Anatomy Thorax Book Flashcards
Course of oblique fissure
Starts at 3rd spinous
Runs until 6th CC on anterior chest wall
Course of right horizontal fissure
From Rib 5 MAL from OF
To lower border of 4th rib
Where do the lung pleura meet and separate
Run to meet obliquely at 2nd CC
Left peels away at 4th CC
6th CC- right comes away from midline
Both return at 12th
Apex beat is found where
5th ICS
MCL
Four corners of heart
Top right- third CC just right of sterum
Top left- 2nd CC- 2cm left of sternum
Bottom left- 5th ICS MCL
Bottom right- 6CC just right
What structure cross diaphragm at T12
Aorta
Lesser splanchnic
Greater
Thoracic duct
Hemizygous and azygous
Relations of thoracic duct to azygous vein, aorta and oesophagus
Thoracic duct is midline
Lies in between aorta and azygous
Aorta - lateral
Azygous- medial
Oesophagus- anterior until T4-6
Location of heart valves
All retrosternal
Aortic- 3rd ICS mid sternum
Pulmonary- 3rd CC to left of sternum
Tricuspid- 4th ICSmid sternum
Mital- 4th CC 2cm to left
Proportion of population of heart nodes supplied by RCA and LCA
SA- 60% RCA, 40% LCA
AV- 90% RCA, rest by circumflex
Course of LCA
Arrises from left posterior sinus of aorta
Passes between left auricle and left side of pulmonary trunk
Decided into LAD and LC
LAD- runs in interventricular groove anastomosing with posterior descending branch of RCA
LC- follows coronary groove to posterior heart
What does the LAD supply
LAD- supplies both ventricles and anterior interventricular septum
What occurs at T4
End of aortic arch
Azygous joins SVC
Left laryngeal loops round ligaments venosum
Pulmonary trunk bifurcates (artery)
Involvement of long thoracic and first rib in inspiration
1st rib not involved
Long thoracic- aids lifting ribs in inspiration
Movements of diaphragm in phrenic nerve damage
Main root C5
In inspiration domes due to paralysis
In expiration flattens due to increased pressure
Where are the origins of coronary arteries
Superior to aortic valve
Right - anterior aortic sinus/right coronary, left - left post
Divisions of RCA
Marginal- supplies anterior and posterior interventricular
Proportion of population that CA supplies posterior descending
Right dominant- 70%
20%- co
10% left
Where left and right phrenic nerve crosses diaphragm
left -Pierces central tendon
Right with IVC
Where sympathetic chain crosses diaphragm
Behind median arcuate line with posts
Arterial supply of oesophagus
Cervical- inferior thyroid- from thyrocerivcal from subclavian
Thoracic- descending aorta
Abdo- left gastric and eft inferior phrenic
Venous supply of oesophagus
Cervical- inferior thyroid
Thoracic- azygous
Abdo- left gastric
Three main openings in diaphragm
T8- central tendon- IVS and right phrenic
T10- muscular fibres din right crus- oesophagus, left gastric and 2 vagus nerves
T12- aorta, thoracic duct and azygous vein
Venous drainage of heart
Small vein-located on the anterior surface of the heart, in a groove between the right atrium and right ventricle. It travels within this groove onto the posterior surface of the heart, where it empties into the coronary sinus.
Middle- begins at the apex of the heart and ascends in the posterior interventricular groove to empty into the coronary sinus
Left Posterior V- located on the posterior surface of the left ventricle. It lies to the left of the middle cardiac vein and empties into the coronary sinus.
Great- It originates at the apex of the heart and ascends in the anterior interventricular groove. It then curves to the left and continues onto the posterior surface of the heart
Left marginal- post left vent- drains into great
Right Marginal drain into RA
Anterior- direct into RA
What do the Aortic arches form
1st and 2nd disappear
3rd- carotids
Right 4th- brachiocephalic and subclavian
Left 4th- aortic arch
5th disappears
6th pulmonary arteries
Relations to trachea
Anterior- brachiocephalic artery, left common carotid
Posterior- oesophagus, recurrent laryngeal
Right- vagus, azygous
Left- arch of aorta, left subclavian, left recurrent, left carotid
Diaphragm hernia locations
Left posterior- Bochdalek
Morgani- between sternum and costal- more severe
Lobe bronchus with most likely inhaled foreign object
Right lower lobe bronchus
Pathway of thoracic duct
Starts at cisterns chill at T12
Passes between aorta and azygous
T5 goes behind oesophagus
Enters at confluence of left IJ and SC
How much lymph is drained per day
4L
Drainage of right lymphatic trunk
Drain right arm, head, neck and trunk
Drains into confluence of right where subclavian and internal jugular meet
Lymph drainage of oesophagus
Cervical- internal jugular
Thoracic- mediastinal
Abdo- gastric and coeliac
Layers of oesophagus
Mucosa
Submucosa
Muscularis propsa- 2 layers- inner circular and outer longitudinal
Adventita
Narrowest constriction of oesophagus
Cicropharygeal muscle
Branches of subclavian artery
VIT C+D
Vertebral
Internal thoracic
Costocervical
Dorsal scapular
Branches of thoracic aorta
Pericardial -unpaired
Oesophageal - unapired
Mediastinal - unpaired
Posterior intercostal -paired
Superior phrenic -paired
Bronchial - paired
Subcostal- paired
Dimensions of right vs left bronchus
Left is longer
Right is shorter, fatter and more vertical
Which vertebra does rib 1 articulate with
T1 only
Where does the RCA orginate
SInus of valsalva
RIght sinus
