CR anatomy Flashcards
Sternal angle level
T4
2nd rib
Pectoralis major attachments
Intertuberculular sulcus of humerus
–> sternum and clavicle
Pectoralis major innervation
Sternal head = medial pectoral nerve (C7-T1)
Clavicular head = lateral pectoral nerve (C5-C6)
Serratus anterior attachments
Ribs 2-8 –> scapula
Serratus anterior innervation
Long thoracic nerve
C5-C7
Pectoralis minor attachments
Scapula –> ribs 3-5
Pectoralis minor innervation
Medal pectoral nerve (C7-T1)
Intercostal bundle content from superior to inferior
Vein
Artery
Nerve
Where does the intercostal bundle lie?
Inferior to the superior rib
Between internal and innermost intercostals
Parts of internal intercostals and their role
Interosseous = forced expiration Interchondral = inspiration
Where is a thoracocentesis performed?
9th IC space
Mid-axillary line
Where is a chest drain places?
5th IC space
Mid-axillary line
What passes through the diaphragm at T12?
Aorta
Thoracic duct
Azygous vein
Where does the hemiazygous cross the midline?
T7/8
Referred pain of the pleura
Costal –> intercostal strip
Mediastinum surface –> C4-5 around shoulders
Oblique fissure surface markings
C2 vertebrae –> 6th rib at mid-clavicular line
Transverse fissure surface markings
Midline of oblique fosse (or where crosses mid-axillary line) –> midsternal line at the level of the 4th costal cartilage
Order of structures in the lung hilum
Superior = arteries Middle = bronchi Inferior = veins
What is the Stellate ganglion?
Fusion of inferior cervical and first thoracic sympathetic ganglion
Referred pain of the heart
T1-4 for chest, neck and arm pain
Inferior = T5-9 for epigastric pain
Arterial supply to heart nodes
RCA = SAN
PD = AVN
Bundle branches = LAD
Lateral ECG leads
V5, V6, I, aVL
Inferior ECG leads
II, III, aVF
Causes of concentric vs eccentric hypertrophy
Concentric = pressure overload Eccentric = volume overload
S3 heart sound
Large volume of blood striking overly compliant LV
= systolic heart failure
S4 heart sound
Atrial contraction forcing blood into a non-compliant LV
= diastolic heart failure
CXR signs of pulmonary oedema
Alveolar oedema Kerley B lines Cardiomegaly Upper lobe diversions Pleural effusions
CXR signs of COPD
Hyper-inflated lungs (>6 anterior >10 posterior ribs)
Flattened hemidiaphragms –> blunted costophrenic angled
What forms the valve over the foramen ovale?
Septum primum
What does the bulbis cordis become?
Right ventricle
What does the sinus venosus become?
Inflow tracts to the heart
What does the truncus arteriosus become?
Aorta and pulmonary trunk
When does the septum primum appear?
Day 28
When do the heart tubes fuse?
Day 21
When does the heart begin to beat?
Day 22