anatomy- thorax Flashcards
modified sweat gland located at the 2ND to -6TH rib
breast
breast innervation
2nd -6th intercostal nerves
nipple location
dermatome?
4th ICS
T4
- accessory nipple
- mc congenital breast anomaly
- failure of complete regression of the milk streak
polythelia
polythelia mc location
inferior to the breast
mc location of polymastia
acillq
amastia is 90%assoc with —— syndrome?
amastia
causes nipple retraction in breast ca
mammary ducts
cause orange peel appearance in breast ca
obstruction of subcutaneous lymphatics
causes dimpling in breast ca
retraction of cooper ligament
- eczematous lesion of the nipple/areola
- assoc with underlying ductal malignancy
pagets dse
blood supply of the breast?
medial?
lateral?
- internal thoracic artery
- axillary artery
baseline mammography screening age
40 y/o
nerves identified in MRM
- long thoracic nerve
- thoracodorsal nerve
(vertebral angle)
jugular notch
t4
(vertebral angle)
sternal angle
t4/5
(vertebral angle)
xiphoid process
T9
true ribs
attached to sternum
1-7
false ribs
attached to coatal cartilage above
8-10
floating ribs
no attachment anteriorly
t11-12
typical ribs
3-9
mc location of rib fracture
5-10
rib 1-2 - severe
lower rib injury- liver or splenic injury
PE of flail chest
paradoxical chest movement
major cause of respi compromise in flail chest
respi compression
tx of flail chest
PEEP
tenderness over the costochondral joints
costochondritis/teitz syndrome
tx costochondritis
NSAIDS
vit d deficiency
PE
-rachitic rosary
harrison groove
rickets
external intercostal action
inspiration
intercostal nerve block complications
pneumothorax
hemorrhage
mngt for tension pneumothorax?
anterior approach-
lateral approach-
needle thoracostomy
2nd ICS MCL
2nd ICS AAL
definitive tx for tension pneumothorax
used for Ir removal and fluid drainage
-incision site
4th or 5th ICS
5th or 6th-snell
thoracentesis
site?
9th ics mal
end of expiration
needle angled upwards
main muscle of expiration
diaphragm
(diaphragmatic appertures)
caval opening
T?
what goes out?
t8
- ivc
right phrenic nerve
(diaphragmatic appertures)
esophageal opening
T?
what goes out?
t10
- esophagus
- vagus
- left gastric vessels
(diaphragmatic appertures)
aortic hiatus opening
T?
what goes out?
t12
-aorta
thoracic duct
azygous
hernia with SCAPHOID abdomen
- bowel sounds on the chest wall
- located posterior to the left
bochdaleck
sefect in morgagni hernia(rare and right)
septum
- 10% of population
- usually arise from the brachiocephalic artery
- identified in surgery
- lower thyroid
thyroidea ima artery
starts at the CYSTERNA chyli and enters the AORTIC opening
thoracic duct
communicates with the internal and vertebral venous plexus
-valveless
azygous
mc ANTERIOR mediastinal mass in adult
thymoma
mc ANTERIOR mediastinal mass in pedia
lymphadenopathy
mc MIDDLE mediastinal mass in adult
lymphadenopathy
mc pediatric mediastinal mass un adult
benign cyst
mc POSTERIOR mediastinal mass un adult
nerve sheath tumors
mc POSTERIOR mediastinal mass in pedia
neuroblastoma
left shoulder pain affecting C3-C4
- splenic rupture -hemorrhage within peritoneal cavity
kehr sign
intercostal approach of perocardiocentesis
5th 6th ics bear sternum
xiphisternal approach to pericardiocentesis
larreys point
pericardial effusion
-imaging
water bottle configuration
wedge shaped density in pulmonary embolism
hamptons hump
mc source of pulmo thromboembolism
thrombin in deep vein of the legs
mc lung ca
location?
adeno carcinoma
-peripheral mass
closest correlation with smoking
location?
squamous cell carcinoma
central
most malignant, assoc with with smoking
small cell ca
autoantibodies against PRESYNAPTIC voltage gated ca channels at NMJ -failure of ACH release
Lambert eatob syndrome
antibodies against POSTSYNAPTIC nicotinic receptors
myesthenia gravis
aka superior sulcus tumor, pulmonary sulcus tumor
- horners syndrome
- apical neoplasm (pancoast tumor)
pancoast tumor
often assoc with small cell carcinoma
-positive PEMBERTON sign
superior vena cava syndrome
partial development of the AP septum
-single vessel exits both ventricles and gives rise to both systemic and pulmonary circulation
persistent truncus arteriosus
- nonspiral devt of ap septum
- mc cause of cardiac cause of cyanosis in neonatal period
- cxray?
transposition of great arteries
-egg on a string
downward displacement of the tricuspid valve
imaging?
ebstein anomaly
box shaped heart
slowest velocity in the conduction system
AV node
fastest velocity in the conduction system
purkinje fibers
