Anatomy-Thorax & Back Flashcards
1
Q
What is located at the bifurcation of the trachea into the R/L primary bronchi?
A
Sternal angle
2
Q
The angle formed from the junction of the 12th rib and vertebral column
A
Costovertebral angle (CVA)
3
Q
The _________ are located deep to the costovertebral angle
A
Kidneys
4
Q
On the anterior view, the inferior border of the lungs spans from the costal cartilage of the _________th rib to the __________ th rib
A
6,8
5
Q
Aortic valve located at what intercostal ICS
A
Right 2nd ICS
6
Q
Pulmonary valve located at what ICS
A
Left 2nd ICS
7
Q
Erb’s point located at what ICS
A
Left 3rd ICS
8
Q
Tricuspid valve located at what ICS
A
Left 4th ICS or 5th ICS at left sternal border
9
Q
Mitral valve located at what ICS
A
Left 5th ICS midclavicular line
10
Q
Apex of the heart located at what ICS
A
Just inferior/medial to left nipple in 5th ICS
11
Q
In the female breast, this landmark extends along the inferior border of the pec to the axilla
A
Axillary process
12
Q
75% of great lymph drains into
A
Axillary lymph nodes
13
Q
True ribs
A
1-7
14
Q
Components of the sternum
A
Manubrium
Body
Xiphoid process
15
Q
False ribs
A
8-10
16
Q
Floating ribs
A
11-12
17
Q
Typical ribs
A
3-9
18
Q
Atypical ribs
A
1,2, 10-12
19
Q
Tubercle of typical ribs
A
Articulates with transverse process of thoracic vertebrae
20
Q
Costal angle of typical ribs
A
Common site of rib fracture, weakest point of the rib
21
Q
Superior aperture contents
A
Esophagus, trachea, nerves, blood vessels
22
Q
Inferior aperture contents
A
Esophagus, IVC, aorta
23
Q
Rib articulation with costal cartilage
A
Costochondrial joints
24
Q
Articulation between costal cartilage and sternum
A
Sternocostal joints
25
Articulation between sternum and clavicle
Sternoclavicular joint
26
What muscle on the inner wall of the rib cage depresses the ribs during expiration?
Transversus thoracis
27
Innervation of diaphragm
Phrenic nerve (C3-C5)
28
Diaphragm will _______ during inspiration
Flatten (contract)
29
Most posterior of the three openings in the diaphragm
Aortic hiatus
30
What travels in the intercostal space deep to the internal intercostal muscle?
VAN (vein, artery, nerve)
31
This artery supplies the anterior intercostal artery from the font
Internal thoracic artery
32
This artery supplies the posterior intercostal artery from the back
Thoracic aorta
33
The anterior and posterior intercostal arteries form a
Anastomosis
34
Thoracic spinal nerves exit the
Intervertebral foramen
35
Landmark for performing Thoracentesis
Near the inferior rib in the intercostal space
36
Which two arteries are the initial supply of blood to the thorax?
Aorta
Subclavian artery
37
The aorta supplies what two thoracic arteries
Posterior intercostal arteries
Bronchial arteries
38
The subclavian artery supplies what thoracic artery
Internal thoracic artery
39
Internal thoracic artery aka
Internal mammary artery
40
As the mammary artery descends, what branches off of it
Anterior intercostal arteries
41
The mammary artery continues to descend into the abdominal region and is named
Superior epigastric artery
42
Drains blood from the left side 1st-4th intercostal veins
Left brachiocephalic vein
43
Drains blood from the left side 5th-8th intercostal veins
Accessory hemi-azygos vein
44
Drains blood from the left side 9th-11th intercostal veins
Hemi-azygos vein
45
Azygos system acts as a ________ if needed
Collateral pathway
46
Forms the back wall of the trachea
Trachealis muscle
47
How many intersegmental bronchi
20-25
48
Apex of lungs is superior or inferior
Superior
49
Base of lungs is superior or inferior
Inferior
50
What is contained in the hilium?
Primary bronchus
Pulmonary arteries/veins
Lymph vessels/nodes
51
Landmark of the superior lobe in left lung
Lingula
52
Cardiac notch located on which lung
Left
53
Visceral pleura pain sensation or not?
Limited nociception
54
Parietal pleura pain sensation or not?
Focal nociception
55
Formed between the diaphragmatic parietal pleura and the costal parietal pleura
Costodiaphragmatic recesses (CDR)
56
Junction of the ribs and diaphragm that is visualized on chest x-ray
Costophrenic angle
57
Pulmonary circulation
Provides blood to the alveoli for gas exchange
58
Parietal pericardium is composed of what two layers
Fibrous and serous pericardium
59
Attaches to the central tendon of the diaphragm via the pericardiophrenic ligament
Fibrous pericardium
60
This nerve descends between fibrous pericardium and mediastinal pleural walls
Phrenic vein
61
Potential space between parietal and visceral layers of serous pericardium
Pericardial cavity
62
What arteries originate at the base of the aorta
Coronary arteries
63
Backflow pressure gradient occurs during which phase of the cardiac cycle
Early diastole (isovolumetric relaxation)
64
3 branches of the RCA
Nodal branches
Marginal branches
Posterior descending
65
3 branches of the LCA
Left anterior descending
Circumflex
Marginal
66
Most of the cardiac veins drain into
Coronary sinus
67
The point of maximal impulse is heard at which ICS
5th ICS midclavicular
68
Border between the superior and inferior mediastinum located at the level of
T4/T5 and sternal angle
69
Content of superior mediastinum
Thymus in children (remnants in adults)
Arch of aorta
Trachea
Esophagus
70
Content of anterior mediastinum
Internal thoracic vessels
Fat
Lymph nodes
71
Content of middle mediastinum
Pericardium
Heart
Root of great vessels
72
Content of posterior mediastinum
Esophagus
Descending aorta
Thoracic duct
Lymph nodes
73
CXR taken during inspiration or expiration?
Inspiration
74
Preferred CXR view?
PA
75
Costovertebral angle located at the level of
T12
76
Functions of vertebral column
Absorb shock
Protect spinal cord
77
Primary curve results in _______ posture
Kyphotic
78
Secondary curves results in ________ posture
Lordotic
79
What can cause a lordotic posture?
Orthopedic anomalies
Postural habits
Pregnancy
80
What can cause a kyphotic posture?
Compression fracture, postural habits, pathology
81
What are two components of scoliosis?
Lateral deviation
Rotary component
82
4 movements of the vertebral column
Flexion
Extension
Lateral flexion
Rotation
83
Projects posteriorly from the junction of the R/L lamina
Spinous process
84
Projects laterally from the junction of pedicles and lamina
Transverse process
85
Projects from the junction of pedicle and lamina in typical vertebrae
Superior and inferior articular processes
86
Formed “between vertebrae” via the vertebral notches of 2 adjacent segments (in typical vertebrae)
Intervertebral foramen
87
Formed by the body and the vertebral arch in typical vertebrae
Vertebral foramen
88
The vertebral foramen from 2 or more vertebrae
Vertebral canal
89
Components of the atypical vertebrae C1
Anterior arch
Anterior tubercle
Posterior arch
Posterior tubercle
Lateral masses
Transverse process
90
Components of the atypical vertebrae C2
Dens (Odontoid process)
Vertebral body
Transverse body
91
Which cervical vertebrae spinous process is most prominent?
C7
92
Which cervical vertebrae spinous process are bifid?
C3-C5
93
Located on superior portion of cervical vertebrae bodies; “raised lateral edges”
Uncinate processes
94
The vertebral foramen of thoracic vertebrae are smaller or larger than cervical vertebrae?
Smaller
95
“Kidney shaped body”
Lumbar vertebrae
96
Lumbar vertebrae
“Hatchet shape” spinous process
97
Inferior end of sacrum
Apex
98
Superior portion of S1
Base
99
Prominent anterior edge of S1
Promontory
100
Superior/lateral portion of sacrum
Ala
101
Formed by failure of lamina of S5 to fuse
Sacral hiatus
102
Formed by the pedicles of S5
Sacral Cornu
103
Contain nerve roots of cauda equina
Sacral canal
104
Wedge shaped bone of 4 fused coccygeal vertebrae
Coccyx
105
Synovial joints between superior and inferior facets of articular process
Facet joints
106
Facet joints are prone to
Osteoarthritis, bone spurs
107
Intervertebral disc joint
Shock absorber, influences motion
108
Concentric layers of collagen fibers in the intervertebral disc
Annulus fibrosus
109
Annulus fibrosis is a potential source of
Pain
110
Center of intervertebral disc
Nucelus pulposus
111
Radicular pain results from
Herniation, nerve compression
112
Discogenic pain caused by
Fissures
113
Joints of Luschka
Joint formed by the uncinate process of C3-C7
114
Joints of Luschka considered a “_________” joint
pseudo
115
Atlanto-axial joint
Joint 1: dens and anterior arch
Joint 2: R/L facet joints C1 and C2
116
Atlanto axial joint allows what movement
Rotation of head/neck
117
Synovial joints between C1 facet and occipital condyles
Atlanto-occipital joint
118
Ligament: Anterior portion of the vertebral column
Anterior longitudinal ligament (ALL)
119
Ligament: Posterior vertebral column with vertebral canal
Posterior longitudinal ligament (PLL)
120
Connects the lamina between each vertebrae
Ligamentum flavum
121
Ligamentum Flavum has a high ______ content
Elastin
122
Ligament: Connect adjacent spinous processes along inferior and superior border of SP
Interspinous ligaments (ISL)
123
Ligament: Connect adjacent spinous processes
Supraspinous ligament (SSL)
124
Anterior atlanto-occipital membrane (AAOM) is a continuation of
ALL
125
Tectorial membrane is a continuation of
PLL
126
Posterior Atlanta-occipital membrane is a continuation of
Ligamentum Flavum
127
Nuchal ligament is a continuation of
Supraspinous ligament
128
Acts a septum separating the muscles of the R/L posterior neck
Nuchal ligament
129
Stabilizes the dens against the anterior arch of C1
Cruciate ligament
130
Extends from sides of dens to lateral margin of foramen magnum
Alar ligament
131
Apical ligament
Apex of dens to foramen magnum
132
3 main layers of back muscles
Superficial
Intermediate
Deep (divided into superficial, intermediate, and deep)
133
Superficial layer muscles of the back
Trapezius
Latissmus dorsi
Rhomboid major/minor
Levator scapula
134
Attachments of trapezius
Occiput, Nuchal ligament, and spinous process
Spine of scapula
135
Attachments of latissimus dorsi
SPs of lower T spine, thoracolumbar fascia, iliac crest
136
Attachments of Rhomboids
Medial border of scapula
Nuchal ligament
137
Levator scapula attachments
Medial border of scapula
TPs of C1-C4
138
Intermediate layer muscles of back
Serratus posterior superior
Serratus posterior inferior
139
Serratus posterior superior located _________ to rhomboids
Deep
140
Serratus posterior superior attachments
Upper ribs
SPs of C7-T3
141
Action of Serratus posterior superior
Elevate ribs
142
Attachments of Serratus posterior inferior
Lower ribs
SPs of T11-L1
143
Action of Serratus posterior inferior
Depress ribs
144
Superficial muscle of deep layer
Splenius capitis/cervicis
145
Intermediate muscle of deep layer
Erector spinae
146
Deep muscles of deep layer
Semispinalis
Multifidi
Rotators
147
Actions of splenius capitis/cervicis
Ipsilateral flexion and rotation to same side
148
Erector spine composed of what three muscles
Ilicostalis
Longissimus
Spinalis
149
Actions of erector spine muscles
Extension of back
Assist with flexion of back (eccentric)
150
Action of deep muscles
Contralateral rotation of spine
151
4 sub-occipital muscles
Rectus capitis posterior major
Rectus capitis posterior minor
Obliquus capitis inferior
Obliquus capitis superior
152
Sub occipital triangle formed by what three muscles
Rectus capitis posterior major
Obliquus capitis inferior
Obliquus capitis superior
153
Content of sub-occipital triangle
Vertebral artery
Sub occipital nerve (CN 1)
154
Termination of spinal cord at T12/L1 is called
Conus medullaris
155
Lumbosacral nerve roots descending in vertebral and sacral canal
Cauda equina
156
Dura extension anchors to coccyx
Filum terminale
157
Pia extension anchor spinal cord to dura
Dentate ligaments
158
How many cervical spine roots?
8
159
3 components of radiculopathy
Sensory
Motor
Reflex
160
The outer layer meninges do not ___________
Adhere to the bones in the vertebral canal
161
Lumbar cistern is the location for
Lumbar puncture
162
Subarachnoid space in lumbar region of vertebral column
Lumbar cistern
163
Spina bifida occulta
Most common and least severe form of spina bifida without protrusion of the spinal cord or meninges
164
Spina bifida meningocele
Meninges protrude through bony defect
165
Spina bifida meningomyelocele
Herniation of meninges and nerve roots through defect, associated with neurological deficits
166
Arnold-Chiari type 2 malformation
Group of cranial abnormalities associated with Spina bifida.
Brain stem/cerebellum is pulled through foramen magnum into the upper spinal canal
167
Supplies anterior 2/3 of spinal cord
Anterior spinal artery
168
Supplies posterior 1/3 of spinal cord
Posterior spinal arteries (pair of arteries)
169
Massive longitudinal venous plexus system drains
Azygos system
Iliac veins of pelvis
Head/neck veins
170
Valve less network of veins that are located longitudinally within vertebral canal
Internal vertebral plexus (Batson plexus)
171
Female breast tissue ribs
2-6
172
What is contained in the canal foramen?
IVC
173
Clinically, internal mammary artery often used for
CABG
174
How many pulmonary veins go into left atrium?
4
175
Nodal branches supply
SA/AV nodes
176
Which coronary artery is commonly known as the widow maker
Left anterior descending
177
Point of maximal impulse (PMI)
5th intercostal space, midclavicular line
178
4 CXR positions
PA
AP
Lateral
Lateral decubitus
179
Primary curves
Thoracic and sacral
180
Facet joints function
Some weight bearing function in C and L region
181
What creates stenosis of IVF
Bone spurs
182
No intervertebral disc between
C1 and C2, C1 and occiput
183
How many sections does cruciate ligament have
3
184
Least common type of Spina bifida
Meningocele
185
What ICS is an incision made for a chest tube and where
5th or 6th ICS midaxillary line
186
Lung decortication
Removal of infected intrapleural blood that has clotted and formed fibrous
187
Hemopericardium
Blood in the pericardial sac
188
What might cause hemopericardium
Perforation due to a pervious MI, stab wounds, operations
189
Most common site for coarctation of the aorta
Ligamentum arteriosum
