Clinical contact of thoracic anatomy Flashcards
Examples of structures passing through superior thoracic aperture
Trachea, oesophagus, L common carotid, l subclavian, l brachiocephalic, l phrenic vein
Difference between parietal and visceral
Parietal is next to lungs, visceral is next to ribs
Suprasternal notch level
T2
Angle of louis
T4/5
Inferior angle of scapula
T8
Xiphisternum
T9
Lowest part of costal q0th rib
L3
Apex beat level
5th intercostal space, mid-clavicular line
Innervation of lungs
Pulmonary plexus at hilum
Sympathetic T2-6 and PS fibres
Afferent from nociceptors and efferent to bronchodilators
Cause of muscle wasting in hand
Subclavian artery, vein and BP can be trapped against rib 1 - especially T1
Where do you conduct centesis?
Mid-clavicular line, second intercostal space on same side of collapsed lung
Why can lung cancer affect voice?
Vagus affects recurrent laryngeal nerve
Where in relation to the rib should a chest drain be placed?
Superiorly
Thoracic outlet syndrome
Obstructed by extra ribs or abnormally tight band connecting ribs and spine
F 30-40 are risk factors
Causes pain in neck and shoulder + paraesthesia in ulnar hand/forearm
Flail chest
- Fracture in two places of 3 adjacent ribs
- Segment of chest wall is unstable and becomes free
- Moves in opposite direction to respiratory movements
Pneumothorax impacts
Diaphragm is depressed on one side and elevated on the other
Ribs come closer together and narrow intercostal spaces
Mediastinal shift away from pneumothorax
Collapsed lung appears whiter
Sx pneumothorax
- Hypotension and hypoxia
- Breath sounds absent on affected side
- Trachea deviates to unaffected side
