Blackcloud Body Wall and Thorax p.1-18 Flashcards
most superficial thoracic wall muscle
external intercostal m.
deeper thoracic wall muscles, fiber perpedicular to external intercostal
internal thoracic muscles
internal to intercostal, attached t osternum and inner surface of ribs
tranversus thoracis
intercostal vessels from superior to inferior
intercostal vein, artery, nerve
anterior intercostal arteries are ____ than posterior intercostal arteries
much smaller
posterior intercostal arteries arise from
descending aorta (most superior, from branches of the subclavian)
posterior intercostal arteries anastomose with
anterior intercostals, duh
intercostal nerves are (come from)
ventral rami of spinal nerves 1 t o11
First 6 instercostal nerves run
within an intercostal space
intercostal ribs 7-11
being intercostally, run along anterior abdominal body wall
branches of internal thoracic artery
musculophrenic and superior epigastric arteries
fluid, blood or pus can safely be removed from
costodiaphragmatic recess
where to insert needle to reach costodiaphragmatic space
near middle of 9th intercostal space
blood supply and innervation of visceral layer is same as
the organ
blood supply and innervation of parietal layer is same as
adjacent body wall
parietal pericardium is innervated by
phrenic nerve
parietal pericardium receives blood from which two branches of the internal thoracic artery, and what else?
pericardiophrenic artery, musculophrenic artery, descending thoracic aorta
parietal pleura is innervated by
phrenic nerve & intercostal nerves
parietal pleura receives blood from
intercostal arteries
parietal pericardium cannot be separated from
the diaphragm
visceral pericardium cannot be separated from
the heart
the place between the two pleural cavities is called
the mediastinum
mediastinum superior border
superior thoracic aperture, an imaginary line from T1 to superior borer of manubrium
mediastinum inferior border
diaphragm
mediastinum posterior border
vertebral column
mediastinum anterior border
sternum
superior mediastinum
thoracic inlet to T4-5
anterior mediastinum
sternum to pericardium
middle mediastinum
space occupied by heart
posterior mediastinum
back of pericardium to T4-12
brachiocephalic veins drain
upper limbs, head and neck
upper half of superior vena cava drains
from upper half of body to right atrium
arch of the azygous vein drains
from posterior walls of thorax and abdomen into superior vena cava
ventral rami of C3,4,5
phrenic nerve
phrenic nerve innervates
diaphragm, parietal pericardium, mediastinal parietal pleura
phrenic nerve and pericardiophrenic vessels pass ____ the root of the lung
in front of
vagus nerve passes ____ the root of the lung
behind
passes posterior to the ligamentum arteriosum to reach the trachea
left recurrent laryngeal nerve
the vagus nerve provides
parasympathetic innervation to thoracic viscera
the vagus nerve breaks up into _____ before branching into _______
esophageal plexus, left vagus nerve (becomes anterior vagal trunk) and right vagus nerve (becomes posterior vagal trunk)
the fibrous pericardium, what is it good for?
continuous with central tendon of diaphragm, protects the heart from sudden overfilling and anchors it to the wall
the two layers of the serous pericardium are called what?
parietal layer, visceral layer
what runs posterior to the pulmonary trunk and aorta, anterior to superior vena cava?
transverse pericardial sinus
where do the arterial and venous ends of the developing heart meet?
transverse pericardial sinus
what is underneath the heart, up to a superior border of parietal and visceral pericardium?
oblique pericardial sinus
what facilitates clamping the aorta and pulmonary trunk during cardiac surgery?
transverse pericardial sinus
right coronary artery runs in which sulcus?
coronary (atrioventricular) sulcus
anterior interventricular artery runs in which sulcus?
anterior interventricular sulcus
what runs in the posterior intraventricular sulcus?
posterior interventricular artery
where does the posterior interventricular artery branch from?
right coronary artery (70%) or anterior interventricular artery (30%)
what vein runs in the anterior interventricular sulcus and coronary sulcus and becomes the coronary sinus?
great cardiac vein
where does the coronary sinus enter the heart?
right atrium
what vein runs in the posterior interventricular sinus and drains into the coronary sinus?
middle cardiac vein
anterior cardiac vein drains directly into
right atrium
a branch of the right coronary artery at or near the intersection of the coronal and posterior interventricular sulci
antrioventricular nodal artery
arterial blockages of right coronary artery are of primary concern in:
Right-dominant hearts (15% of population, right coronary continues in atrioventriuclar sulcus past the interventricular sulcus
In left-dominant hearts, ____ gives rise to posterior interventricular artery
circumflex branch of left coronary
patent foramen ovale found in
right atrium, 20% of population
what opens into right atrium
SVC, IVC, coronary sinus
pectinate muscle in right atrium attach to
crista terminalis
near tricuspid valve, right ventricle raises into ridges called
trabeculae carneae
Cone-shaped entrance to pulmonary trunk is found in the _____ and called ____
right ventricle, conus arteriosis
most of the diaphragmatic surface of the heart is formed by the
left ventricle
trabeculae carneae are found
in both ventricles
four pulmonary veins run into
left atrium
valve between right atrium and right ventricle
tricuspid (anterior, septal, posterior)
cusps are anchored to ____ by ____
papilllary muscles (extensions of trabeculae carneae), tendinous cords
valve between left atrium and left ventrical
mitral valve
contraction of papillary muscles
prevents them from prolapsing. Valve opening and closing is passive
what are the two semilunar valves
pulmonary and aortic
aortic valve has
right, left, and posterior cusps
pulmonary valve has
right, left and anterior cusps
ventricles relax and fill
diastole. mitral and tricuspid valves are open
ventricles contract and empty
systole. Aortic and pulmonary valves are open
the heart receives sympathetic innervation from
splanchnic nerves from sympathetic chain at cervical level and T1-T4
pass through ventral roots, spinal nerve, and white ramus communicantes from T1-T4
presynaptic sympathetic axons (to heart)
travel in cervical and upper thoracic splanchnic nerves passing through cardiac plexus to reach heart
Postsynaptic sympathetic axons (to heart)
the only time that sympathetics dilate
coronary artery vasodilation
heart receives parasympathetic innervation from
vagus nerve
located within vagal nuclei in the brainstem
presynaptic parasympathetic neuronal bodies (to heart)
synapse in tiny ganglions within cardiac plexus or within walls of the atria
presynaptic parasympathetic neuronal bodies (to heart)
parasympathetic action in heart
vasoconstriction of coronal arteries, decreased heart rate and force of contraction
GA for reflexes return with
vagus nerve
GA for pain return with
cervical and/or upper thoracic splanchic, through sympathetic ganglia and white ramus comminicantes to reach spinal nerves and dorsal roots
blockages in coronary arteries cause
myocardial ischemia, due to insufficient anastomoses
sensory innervation in heart sensitive to
oxygen changes, but not temperature or cutting
what is responsible for initiating and coordinating heartbeat?
sinuatrial and atrioventricular nodes
which node is faster (pacemaker)?
Sinuatrial node
series of fibrous rings surrounding atrioventricular and semilunar valves
cardiac skeleton
role of cardiac skeleton
stabilizes valves, serves as an attachment site for cardiac muscle fibers, electrically isolates atria from ventricles
ridge of cartilage in the midline of the bifurcation between the primary bronchii
carina
brnaches of the aorta, supply oxygenated blood to lungs and visceral pleura
bronchial arteries
tributaries of azygous system, drain blood form structures within or close to root of lung
bronchial veins
right bronchial vein drains into
azygous vein
left bronchial vein drains into
accessory hemiazygous vein
pulmonary arteries contain
deoxygentaed blood
pulmonary veins contain
oxygenated blood
pulmonary arteries are initially ____ pulmonary veins, then ____ as they enter the lungs
superior to, posterior to
which pulmonary artery is longer?
right
the bronchii are ____ to the pulmonary arteries and veins in the root of the lung
posterior to
sympathetic innervation to lungs: presynaptic
neurons loacted T1-T4, through white ramus communicantes, synapse in upper thoracic sympathetic chain ganglia from T1-T4
sympathetic innervation to lungs: postsynaptic
travel in upper thoracic splanchnic nerves through pulmonary plexus to lungs
symapthetic innervation to lungs: action
inhibit bronchial glands, inhibit smooth muscle, cause vasoconstriction of vasculature,
parasympathetic innervation to lungs: presynaptic
from vagal nuclei in brainstem, through sensory ganglion of vagus nerve, to pulmonary plexus, synapsing on tiny ganglia.
parasympathetic innervation to lungs: postsynaptic
from pulmonary plexus to lungs
parasympathetic to lungs: action
secretomotor to bronchial glands, motor to smooth muscle in bronchial walls, vasodilation of pulmonary vasculature
GA for lung reflexes returns with
vagus, with cells located in sensory ganglion of vagus nerve.
pain axons in lung?
nope.
pain axons in parietal pleura?
yes: somatic intercostal and phrenic nerves