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MCM Test 4 > B2.086 Intro to Gross Anatomy, Thoracic Wall, Lung Cavities, and Lungs > Flashcards

B2.086 Intro to Gross Anatomy, Thoracic Wall, Lung Cavities, and Lungs Flashcards

1
Q

median plane (midsagittal)

A

vertical plane

dividing body into right and left halves (midline)

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2
Q

sagittal

A

any plane parallel to the median plane

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3
Q

coronal

A

vertical plane

divides body into anterior and posterior

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4
Q

horizontal (axial) (transverse)

A

plane that passes through body parallel to the horizon

divides body into cranial and caudal

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5
Q

oblique

A

any section cut at any other angle

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6
Q

anterior (ventral)

A

front

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7
Q

posterior (dorsal)

A

back

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8
Q

superior (cranial)

A

nearer the head

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9
Q

inferior (caudal)

A

nearer the feet

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10
Q

medial

A

nearer to median plane

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11
Q

lateral

A

farther from medial plane

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12
Q

proximal

A

nearer to trunk or point of origin

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13
Q

distal

A

farther from trunk or point of origin

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14
Q

origin

A

proximal attachment of a muscle

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15
Q

insertion

A

distal attachment of a muscle

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16
Q

thorax

A 
extends between neck and abdomen
cage for breathing, protection of the heart, and support of upper arms
12 vertebrae
12 ribs and costal cartilage
1 sternum (3 parts)
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17
Q

parts of sternum

A

manubrium
body
xiphoid process

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18
Q

true ribs

A

1-7

attach to sternum anteriorly w cartilage extensions

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19
Q

false ribs

A

8-10

do not attach to sternum, costal cartilage present

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20
Q

floating ribs

A

11-12

lack costal cartilage

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21
Q

rib head

A

articulates with body of corresponding vertebra, or vertebra and vertebra immediately superior

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22
Q

tubercle

A

transverse process of corresponding vertebra

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23
Q

shaft/body

A

bulk of rib that curves anteriorly

groove on inferior surface for intercostal vein, artery, nerve

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24
Q

costal angle

A

lateral to tubercle

rib first starts to turn anteriorly

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25
Q

frequent site of rib fracture

A

lateral to angle of rib

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26
Q

site of insertion of iliocostalis muscles

A

costal angle

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27
Q

why do broken ribs rarely need surgical intervention

A

held to each other by 3 sets of interconnecting skeletal muscles

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28
Q

what happens when ribs are removed

A

grow back is periosternum is intact

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29
Q

cervical rib

A

elongation of transverse process ossification center of the 7th cervical vertebra
13th rib
present in 0.5-1% of pop

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30
Q

consequences of cervical rib

A

limit crowded thoracic aperture
lead to compression of brachial plexus nerves to the arm
compression of subclavian artery
thoracic outlet syndromes

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31
Q

superior thoracic aperture (thoracic outlet)

A

bound by T1 vertebra, 1st rib, and superior border of manubrium

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32
Q

arterial thoracic outlet syndrome

A

cervical rib compresses subclavian artery
bulge in subclavian artery downstream of the constriction
2nd bulge lateral to rib develops over time due to turbulence

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33
Q

neurogenic thoracic outlet syndrome

A

compression of c8 and T1 nerve roots as they pass over cervical rib
10% of patients w cervical rib have it
mimics ulnar neuropathy or Klumpke’s palsy

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34
Q

venous thoracic outlet syndrome

A

blood clot forms in a deep arm or shoulder vein

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35
Q

manubrium

A

triangular bone
superior edge = suprasternal notch
attachment of clavicles, 1st ribs, and half of second ribs

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36
Q

body of sternum

A

articulates w manubrium, ribs 2-7 and xiphoid process

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37
Q

xiphoid process

A

cartilaginous until 4th decade

T10 level

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38
Q

separation between superior and middle mediastinum

A 
sternal angle of lewis
2nd rib
junction of manubrium w nody of sternum
between T4 and T5
azygous veins drain into SVC
inferior part of arch of aorta
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39
Q

pectus excavatum

A

sternal abnormality
sunken sternum
mitral valve prolapse and decreased lung capacity
1:150 births

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40
Q

pectus carinatum

A

ridge projecting anteriorly

more rare than excavatum

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41
Q

premature sternal fusion

A

increased incidents of heart defects

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42
Q

sternal fistula

A

hole in sternum
uncommon
congenital heart defects

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43
Q

synchondrosis joint

A

cartilaginous joint between 1st rib and manubrium

very little fluid

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44
Q

sternocostal joint

A

synovial joint between ribs 2-7 and sternum

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45
Q

costochondrial joint

A

union of rib bone with hyaline cartilage of the same rib (synchondrosis joint)

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46
Q

costochondritis

A

chets pain due to inflammation of cartilage and bones in the chest wall
overuse in athletes
secondary to heavy exercise

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47
Q

muscles of thoracic wall

A

external intercostal
internal intercostal
innermost intercostal

48
Q

external intercostal muscles

A

run inferiorly and medially
replaced anteriorly by a membrane
raise ribs during inspiration

49
Q

internal intercostal muscles

A

run inferoposteriorly
replaced posteriorly by a membrane near thoracic vertebra
interchondral parts anteriorly raise ribs
lateral fibers depress ribs

50
Q

innermost intercostal muscles

A

run inferoposteriorly
replaced anteriorly and posteriorly by a membrane
depress ribs during heavy exercise

51
Q

goal of all intercostal muscles

A

keep intercostal space from bulging or collapsing during respiration

52
Q

transverse thoracic muscles

A

originate on inner surface of sternum
insert onto inner anterior surface of ribs 2-6
depress ribs during heavy exercise

53
Q

subcostal muscles

A

small slips of muscle
attach to the inner surface of the lower ribs on the posterior portion of the thoracic wall
run 2 ribs long (skip a rib)
depress ribs

54
Q

serratus posterior superior

A

originates from nuchal ligament and spinous process of C7 to T3
inserts on superior posterior border of 3rd-6th ribs
raise ribs during inspiration

55
Q

serratus posterior inferior

A

originates from spinous process of T11 to L2
inserts on inferior posterior border of 8th-12th ribs
depress ribs during expiration

56
Q

levator costarum

A

small short muscle slips
originate from transverse processes of C7 to T11
insert on upper posterior edge of the rib just inferior
elevate ribs during inspiration

57
Q

neck muscles

A

anterior, middle, and posterior scalene muscle

58
Q

anterior scalene

A

originates from transverse process of c3-c6; inserts on to scalene tubercle of 1st rib

59
Q

middle scalene

A

originates from transverse process of c2-c7

inserts on to 1st rib posterior to the subclavian artery groove

60
Q

posterior scalene

A

originates from the transverse process of c5-c7

inserts on to upper surface of 2nd rib

61
Q

function of scalene muscles

A

act as elevators of the ribs during heavy inspiration

laterally bend the neck and head to one side

62
Q

pectoralis major

A

originates from costal margin, sternum, and medial clavicle
inserts onto crest of the greater tubercle of the humerus
functions to flex, adduct, and medially rotate arms

63
Q

pectoralis minor

A

originates from outer surface of ribs 3-5
inserts onto the coracoid process of the scapula
fun
functions to pull scapula down and anteriorly

64
Q

serratus anterior major

A

originates from upper outer surface of ribs 1-8
inserts onto medial angle, vertebral border of scapula
functions to pull scapula forward

65
Q

intercostal nerves

A

ventral rami of T1 to T11
course between the internal and innermost intercostal muscles
partially under the groove of the superior ribe

66
Q

lateral cutaneous branch

A

bran of intercostal nerve that goes to skin anterior to the angle of the ribs

67
Q

anterior cutaneous branch

A

goes to skin near sternum

68
Q

subcostal nerve

A

T12 under 12 rib onto abdominal wall

69
Q

VAN

A

vein
artery
nerve
from cranial to caudal is the typical order of the structures under the groove of each rib

70
Q

thoracentesis

A

invasive procedure to remove fluid or air from the pleural space
cannula is introduced through the space between the ribs into pleural space

71
Q

thoracotomy

A

incision into the chest

72
Q

layers a thoracentesis will penetrate

A 
skin
subcutaneous tissue
external intercostal
internal intercostal
innermost intercostal
parietal pleura
73
Q

coarctation of the aorta

A

stenosis of the aorta
increased blood flow within the intercostal arteries
can lead to engorgement of the intercostal arteries and costal notching of the under surface of the ribs

74
Q

dermatomes

A

areas of the skin which receive innervation from the spine

75
Q

C5

A

clavicle

76
Q

T4

A

teat

77
Q

T7

A

xiphoid process

78
Q

T10

A

umbilicus

79
Q

L1

A

inguinal ligament

80
Q

shingles

A

reactivation of latent herpes varicella-zoster

unilateral condition restricted to a dermatome

81
Q

breast adenocarcinoma

A

lactiferous duct carcinomas that begin as painless masses in the upper lateral quadrant

82
Q

polythelia, polymastia

A

extra nipples or breast that develop along the embryonic mammary ridge
thelia (nipple) more common than mastia (breast)
associated w increase incidence of renal abnormalities including duplication of ureters

83
Q

breast cancer in men

A

1.5%
not detected until late and more deadly
masses or secretion

84
Q

gynecomastia

A

excessive development of male mammary gland
due to ductal proliferation and periductal edema
increased estrogen levels
65% of men between 50-80

85
Q

right dome of diaphragm

A

reaches to 4th intercostal

86
Q

left dome of diaphragm

A

reaches to 5th intercostal

87
Q

3 major openings in diaphragm

A

T8- inferior vena cava
T10- esophageal hiatus
T12- aortic hiatus

88
Q

diaphragm innervation

A

phrenic nerve from C 3,4,5

runs with pericardiacophrenic artery and vein

89
Q

pleurisy/pleuritis

A 
inflammation of the pleural membrane
due to viral or bacterial causes
can lead to pleural friction and adhesions of the visceral and parietal layers
sharp stabbing pain on inhalation
rubbing can be hear w stethoscope
90
Q

parietal pleura subdivisions

A

cervical - superior to 1st rib
costal - contact w rib cage
diaphragmatic - contact w upper diaphragm
mediastinal- contact w mediastinal structures

91
Q

costomediastinal recess

A

costal and mediastinal pleura meet anterior to the heart

particularly in left pleural space

92
Q

lingula

A

caudal portion of superior lobe of the left lung

adjacent to costomediastinal recess

93
Q

costodiaphragmatic recess

A

most likely to collect excess fluid

94
Q

congenital diaphragmatic hernia (CDH)

A

1 in 2500 births
difficulty breathing
survival rates 60-90%

95
Q

bochdalek hernia

A

hole in back of diaphragm
90% of CDH
85% in left side

96
Q

Morgagni hernia

A

hole in the from of diaphragm near xiphoid process

2% of CDH

97
Q

why can lungs collapse

A

fluid in pleural cavity is 2-6 mmHg less than atmospheric pressure

98
Q

pneumothorax

A

result of a traumatic injury to the wall of lung or an infection causing a hole in the lung
allows air into pleural space
inherent elasticity of lung causes it to collapse on itself

99
Q

empyema

A

condition in which pus and fluid from infected tissue collects in a body cavity
empyema thoracis in pleural cavity

100
Q

flotation of lungs at autopsy

A

lungs that take taken in air will float when cut and placed in water
lungs which have never taken a breath of lungs that inhaled water actively will sink in water

101
Q

right lung impressions

A

groove for SVC

groove for arch of the azygous vein

102
Q

right hilum

A

rt bronchus- superior and posterior
rt pulmonary arteries- middle
rt pulmonary veins- anterior and inferior

103
Q

left lung impression

A

cardiac impression

groove for the arch of the aorta

104
Q

left hilum

A

lt. bronchus- posterior
lt. pulmonary artery- superior
lt. pulmonary veins- anterior and inferior

105
Q

right bronchus

A

wider, shorter, more vertical

more likely to receive aspirated foreign body

106
Q

left bronchus

A

narrower, more horizontal

107
Q

carina

A

ridge that subdivides the trachea into right and left bronchi

108
Q

pleural pain

A

visceral pleura and lungs have no pain nerve fibers themselves
parietal pleura is innervated with pin fibers
diaphragm pain may be referred in neck and shoulder regions

109
Q

mid clavicular line (anteriorly)

A

lungs- 6th rib

pleural - 8th rib

110
Q

mid axillary line (lateral scapular line)

A

lungs- 8th rib

pleural- 10th rib

111
Q

medial edge of scapula (posteriorly)

A

lungs- 10th rib

pleural- 12th rib

112
Q

inhaled foreign bodies

A

right inferior lobar bronchus

113
Q

quiet inspiration

A

diaphragm
external intercostals
interchondral portion of internal intercostals

114
Q

quiet expiration

A

passive recoil of lungs and thoracic cage

abs

115
Q

forced inspiration

A

sternocleidomastoid
scalene
levator costarum
serratus posterior superior

116
Q

forced expiration

A

active contraction of rectus abdominis
external and internal obliques
serratus posterior inferior
transversus thoracis

117
Q

hiccups

A

involuntary, spasmotic contractions of the diaphragm

interrupted by spasmodic closure of glottis of the larynx

MCM Test 4 (19 decks)

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