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thhth > Block 1 - Anatomy - Thorax - Gray's Text > Flashcards

Block 1 - Anatomy - Thorax - Gray's Text Flashcards

1
Q

Does the IVC pass directly through the diaphragm?
Does the esophagus pass directly through the diaphragm?
Does the aorta pass directly through the diaphragm?

A

Yes (at T8);
yes (at T10);
no (it passes behind it at T12)

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2
Q

What plane divides the superior and inferior mediastinum?

What structural points are relevant to this area?

A

A plane transecting T4 to the sternal angle;
the arch of the aorta passes just over it;
the top of the pericardium is just below;
it is the level of the carina

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3
Q

What three veins are very important in shunting blood from the left side of the body to the SVC (which is found right of midline)?

A

The left brachiocephalic, the accessory vein of the hemiazygous, and the hemiazygous vein

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4
Q

What set of small nerves connect the paravertebral (sympathetic) ganglia to the ventral ramus of the spinal cord?
Which is proximal (medial) and which is distal (lateral), respectively?

A

The white and gray rami;

gray, white

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5
Q

By what system can cancers be staged (in very basic terms)?

A

The TNM system

tumor size, nodal involvement, metastasis

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6
Q

What is unique about the first costovertebral joint?

What other three rib levels are similar?

A

The first rib only interacts with the first thoracic vertebra, unlike most ribs which interact with two vertebrae (their same level and the superior vertebra);

the ribs at TX, TXI, and TXII

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7
Q

Which thoracic vertebrae lack transverse costal facets?

A

Ribs at TXI and TXII

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8
Q

What rib interacts with the manubriosternal joint?

What rib interacts with the xiphisternal joint?

A

II;

VII

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9
Q

Is the rib attached to the vertebrae by anything other than positioning on the costal facets?

A

Yes;

an intra-articular ligament; a lateral, a superior, and a primary transverse ligament; and a synovial joint

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10
Q

What connects ribs I - VII directly to the sternum? What is absent in rib I that is present in the others?

A 
Costal cartilage (hyaline);
a synovial capsule
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11
Q

What is a potential result of the presence of a cervical rib?

A

Thoracic outlet syndrome

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12
Q

What muscle of the rib cage lies deep to the internal thoracic vessels?

A

Transversus thoracis

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13
Q

What differentiates the uppermost two posterior intercostal arteries from the rest?

A

They are derived from the supreme (superior) intercostal artery

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14
Q

Of what structure is the supreme (superior) intercostal artery a branch?

A

The costocervical trunk

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15
Q

Where does the right superior intercostal vein drain?

Where does the left drain?

A

The azygous v.;

the left brachiocephalic v.

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16
Q

What is a thoracostomy? Where is it performed?

A

A chest tube inserted to drain the pleural space;

the 4th or 5th intercostal space, just superior to the rib

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17
Q

Which artery passes near the phrenic nerve?

A

The pericardiacophrenic artery

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18
Q

Pain in the lateral neck and supraclavicular region could be referred from what structures?
(Hint: this is the C3, C4, and C5 dermatome)

A

The diaphragm, diaphragmatic pleura, parietal or fibrous pericardium, and mediastinal pleura

19
Q

What is the largest pleural space?

A

The costodiaphragmatic recess

20
Q

Identify which of the following structures passes posterior to the lung roots:

SVC
vagus nerves
esophagus
phrenic nerves
thoracic duct
descending aorta
ascending aorta
azygous vein
A 
vagus nerves
esophagus
thoracic duct
descending aorta
azygous vein
21
Q

What landmarks typically outline the general path of the oblique fissure?

A

TIV –> cross the 5th intercostal space –> follow rib VI to the sternum

22
Q

Pericarditis and MI can present in similar ways. What is one method of differentiating their presentations?

A

The pain associated with pericarditis can be relieved by leaning forward

23
Q

What should normally happen to the jugular venous pulse upon inspiration?

What is called if the opposite happens? What might this indicate?

A 
It drops 
(due to increased blood flow into the pulmonary system out of the right side of the heart);

Kussmaul’s sign, constrictive pericarditis (thickening of the pericardium)

24
Q

Necrosis of what structure can lead to valve prolapse in the heart?
What might lead to this outcome?

A

The papillary muscle associated with that particular valve leaflet;
infarction

25
Q

Where is the diaphragm at developmental week 4?
Week 6?
Week 8?

A

C4;
T4;
L1

26
Q

Identify which of the following structures passes anterior to the lung roots:

SVC
vagus nerves
esophagus
phrenic nerves
thoracic duct
descending aorta
ascending aorta
azygous vein
A

SVC
phrenic nerves
ascending aorta

27
Q

What is another name for the bundle of His?

A

The atrioventricular bundle

28
Q

Where are the bundle branches and plexus of Purkinje fibers within the heart wall?

A

They are subendocardial

the contraction is initiated on the inside of the heart wall and spreads across it from inside to out

29
Q

The beginning of the atrioventricular bundle (bundle of His) is called the ________________ ______.

A

Atrioventricular node

30
Q

Both the transverse and oblique coronary sinuses are within what structure?

A

The pericardial sac

31
Q

What is a common potential location for ectopic parathyroid glands?
(Hint: remember how the pharyngeal arches develop)

A

The thymus (3rd pharyngeal arch)

32
Q

From insertion in the subclavian, internal jugular, or axillary vein, to where are central line endpoints guided?

A

The distal SVC

33
Q

What structure is useful for accessing the IVC and liver via guidewire catheterization?

A

The SVC (often through a transjugular approach)

34
Q

What are the three fixed points of the thoracic aorta?

In what scenario are they most susceptible to being damaged?

A

Aortic valve, ligamentum arteriosum, aortic hiatus of the diaphragm;
trauma

35
Q

What is the term referring to a complete inversion of the body organs (from left-to-right)?
With what heart pathology is it associated?

A

Situs inversus;

dextrocardia

36
Q

What might be a presenting symptom of an abnormal right subclavian artery projecting from the aortic arch to supply the right arm?

A

Dysphagia

the great vessels form a ring around the trachea and esophagus

37
Q

Do visceral afferents in the vagus n. carry pain information to the CNS?
What nerves do?

A

No;

the cardiopulmonary and splanchnic nerves

38
Q

What name is given to the space between the pulmonary trunk and aorta?

What nervous structure passes through this space?

A

The aortopulmonary window;

the left recurrent laryngeal nerve

39
Q

What information do visceral afferents in the vagus n. carry to the CNS?

A

Normal physiologic processes (no pain fibers)

40
Q

A flat, thin structure is noted along the right posterior mediastinum near the esophagus. The structure is branched. What might it be?
What vessel might be present alongside it?

A

The azygous vein;

the thoracic duct between it and the esophagus

41
Q

At what level does the trachea bifurcate?
To what level is the aortic arch just superior?
What plane separates the superior and inferior mediastinal spaces?

A

T4 to the sternal angle;
T4 to the sternal angle;
T4 to the sternal angle

42
Q

Accessory cervical ribs may lead to thoracic outlet syndrome. What are three potential effects of this syndrome?

A

Subclavian artery compression - atheroma and embolus formation;
T1 nerve compression - musculature wasting of the intrinsic hand and medial forearm;
Subclavian vein compression - axillary vein thrombosis

43
Q

What condition can cause notching of the ribs, and through what medium is this visualized?

A

Coarctation of the aorta;

CXR

44
Q

What types of effects can an aortic dissection have on systemic circulation?

A

It can occlude peripheral arteries all along the aorta, potentially causing infarction of the heart, kidneys, intestines, legs, and other locations

thhth (10 decks)

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