Exam 1 Review - Thoracic Viscera Flashcards
The scalene tubercle of the first rib is grooved to allow insertion of the anterior scalene muscle.
a) What crosses the rib anterior to the scalene tubercle?
b) What crosses the rib posterior to the scalene tubercle?
a) The subclavian vein crosses the rib anterior to the scalene tubercle
b) The subclavian artery and inferior trunk of the brachial plexus cross the rib posterior to the scalene tubercle.
In coronary artery disease, pain is referred along what nerve to the medial side of the arm?
2nd (sometimes 3rd) intercostal nerve (lateral cutaneous branch)
The phrenic nerve provides sensory innervation to what parts of the diaphragm?
Central part of the diaphragmatic parietal pleura
Central part of the diaphragmatic parietal peritoneum
Besides the diaphragm, the phrenic nerve provides sensory innervation where?
Fibrous pericardium
Parietal serous pericardium
Mediastinal parietal pleura
The upper six intercostal spaces are supplied by branches of what anterior intercostal artery?
Internal thoracic artery
Note: These anastomose laterally with the posterior intercostal arteries.
The lower anterior intercostal spaces are supplied by the ______ artery, a terminal branch of the internal thoracic artery.
Musculophrenic artery
Which costomediastinal recess is larger (left or right) and why?
The LEFT costomediastinal recess is larger due to the cardiac notch of the left lung.
Note: The lingula of the left lung enters the costomediastinal recess here during deep inspiration.
Where is the plane between superior and inferior mediastinum?
4th thoracic vertebrae/sternal angle
The superior mediastinum is chiefly behind the?
Manubrium sterni
What are the contents of the superior mediastinum?
Aortic arch Brachiocephalic veins/SVC Cardiac plexus of nerves Vagus and phrenic nerves Left recurrent laryngeal nerve Esophagus Trachea Thymus gland Thoracic duct Lymph nodes
The trachea and esophagus are crossed by what vein on the right?
Azygous vein
The trachea and esophagus are crossed by what structure on the left?
Aortic arch
Where does the aortic arch begin and end?
It commences at the RIGHT border of the sternal angle, runs left and downward anterior to trachea/esophagus, ends at sternal angle
The brachiocephalic trunk divides into right subclavian and right common carotid arteries where?
Behind the right sternoclavicular joint
Where does the left common carotid enter the neck?
Behind the left sternoclavicular joint
What causes notching of inferior border of the ribs?
Dilated intercostal arteries pressing on the inferior border of the ribs causing localWized areas of respiration. This occurs in coarctation of the aorta.
Where do the left brachiocephalic and right brachiocephalic veins form the superior vena cava?
Behind sternal end of first costal cartilage
Where do the vagus nerves descend?
In FRONT of subclavian arteries;
BEHIND roots of the lungs
What is the path of the left recurrent laryngeal nerve?
Hooks around left side of arch of aorta
Behind ligamentum arteriosum
Ascends in a groove between trachea and esophagus
In superior mediastinum!
Note: The right recurrent laryngeal nerve is NOT found in the mediastinum - it hooks around the right subclavian in the root of the neck.
Which structure descends between the subclavian artery and vein?
Phrenic nerve
Which structure descends between the internal jugular vein and common carotid artery?
Vagus nerve
What enters the superior mediastinum between the trachea and vertebral column, behind the left principal bronchus?
Esophagus
What are four places where the esophagus faces constrictions?
a. Where the pharynx joins the upper end
b. Where it contacts the arch of the aorta
c. Where it contacts the left principal bronchus
d. The esophageal hiatus of the diaphragm
What does a barium swallow highlight?
Esophageal constriction sites
