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)
2
Q
sagittal
A
any plane parallel to the median plane
3
Q
coronal
A
vertical plane
divides body into anterior and posterior
4
Q
horizontal (axial) (transverse)
A
plane that passes through body parallel to the horizon
divides body into cranial and caudal
5
Q
oblique
A
any section cut at any other angle
6
Q
anterior (ventral)
A
front
7
Q
posterior (dorsal)
A
back
8
Q
superior (cranial)
A
nearer the head
9
Q
inferior (caudal)
A
nearer the feet
10
Q
medial
A
nearer to median plane
11
Q
lateral
A
farther from medial plane
12
Q
proximal
A
nearer to trunk or point of origin
13
Q
distal
A
farther from trunk or point of origin
14
Q
origin
A
proximal attachment of a muscle
15
Q
insertion
A
distal attachment of a muscle
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)
17
Q
parts of sternum
A
manubrium
body
xiphoid process
18
Q
true ribs
A
1-7
attach to sternum anteriorly w cartilage extensions
19
Q
false ribs
A
8-10
do not attach to sternum, costal cartilage present
20
Q
floating ribs
A
11-12
lack costal cartilage
21
Q
rib head
A
articulates with body of corresponding vertebra, or vertebra and vertebra immediately superior
22
Q
tubercle
A
transverse process of corresponding vertebra
23
Q
shaft/body
A
bulk of rib that curves anteriorly
groove on inferior surface for intercostal vein, artery, nerve
24
Q
costal angle
A
lateral to tubercle
rib first starts to turn anteriorly
25
frequent site of rib fracture
lateral to angle of rib
26
site of insertion of iliocostalis muscles
costal angle
27
why do broken ribs rarely need surgical intervention
held to each other by 3 sets of interconnecting skeletal muscles
28
what happens when ribs are removed
grow back is periosternum is intact
29
cervical rib
elongation of transverse process ossification center of the 7th cervical vertebra
13th rib
present in 0.5-1% of pop
30
consequences of cervical rib
limit crowded thoracic aperture
lead to compression of brachial plexus nerves to the arm
compression of subclavian artery
thoracic outlet syndromes
31
superior thoracic aperture (thoracic outlet)
bound by T1 vertebra, 1st rib, and superior border of manubrium
32
arterial thoracic outlet syndrome
cervical rib compresses subclavian artery
bulge in subclavian artery downstream of the constriction
2nd bulge lateral to rib develops over time due to turbulence
33
neurogenic thoracic outlet syndrome
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
34
venous thoracic outlet syndrome
blood clot forms in a deep arm or shoulder vein
35
manubrium
triangular bone
superior edge = suprasternal notch
attachment of clavicles, 1st ribs, and half of second ribs
36
body of sternum
articulates w manubrium, ribs 2-7 and xiphoid process
37
xiphoid process
cartilaginous until 4th decade
| T10 level
38
separation between superior and middle mediastinum
```
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
```
39
pectus excavatum
sternal abnormality
sunken sternum
mitral valve prolapse and decreased lung capacity
1:150 births
40
pectus carinatum
ridge projecting anteriorly
| more rare than excavatum
41
premature sternal fusion
increased incidents of heart defects
42
sternal fistula
hole in sternum
uncommon
congenital heart defects
43
synchondrosis joint
cartilaginous joint between 1st rib and manubrium
| very little fluid
44
sternocostal joint
synovial joint between ribs 2-7 and sternum
45
costochondrial joint
union of rib bone with hyaline cartilage of the same rib (synchondrosis joint)
46
costochondritis
chets pain due to inflammation of cartilage and bones in the chest wall
overuse in athletes
secondary to heavy exercise
47
muscles of thoracic wall
external intercostal
internal intercostal
innermost intercostal
48
external intercostal muscles
run inferiorly and medially
replaced anteriorly by a membrane
raise ribs during inspiration
49
internal intercostal muscles
run inferoposteriorly
replaced posteriorly by a membrane near thoracic vertebra
interchondral parts anteriorly raise ribs
lateral fibers depress ribs
50
innermost intercostal muscles
run inferoposteriorly
replaced anteriorly and posteriorly by a membrane
depress ribs during heavy exercise
51
goal of all intercostal muscles
keep intercostal space from bulging or collapsing during respiration
52
transverse thoracic muscles
originate on inner surface of sternum
insert onto inner anterior surface of ribs 2-6
depress ribs during heavy exercise
53
subcostal muscles
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
serratus posterior superior
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
serratus posterior inferior
originates from spinous process of T11 to L2
inserts on inferior posterior border of 8th-12th ribs
depress ribs during expiration
56
levator costarum
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
neck muscles
anterior, middle, and posterior scalene muscle
58
anterior scalene
originates from transverse process of c3-c6; inserts on to scalene tubercle of 1st rib
59
middle scalene
originates from transverse process of c2-c7
| inserts on to 1st rib posterior to the subclavian artery groove
60
posterior scalene
originates from the transverse process of c5-c7
| inserts on to upper surface of 2nd rib
61
function of scalene muscles
act as elevators of the ribs during heavy inspiration
| laterally bend the neck and head to one side
62
pectoralis major
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
pectoralis minor
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
serratus anterior major
originates from upper outer surface of ribs 1-8
inserts onto medial angle, vertebral border of scapula
functions to pull scapula forward
65
intercostal nerves
ventral rami of T1 to T11
course between the internal and innermost intercostal muscles
partially under the groove of the superior ribe
66
lateral cutaneous branch
bran of intercostal nerve that goes to skin anterior to the angle of the ribs
67
anterior cutaneous branch
goes to skin near sternum
68
subcostal nerve
T12 under 12 rib onto abdominal wall
69
VAN
vein
artery
nerve
from cranial to caudal is the typical order of the structures under the groove of each rib
70
thoracentesis
invasive procedure to remove fluid or air from the pleural space
cannula is introduced through the space between the ribs into pleural space
71
thoracotomy
incision into the chest
72
layers a thoracentesis will penetrate
```
skin
subcutaneous tissue
external intercostal
internal intercostal
innermost intercostal
parietal pleura
```
73
coarctation of the aorta
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
dermatomes
areas of the skin which receive innervation from the spine
75
C5
clavicle
76
T4
teat
77
T7
xiphoid process
78
T10
umbilicus
79
L1
inguinal ligament
80
shingles
reactivation of latent herpes varicella-zoster
| unilateral condition restricted to a dermatome
81
breast adenocarcinoma
lactiferous duct carcinomas that begin as painless masses in the upper lateral quadrant
82
polythelia, polymastia
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
breast cancer in men
1.5%
not detected until late and more deadly
masses or secretion
84
gynecomastia
excessive development of male mammary gland
due to ductal proliferation and periductal edema
increased estrogen levels
65% of men between 50-80
85
right dome of diaphragm
reaches to 4th intercostal
86
left dome of diaphragm
reaches to 5th intercostal
87
3 major openings in diaphragm
T8- inferior vena cava
T10- esophageal hiatus
T12- aortic hiatus
88
diaphragm innervation
phrenic nerve from C 3,4,5
| runs with pericardiacophrenic artery and vein
89
pleurisy/pleuritis
```
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
parietal pleura subdivisions
cervical - superior to 1st rib
costal - contact w rib cage
diaphragmatic - contact w upper diaphragm
mediastinal- contact w mediastinal structures
91
costomediastinal recess
costal and mediastinal pleura meet anterior to the heart
| particularly in left pleural space
92
lingula
caudal portion of superior lobe of the left lung
| adjacent to costomediastinal recess
93
costodiaphragmatic recess
most likely to collect excess fluid
94
congenital diaphragmatic hernia (CDH)
1 in 2500 births
difficulty breathing
survival rates 60-90%
95
bochdalek hernia
hole in back of diaphragm
90% of CDH
85% in left side
96
Morgagni hernia
hole in the from of diaphragm near xiphoid process
| 2% of CDH
97
why can lungs collapse
fluid in pleural cavity is 2-6 mmHg less than atmospheric pressure
98
pneumothorax
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
empyema
condition in which pus and fluid from infected tissue collects in a body cavity
empyema thoracis in pleural cavity
100
flotation of lungs at autopsy
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
right lung impressions
groove for SVC
| groove for arch of the azygous vein
102
right hilum
rt bronchus- superior and posterior
rt pulmonary arteries- middle
rt pulmonary veins- anterior and inferior
103
left lung impression
cardiac impression
| groove for the arch of the aorta
104
left hilum
lt. bronchus- posterior
lt. pulmonary artery- superior
lt. pulmonary veins- anterior and inferior
105
right bronchus
wider, shorter, more vertical
| more likely to receive aspirated foreign body
106
left bronchus
narrower, more horizontal
107
carina
ridge that subdivides the trachea into right and left bronchi
108
pleural pain
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
mid clavicular line (anteriorly)
lungs- 6th rib
| pleural - 8th rib
110
mid axillary line (lateral scapular line)
lungs- 8th rib
| pleural- 10th rib
111
medial edge of scapula (posteriorly)
lungs- 10th rib
| pleural- 12th rib
112
inhaled foreign bodies
right inferior lobar bronchus
113
quiet inspiration
diaphragm
external intercostals
interchondral portion of internal intercostals
114
quiet expiration
passive recoil of lungs and thoracic cage
| abs
115
forced inspiration
sternocleidomastoid
scalene
levator costarum
serratus posterior superior
116
forced expiration
active contraction of rectus abdominis
external and internal obliques
serratus posterior inferior
transversus thoracis
117
hiccups
involuntary, spasmotic contractions of the diaphragm
| interrupted by spasmodic closure of glottis of the larynx
