:neck of the first rib,superior intercostal a, sympathetic trunck, 1st thoracic nerve
Whats the sternal costal joint and its type?
- With the first rib costal cartilage and sternum (1ry cartilaginous)
- with 2-7 synovial
Nerve supply of parietal pleura?
Mediastinal: phrenic nerve
Costal: intercostal Nerve(typical)
Diaphragm:medially by phrenic N laterally by intercostal N(atypical)7-11
Where dies the esophagus incline?
Its upper and lower part T8-T10 to the left
Whats the pleura and what type of cells it have?
Its a closed serous sac that invaginated medially by the lung
-it have a single layer wall of mesothelium that secrete serous in the pleural cavity
At what level the phrenic nerve pierce the diaphragm and with who?
At T8 with venacava
Whats the type of intervertebral joint and what support it?
- 2ndry cartilaginous joint
- ant and post longitudinal ligaments
Where does the trachea lays?
In the superior mediastinum
The base of the lung related to?and its shape?
diaphragm
Concave
The lymph nodes of pareital pleura?
Intercostal,parasternum,post mediastinum and diaphragmric
What are the fissures of the left lung?and it’s begging and ending?
One fissure
-oblique starts from 3rd spine of thoracic vertebrae and end on 6th costochondral junction
Whats the pleural Recesses?
The space inside the pleura occupied by the lung only in deep inspiration
Where the 1st post intercostal veins draint to Lt
Brachiocephaliv vein
The level of the hilum of the lungs is at?
T5,T6,T7
Abnormal substances in the pleural cavities cases?
Blood: hemothirax Pus: empayema Water: hydrothorax Air:pneumothorax Inflammation:pleuracy
What distinguishes the typical ribs?
3-9 ribs (head nech tubrivle shaft)
1-Head(upper facet with vertebrae above - lower facet with body of vertebrae same number - tubricle for intervertebral disc
2-neck(post surface connected to inferior costotrasnvese lig - ant sufrace for pareital pleura-upper sharp border with superior costotrasverse lig-lower with post intercostal membrane)
3-tubricle: (medially surface with transverse process at same number laterally with lt costotransverse at the same number)
4-shaft :(inner and outer surface and upper and lower surface and costal groove at the lower border)
From where the thoracic duct begins?
L1-L2
Whats the bronchopulmonary segments?and how many of then in both right and left lungs?formed of?
Functional unit of lung
- formed of :tertiary bronchi,bronchiol, alveoli
- 10in rt lung - 8 in left lung
Where does the azygos vein originate and from where it passes?
From the back of IVC pass from the aortic opening
Where does the thoracic duct terminates?
At the joint between left internal jugular and left subclivian to the brachiocephalic vein
What forms the inferior hemiazygos?
Lft ascending lumbar
Lft subcostal
Whats the biggest lymph duct in the body?
Thoracic duct
Nerve supply of trachea is?
Two vagi from para
Two sympathetic chains
Whats the costo vertebral joint and its type?and supported by ?
- plane synophial
- superior small facet of the rib articulate with inferior facet of the vertebrae above
- inferior big facet of rib articulate with superior facet of vertebrae at the same level
- the cresr of the rib articulate with intervertebral disc
- triradiat ligamt
Where the cervical pleura extends and what is it covered with?
Above the thoracic inlet to the root of the neck
- covers the apex of the lung
- covered by suprapleural membrane
How many borders of the lung and related to?
- Anterior (sharp) related to costo-mediastinal recess
- posterior border(rounded) related to vertebraes
- inferior border(sharp) related to costo-diaphragmtic recess
Root of the hilum of left lung formed of?
- 1 bronchi( most posterior)
- pulmonary A the most superior (from right ventricle)
- inferior pulmonary v the most inferior
- superior pulmonary v the most Anterior
- ant and post pulmonary plexus
- 2 left bronchial Ā
- bronchiopulmonary lymph nodes
Where does the esophagus being and terminates?
Beginning: c6 lower border of pharynx (ciricoid cartilage)
Terminates : T11
Whats the xiphosternal joint and its type?
Between xiphoid and body of sternum
-secondary cartilaginous joint
Whats the anterior surface of the lung related to?
To ribs costal cartilage and intercostal space and muscles
What are the constrictions of the esophagus?
- At the beginning 6 inch from the incissors
- by aortic arch at 9
- by left bronchi at 11
- by left diaphragm curs at 16 inch
What are the fissures of the left lung?and it’s begging and ending?
One fissure
-oblique starts from 3rd spine of thoracic vertebrae and end on 6th costochondral junction
What bronchopulmonary segment is missing in the left lung?
Medial basal in the lower lobe
What lines the thoracic cavity and whats its tissue type?
Endothoracis facia(loose fibrocellular)
How many fissures in the right lung and thier begening and ending?
2 fissures
-oblique starts from 4th thoracic spine
Ends at 6th costochondral junction
-horizontal start at 4hh costal cartilage
End on the mid axillary line on the
Oblique fissure
The surface anatomy of the lung?
- About 0.5-1inch sbove medial 1/3 of calvicle
- descending to 2nd costochondral
- then to4th costochondral
- then 6th costochondral
- then the 6th rib at midclavicular line
- the 8th rib at midaxillary line
- 10 thoracic vertebrae
- the posterior part is a line from the 10 to the apex
Where the 4th to 11th post intercostal veins drain to Rt
To vena azygos
Whats the bronchopulmonary segments of the left lung?
-In upper lobe: apicopsterior, ant, superior lingual
Inferior lingual
-in lower lobe:apicobasal ,ant basal , post badal ,lateral basal
Lymph drainage from thoracic content is due to?
- brachiocephalic LN
- trachiobronchial LN
- posterior mediastinal LN
The location of brachiocephalic LN and thier affernt and efferent?
Location:-left brachiocephalic vein
Affernt:-thyroid and thymus glands, heart ,pericardium,diaphragmatic LNs,esophagus
Efferent:- bronchiomediastinal trunk
Whats the branches of internal mammary artery?
- ant intercostal 1-6
- superior epigastric A
- musculophrenic A
- perforating A
- pericardia phrenic A
- mediastinal A
Location of diaphragmatic lymph nodes and it’s affernt and efferent?
Location: onboth sides of diaphragm
Affernt:- diaphragm and upper surface of liver
Efferent:- parasternal LN,posterior mediastinal LN
Brachiocephalic LN
Then to thoracic duct then to brachiocephalic vein
Whats the accessory phrenic nerve?
C5 of the origin of phrenic nerve forms this nerve by itself
Where the suprapleural membrane connected from the apex and the base? And its function? And it covers?
Apex: transverse process of C7
Base: costal cartilage and rib medial surface
Fucntion: prevent the apex if lunf from bulging during expiration and suction during inspiration
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The apex of the lung wich is covered with cervical pleura
The location of posterior mediastinal LN and thier affernt and efferent?
Location: around the esophagus
Affernt: diaphragmatic LN,pericardium, esophagus
Efferent:thoracic duct on lt
Right thoracic duct on Rt
Whats the lymph drain from lungs and bronchi and trachea?and their efferent
- Trachiobronchial
- pumonary ln in lung tissue
- bronchopulmonary in hilum
- superior trachiobronchial above bifurcation
- inferior trachiobronchial between two bronchi
- pretrachial infront trachea
- paratrachial around trachea
- efferent to brochiomediastinal trunk
The thoracic duct in the posterior and anterior mediastinum its relation to the esophagus?
In post: right to it
In anterior: left to it
Types of plural Recesses and thier site?
- costomediastinal: in ant border of the lung behind the sternum
- costodiaphragmatic: along the inferior border of the lung
Where the 2nd and 3rd post inercostal veins drain to Rt
Unite to form superior intercostal vein then drain to arch of vena azygos
At what level the esophagus penetrate the diaphragm v
At T10
The bronchiomediastinal that drain to the thoracic duct on the lft side have tributaries ?
- parasternal lymph nodes
- brachiocephalic
- trachiobronchial
What are the sternal joints?
- Manibruisternal
- xiphosternal
- costosternal(comdrosternal)
- costochondral
- intercondral
Whats the surface anatomy of the left lung?
-Same as the right but below 4th costochondral it has deviation called superficial cardiac dullness or cardiac bare area
The righ relation of trachea?
- rt vagus nerve
- inominate A
- rt lung and plura
- arch of azygos vein
- trachiobronchial lymph nodes
Where does the trachea begin?
At the lower border of larynx opposite to C6
What are the contents of thoracic cavity?
Pleural cavities,lungs,midiastinum
Blood supply of cervical part of the trachea?and veins
Bs:inferior thyroid A
Veins: inferior thyroid veins
Whats the posterior relations of the esophagus?
- Posterior gastric N
- diaphragm
- hemiazygos v
- descending thoracic aorta and its upper branches 3-7 right posterior intercostal A
- body of vertebrate of C6-T11
- prevertebral muscle and facia
- T5 thoracic duct
Parts of the esophagus?
- Cervical part in the neck
- Thoracic part in the superior and poster mediastinum
- abdominal part
Whats the trachea?
Tube that covey the air out of the lung
Where the 2nd and 3rd post inercostal veins drain to Rt
Unite to form superior intercostal vein then drain to arch of vena azygos
The hilum of the right lung formed of? And thier arrangment? What the other name of the the bronchi?
-two brochi( the most posterior)
-one right bronchial Ā between the bronchi
-pulmonary Ā blood from right ventricle(most Ant)
-sup pulmonary V carry blood to left atrium
-inferior pulmonary V
-ant and post pulmonary plexus
-brochiopulmonary lymph nodes
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Epiatrial the superior
Hypoatrial the inferior
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Where does the suprapleural membrane extend?and its function
Medially: to transverse process of C7
Lat:to the lat part inner surface of 1st rib
-protect the cervical plexus
Where is the posterior intercostal lymph nodes located and it’s affernt and efferent?
Located:on posterior intercostal space
-affernt: posterolateral part of chest
-efferent:upper 5 to :thoracic duct
Lower 6 to cysterna chyli
From where the parasternal lymph nodes drain(affernt)? And efferent?
Affernt: deep structures of chest
Deep structure of medial half mammry g
Ant abdominal wall above ambilicus
Efferent: bronchiomediastinal trunk
Rt: to thoracic duct
Lt: to right thoracic duct
How many ribs and their classifications?
12 pair
According to the relation with sternum
-true(1-7) false[costal margin] (8-10) free(11-12)
According to specific features
-typical ribs(3-9) atypical (1-2-10-11-12)