Anatomy Thorax Flashcards
anterior and posterior articulations of ribs
posterior: all articulate with vertebrae
anterior:
ribs 1-7 attach to sternum
ribs 8-10 attach to costal cartilage above them
ribs 11-12 “floating ribs” no attachment
flail chest
fracture of 2 or more adjacent ribs - paradoxial movement of chest when breathing
what embryonic structure gives rise to thymus
3rd pharyngeal pouch
thymus is found in what compartment and what is its function
superior mediastinum, posterior to manubrium of sternum
helps in development immune system in adolescence then becomes fat
syndrome where thymus does not develop
DiGeorge syndrome "CATCH" Congenital heart defects Abnormal facies Thymus aplasia --> prone to recurrent infections Cleft palate Hypoparathyroidism
what structures in breast are involved in lactation
mammary glands (modified sweat glands)
blood supply to medial side of breast
internal thoracic/mammary artery (from subclavian)
blood supply to lateral side of breast
- lateral thoracic and lateral thoracoacromial
- lateral mammary
- mammary branch
levels of lymph nodes in axillary dissection for breast cancer
level 1: below pectoralis minor (lateral)
level 2: under it
level 3: above it (medial)
What structures are found in lung hilum
bronchus, pulmonary artery, 2 pulmonary veins, nerves+vessels
which bronchus has higher risk of foreign body inhalation
right bronchus due to wider shape and more vertical course
Types of emboli
Thrombus
Fat, from bone fracture or ortho surgery
Air, from neck cannulation
Where do the bronchial veins drain
right bronchial into azygos vein
Left bronchial into accessory hemiazygos vein
SVC is the direct convergence of which 2 veins
Location of this union
right and left brachiocephalic veins
Posterior to first right costal cartilage
What vein is important for right atrium pressure
SVC is valveless so pressure of right atrium is the same as SVC and its branches –> right internal jugular vein
How to measure jugular venous pressure
visualize it with patient at 45 degrees amd head turned left, pulsation between 2 heads of SCM
Causes of raised JVP
right sided heart failure, SVC obstruction, pulmonary hypertension
Test for SVC obstruction
Pemberton’s test
Raise both arms above head, positive test if facial edema or cyanosis after 1 minute
What are the 3 openings in the diaphragm
T8 ‘caval’ for IVC
T10 for esophagus
T12 for aorta
Phrenic nerve roots
C3-5
Phrenic nerve paralysis features
PFTs: Restrictive deficit
If unilateral, asymptomatic
If bilateral, poor exercise tolerance, orthopnea, fatigue
Anterior mediastinum mass differential
thymoma, teratoma, thyroid goiter, lymphoma
Blood supply of heart
RCA: Right marginal, posterior interventricular
LCA: LAD, left marginal, left circumflex
MI changes on leads II, III, aVF
Inferior
RCA
MI changes on leads V3, V4
Anteroapical
Distal LAD
MI changes on leads V1, V2
anteroseptal
LAD
MI changes on leads I, aVL, V5, V6
Anterolateral
Circumflex artery
MI changes on leads I, aVL, V2-V6
Anterior
Proximal LCA
How is a signal conducted in heart
an action potential is created by the sinoatrial (SA) node.
The wave of excitation spreads across the atria, causing them to contract.
Upon reaching the atrioventricular (AV) node, the signal is delayed.
It is then conducted into the bundle of His, down the interventricular septum.
The bundle of His and the Purkinje fibres spread the wave impulses along the ventricles, causing them to contract.
