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Anatomy B3 RE > Chapter 12 BD > Flashcards

Chapter 12 BD Flashcards

1
Q

importance of the sternal angle

A
  • ribs counted from this level down
  • marks plane separating superior and inf mediastinum
  • ascending aorta ends
  • arch of aorta begins and ends
  • descending aorta begins
  • azygos vein opens into SVC
  • trachea divides into two bronchi
  • cardiac plexus situated
    MATAC
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2
Q

what forms costal margin

A

7th to 10th costal cartilages

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3
Q

what lies between the two costal margins

A

infrasternal or subcostal angle

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4
Q

what is the depression in the subcostal angle known as

A

epigastric fossa

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5
Q

where does the xiphoid process lie

A

in the floor of the epigastric fossa

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6
Q

nipple position in males

A

4th intercostal space 10cm from midsternal line

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7
Q

where is the left apex beat normally palpable?

A

left 5th intercostal space, 9cm from midsternal line

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8
Q

what is scapular line

A

vertical line passing through inferior angle of scapula

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9
Q

what are upper 7 ribs known as?

A

true/vertebrosternal ribs - articulate with sternum

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10
Q

what are 8th 9th and 10th ribs known as?

A

vertebrochondral ribs - articulate with next higher costal cartilage

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11
Q

what are 11th and 12th ribs known as?

A

floating/vertebral ribs.

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12
Q

what are false ribs?

A

vertebrochondral and vertebral ribs as they don’t articulate with sternum

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13
Q

CLINICAL: why are rib fractures rare in children?

A

chest walls are elastic

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14
Q

CLINICAL: where do ribs fracture

A

at weakest point - angle

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15
Q

CLINICAL: least commonly injured ribs

A
  • upper 2 ribs (protected by clavicles)
  • lower 2 ribs (free to swing)
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16
Q

thorax shape in transverse section

A

reniform (bean/kidney shaped)

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17
Q

shape of thorax in infants below 2 years

A

circular

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18
Q

CLINICAL: respiration in infants

A

purely abdominal by action of diaphgram as ribs are horizontal

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19
Q

CLINICAL: what are hiccups

A
  • intermittent involuntary spasmodic contraction
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20
Q

CLINICAL: cause of hiccups

A
  • gastric irritation
  • phrenic nerve irritation
  • uraemia
  • hysteria
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21
Q

boundaries of thoracic inlet

A
  • ant: upper border of manubrium sterni
  • post: superior surface of body of first thoracic vertebra
  • on each side: 1st rib with cartilage
22
Q

degree of obliquity of inlet

A

45

23
Q

what fascia covers each half of inlet

A

sibson’s fascia/ suprapleural membrane

24
Q

what is sibson’s fascia considered to be?

A

flattened tendon of scalenus minimus. formed by scalenus minimus and endothoracic fascia

25
Q

function of sibson’s fascia

A
  • rigidity to thoracic inlet, ensures neck not puffed up and down during respiration
26
Q

inferior surface of sibson’s fascia is fused to?

A

cervical pleura (beneath which lies apex of lungs)

27
Q

viscera of inlet

A
  • trachea
  • oesophagus
  • apices of lungs with pleura
  • remnant of thymus
28
Q

larger vessels of inlet

A
  • brachiocephalic artery
  • LCC + LSC arteries
  • Right and left brachiocephalic veins
29
Q

smaller vessels of inlet

A
  • right and left internal thoracic arteries
  • right and left superior intercostal arteries
  • right and left post intercostal veins
  • inferior thyroid veins
30
Q

nerves of inlet

A

right and left:
- phrenic nerves
- vagus nerves
- sympathetic trunks
- 1st thoracic nerves

31
Q

muscles of inlet

A
  • sternohyoid
  • sternothyroid
  • longus colli
32
Q

CLINICAL: what is cervical rib

A
  • extra rib in cervix attached to C7 vertebra
33
Q

CINICAL: cervical rib effects

A
  • exerts traction on brachial plexus
  • parasthaesia/abnormal sensations along ulnar border of forearm
  • wasting of small muscles of hand supplied by T1
  • vascular changes may also occur
34
Q

CLINICAL: coarctation of aorta effects

A
  • posterior intercostal arteries enlarge greatly
  • characteristic notching on ribs
35
Q

CLINICAL: what is thoracic inlet syndrome

A
  • cervical rib/ variations in scalenus anterior muscle press on subclavian artery and 1st thoracic nerve
  • symptoms can be vascular, neural or both
36
Q

boundaries of thoracic outlet

A
  • anteriorly: infrasternal angle between the two costal margins
  • posteriorly: inferior surface of the body of the 12th thoracic vertebra
  • on each side: costal margin
37
Q

structures passing through vena caval opening

A
  • IVC
  • right phrenic nerve
  • lymphatics of liver
38
Q

structures passing through oesophageal opening

A
  • oesophagus
  • both vagal trunks
  • left gastric vessels
39
Q

structures passing through aortic opening

A
  • aorta
  • thoracic duct
  • azygos vein
40
Q

effect of vena caval opening on contraction

A

dilation

41
Q

effect of oesophageal opening on contraction

A

constriction

42
Q

effect of aortic opening on contraction

A

none

43
Q

vena caval opening situation

A

T8, right part of central tendon

44
Q

oesophageal opening situation

A

T10, splitting of right crus

45
Q

aortic opening situation

A

T12, behind median arcuate ligament

46
Q

mnemonic for situation of openings

A

I ate 10 eggs at 12
I= IVC
ate=T8
10=T10
Eggs=esophagus
At= aortic
12=T12

47
Q

where does superior epigastric artery pass

A
  • space of Larrey present b/w slip of xyphoid and 7th costal cartilaginous slip of the diaphragm
48
Q

what is space of larrey known as when enlarged

A

foramen of Morgagni

49
Q

name other smaller openings of diaphragm

A
  • musculophrenic artery perforates at level of 9th costal cartilage
  • lower 5 intercostal vessels and nerves pass between costal orgins of diaphragm and transversus abdominis
  • subcostal vessels and nerves pass behind lateral arcuate ligament
  • sympathetic trunk passes behind medial arcuate ligament
  • greater and lesser splanchnic nerves pierce each crus
  • left phrenic nerve pierces left cupola
50
Q

CLINICAL: what is a sternal puncture/bone marrow biopsy?

A
  • thick needle pierced through sternum till it reaches bone marrow. sample immediately prepared to see if anaemia is due to WBC or RBC maturation

Anatomy B3 RE (4 decks)

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