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Exam 3- Thoracic Cavity Flashcards

1
Q

Thoracic Wall

A

Thoracic cage and skin, Fascia, and Muscles

The Cage consists of 12 pairs of ribs and costal cartilages, 12 Thoracic Vertebrae and IV discs, and Sternum

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2
Q

Diaphragm

A

The prime mover of respiration and the accessory muscles of respiration
Quiet Respiration prime mover
Innervated by a pair of Phrenic Nerves
Blood Supply from the Inferior Phrenic Artery

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3
Q

Ribs 1, 2, 11, 12

A

These are atypical ribs (Ribs 3-10 are normal)

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4
Q

Costochondral, Sternocostal, Costovertebral, and Costotransverse Joints

A

These are all somewhat mobile except for the first rib, which isn’t mobile at all

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5
Q

Superior Thoracic Aperture

A

The opening at the top of the Thoracic Cage surround by the 1st Ribs, Manubrium, and T1

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6
Q

Inferior Thoracic Aperture

A

The opening at the bottom of the Thoracic Cage surrounded by T12, Costal Cartilages 7-10, 11th and 12th pairs of Ribs, and the Xiphisternal Joint
Closed by the Muscular Diaphragm

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7
Q

Accessory Muscles of Respiration

A

Serratus Posterior Superior (proprioception), Serratus Posterior Inferior (proprioception), Levator Costarum (elevates ribs), Transcersus Thoracis (depresses ribs), Subcostal (elevates ribs), Intercostal Muscles (forced respiration and support), and Sternocleidomastoid and Scalenes (forced respiration)

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8
Q

Thoracic Cavity

A

Subdivided into 3 cavities by pleural membranes (right and left pulmonary and central mediastinum)

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9
Q

Muscles of Inspiration

A

Accessory: Sternocleidomastoid (elevates sternum), Anterior Scalenes, Middle Scalenes, and Posterior Scalenes (elevate and fix upper ribs)
Principal: External Intercostals (elevate ribs), Interchondral part of internal intercostal (elevate ribs), and Diaphragm (increase cavity and elevates ribs

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10
Q

Muscles of Expiration

A

Quiet Breathing: Results from passive recoil of lungs and rib cage
Active Breathing: Internal intercostals and Abdominals (depress lower ribs and push the diaphragm up): Rectus Abdominis, External Obliques, Internal Obliques, and Transversus Abdominis

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11
Q

Serous Fluid

A

Creates cohesion which is essential for lung inflation and lubrication which is essential for lung movements during respiration
Produced by Serous Membranes (Pleura)

If air enters the Pleural Cavity (pneumothorax), the lung will collapse due to elasticity of its tissue
Excess Fluid (serous fluid or blood from trauma) may accumulate in the Plueral Cavity and Compress the lungs.
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12
Q

Visceral Pleura

A

Covers Lung
Provides surface cohesion
Insensitive to pain

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13
Q

Parietal Pleura

A

Covers wall of Thorax
4 parts: Cervical (covers apex of lung and extends into the root of the neck), Diaphragmatic (covers the superior surface of the diaphragm), Costal (covers posteriolateral and anteriolateral surfaces), and Mediastinal (covers lateral mediastinum)

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14
Q

Recesses

A

These are gaps between the lung and the parietal pleura to permit expansion
It makes provision to allow expansion of the lung in full inspiration.
It is the most dependent part of the pleural sac; if fluid appears in the pleural sac; it collects first in the costodiaphargmatic recess

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15
Q

Costodiaphragmatic Recess

A

Inferior Margin of the thoracic wall

Location of fluid collection

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16
Q

Costomediastinal Recess

A

Potential space between costal pleura and mediastinal pleura

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17
Q

Thoracocentesis

A

The process of draining fluid from the lungs
Insert a hypodermic needle through and intercostal space into the pleural cavity to remove blood or pus
Insert superior to the 9th rib in the 9th intercostal space, high enough to avoid the collateral branches and the inferior border of the lung

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18
Q

Pneumothorax

A

Pressure entering the thoracic cavity causing the lung to collapse
Penetrating wound of the parietal pleura
Result is a Collapsed Lung

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19
Q

Lungs

A

Apex- blunt end that extends above 1st rib into the root of the neck covered by cervical pleura
Base- concave surgace resting on the ipsilateral convex dome of the diaphragm
Lobes- 2 or 3 from 2 or 3 fissures
3 Surfaces- Costal, Diaphragmatic, and Mediastinal
3 Borders- Anterior, Inferior, and Posterior
The Lungs main function is an exchange of gas- CO2 Out and Oxygen In
Parasympathetic Innvervation by the Vagus Nerve

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20
Q

Hilum

A

This is where everything enters and leaves the lungs

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21
Q

Branchopulmonary Segments

A

The lungs are divided into 10 functional segments-Bronchopulmonary Segments

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22
Q

Rings in Trachea

A

They exist to prevent collapse

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23
Q

Divisions of Trachea

A

Trachea–>Primary Branch–>Secondary Branch–>Tertiary Bronchioles–>Conducting Bronchioles–>Terminal Bronchioles–>Respiratory Bronchioles–>Alveolar Ducts–>Alveolus

Things are more likely to be clogged in the Right Bronchus because it shoots down while the Left bronchus shoots left

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24
Q

Bronchopulmonary Arteries

A

The arteries supplying blood to the lungs

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Lymphatics of the Lung
2 Lymphatic Plexi drain the lung: Superficial Lymphatic Plexus (deep to visceral pleura drains tissue into the bronchopulmonary lymph nodes in the hilum) and Deep Lymphatic Plexus (in lining of bronchi drains root of lung) Both drain into the Thoracic Duct
26
Pulmonary Plexus
Innervates the Lungs and the Visceral Pleura Things Vagus Nerve (CN X) does: Vasodilate, Bronchoconstrict, Stimulate gland secretion, Reflexive Receptors (cough, Hering-Breuer, pressoreceptor and chemoreceptors) or Nociceptive (pain)
27
Asthma Inhalers
They are sympathetics and act on these receptors to relieve symptoms
28
Lobes locations
Inferior Lobe is mostly the back Middle Lobe is just a small portion of the front Superior Lobe is mostly the front
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Horizontal Fissure
Follows the Fourth rib
30
Oblique Fissure
Starts from the Horizontal Fissure, crosses the 5th rib and terminates at the 6th rib
31
Fibrous Skeleton
This acts as an Anchor
32
Divisions of Mediastinum
Anterior Mediastinum Inferior Mediastinum: Middle (Contains heart and pericardium and great vessels), Posterior (Contains esophagus and vessels), and Superior (Contains vessels, thymus, and trachea)
33
Pericardium
Inelastic tough sac that covers heart and beginnings of vessels Prevents heart from overinflating leading to mechanical failure 2 Layers: Fibrous Pericardium (external, continues with vessels, and is the toughest part and Serous Pericardium (2 Layers- Parietal: lines inner surface of fibrous. Visceral: adheres to the heart) Produces Serous Fluid for lubrication Pericardiacophrenic Artery supplies blood to the Pericardium and comes from Internal Thoracic Artery Coronary Artery supplies blood to the Visceral Layer of the Pericardium Phrenic Nerves are the Sensory Nerves for the Pericardium
34
Cardiac Tamponade and Pericardiocentesis
Excess Fluid in the Pericardial Space From Trauma, Infection, Cancer, or Autoimmune problems Pericardiocentesis is the process of draining the fluid (needle is placed at 5th/6th intercostal) A procedure that uses a needle to remove fluid from the pericardial sac. This is the tissue that surrounds the heart.
35
Atria
Receiving chambers of blood
36
Ventricles
Pumping chambers of blood
37
Diastole
Filling of the Ventricles of the Heart
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Systole
Forceful contraction and emptying of the Heart
39
Walls of the Heart
Epicardium (aka Visceral Pericardium) Myocardium (Double Helical bands of cardiac muscle) Endocardium (Covers valves, enourages smooth blood flow, and prevents clots)
40
Right Coronary Artery
Possibly the most important Artery in the Heart Branches: SA Nodal Artery (SA Node), Right Marginal Branch (Right Border of the Heart), AV Nodal Branch (AV Node), and Right Interventricular Artery (Invterventricular Septum) ********Supplies R Atrium, most of R Vent, Diaphragmatic part of L Vent, IV Septum and usually AV (80%) and SA Nodes (60%)
41
Left Coronary Artery
Branches: Anterior Interventriucular Branch (LAD) (Left Ventricle and Interventricular Spetum), Circumflex Branch, and Left Marginal Artery (Left Border of the Heart) Supplies L Atrium, most of L Vent, most of IV Septum, and AV Node (20%) and SA Node (40%)
42
Coronary Sinus
In Coronary Sulcus Drains blood into the Right Atrium from: Great Cardiac Vein (in Anterior Interventricular Sulcus), Middle Cardiac Vein (in Posterior Interventricular Sulcus), and Small Cardiac Vein (wraps around in Coronary Sulcus)
43
Arterior Veins
Originate on the Anterior surface of the Right Ventricle, course over the Coronary Sulcus, and drain straight into the Right Atrium
44
Widowmaker
Left Anterior Descending Artery (Anterior Interventricular Artery)
45
Auricle
Ear- It's a projection of extra capacity
46
Fossa Ovalis
Remnant of Foramen Ovalis, which bypasses the Lungs in the a Fetus
47
Valves
The valves prevent the backward flow of blood The backflow of the blood is responsible for the heart sounds The cusps are attached to Cordae Tendonae which is attached to a Papillary Muscle that helps with the opening and closing of the valves
48
Right AV Valve
Tricuspid Valve- 3 Cusps
49
Trabecula Carnae
The rough border of the inside of the Ventricles
50
Conus Arteriosus
Smooth Cone | Helps with a smooth outflow through the Pulmonary Trunk
51
Crista Terminalis
Conductive Ridge of muscle important for contractility
52
Ventricular Walls
The Left Ventricular Walls are about 2-3x thicker than the Right Ventricular Walls
53
Prolapse
A slipping forward or down of one of the parts or organs of the body Chordae Tendonae and Nodules of Semilunar Valves prevent prolapse
54
Fibrous Skelton
Framework of Dense Collagen 4 Rings that surround and anchor the 4 Major Valves (Right AV Valve, Left AV Valve, Pulmonary Valve, and Aortic Semilunar Valve) Prevent overexpansion of Valve Provides attachment of leaflets, cusps, and Myocardium Provides an electrical "insulator" so that Atria and Ventricles contract independentlySA Node
55
SA Node
Natural Pacemaker- Roughly 70 bpm
56
AV Node
Distributes signal through heart skeleton
57
Heart Pressure
The pressure goes for 0 to beyond the Aortic Pressure
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Annurism
This is a common defect to the aorta
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Vagal Nerve
Part of the Sympathetic and Parasympathetic innervation of the Heart Stimulation of the Parasympathetic Vagus Nerves constricts coronary arteries
60
Referred Pain of the Heart
Vervical and superior 5 Thoracic Sympathetic Ganglia are sensitive to Ischemia (tissue damage due to lack of Oxygen) This causes referred pain to the dermatomes of these regions (Chest and along the Left Arm)
61
Parturition
Child Birth
62
Abdominal Cavity
Divided into two sections: Abdominal Cavity and Pelvic Cavity The pelvic cavity is a body cavity that is bounded by the bones of the pelvis Subdivisions of the Abdominal Cavity From Top Left to Bottom Right. 3 per row Right Hypochondrium, Epigastium, Left Hypochondrium Right Flank, Umbilical, Left flank (Lumbar) Right Inguinal, Hypogastrium, Left Inguinal
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Right Upper Quadrant
Liver: Right Lobe, Gallbladder, Stomach: Pylorus, Duodenum, Pancreas: Head, Right kidney and Suprarenal Gland, Right Colic Flexure, Ascending Colon, Transverse Colon
64
Left Upper Quadrant
Liver: Left Lobe, Spleen, Stomach, Jejunum and Proximal Ileum, Pancreas, Body and Tail, Left Kidney and Suprarenal Gland, Left Colic Flexure, Transverse Colon, and Descending Colon
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Right Lower Quadrant
Cecum, Appendix, Most of Ileum, Ascending Colon, Right Ovary, Right Uterine Tube, Right Ureter, Right Spermatic Cord, Uterus (If enlarged), and Bladder (If very full)
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Left Lower Quadrant
Signmoid Colon, Descending Colon, Left Ovary, Left Uterine Tube, Left Ureter, Left Spermatic Cord, Uterus (If enlarged), and Bladder (If very full)
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Transverse Planes
Subcostal and Interspinous Planes (Most Common) | Transpyloric and Interspinus Planes
68
Sagittal Planes
``` Midclavicular Lines (Most Common) Semilunar Lines ```
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Xiphoid Process
T9
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Transpyloric Plane
Pylorus, Pancreatic Neck, Duodeno-Jejunal Flexure, and Hila of Kidneys L1
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Subcostal Plane
L3
72
Umbilicus
L3/L4
73
Iliac Crest Plane
L4
74
Sacrum
Anterior Superior Iliac Spine | ASIS
75
Campers Fascia
Superficial Fatty Tissue | Looks like Popcorn
76
Scarpa's Fascia
Deep Membranous Continuous with Fascia of Perineum (Colle's Fascia) Looks like a sheet
77
Anterior Abdominal Wall Muscles
Functions are to Compress and Support Viscera and to Flex and Rotate the Trunk The layers of the Anterior Abdominal Wall are: Skin Subcutaneous tissue Fascia-Camper's fascia (fatty superficial layer) and Scarpa's fascia (deep fibrous layer) Muscle: External oblique abdominal muscle, Internal oblique abdominal muscle, Rectus abdominis, Transverse abdominal muscle, Pyramidalis muscle Fascia transversalis Peritoneum
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Abdominal Vessels
The Arteries and Veins are all paired together Superior Epigastric Branches of Internal Thoracic Inferior Epigastric and Deep Circumflex branches of the External Iliac Superficial Circumflex branches from Femoral Posterior Intercostal and Subcostal Vessels
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Superior Epigastric Vessels
From: Internal Thoracic Artery Supply: Rectus Abdominis Muscle and Superior Ubilical Regions
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Inferior Epigastric Vessels
From: External Iliac Artery Supply: Rectus Abdomins Muscle and Inferior Umbilical Regions
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Superficial Circumflex Iliac Vessels
From: Femoral Supply: Superficial Abdominal Wall of Inguinal Region and Iliac Fossa
82
Superficial Epigastric Vessels
From: Femoral Supply: Superficial Abdominal Wall of Pubic and Inferior Ubilical Regions
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Thoracoepigastric Vein
It's a direct connection between Femoral Vein and Axillary Vein in the case of clogs or needs to be redirected
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Lymphatics
Horizontal Bar can be palpated more easily due to being more superficial than the deep Vertical Bars
85
Caput Medusae
Collateral Venus Return resulting from IVC blockage or patients with Portal Vein Hypertension
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Ilioinguinal Nerve
Cutaneous Field is the area surround the sex organ
87
Iliohypogastric
Cutaneous Field is about the area of ASIS and portion that almost looks like a pair of briefs
88
Lateral Cutaneous Nerve of the Thigh
Cutaneous Field is the Lateral portion of the thigh
89
Inguinal Ligament
Connects ASIS to the Pubic Tubercle Clinically important site of herniation Formed by Aponeuroses of the External Oblique
90
Myopectineal Orfice
Site of Hernias
91
Inguinal Canal
Lies superior and parallel to the Inguinal Ligament From Deep Inguinal Ring to Superficial Inguinal Ring Spermatic Cord (Males), Round Ligament (Females), and Genitofemoral Nerve passes through this Ilioinguinal Nerve passes through but does not enter via Deep Inguinal Ring Same: Ilioinguinal Nerve, Genitofemoral Nerve, Lymphatic Vessels Different (Women): Round Ligament of Uterus Different (Men): Spermatic Cord, Ductus (Vas) Deferens, Cremaster Muscle (Internal Oblique)
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Round Ligament
In women the Round Ligament follows the same pattern as the Ductus Deferens (carries sperm) This anchors the Uterus to the skin
93
Indirect vs. Direct Hernia
Indirect is lateral to the Epigastric Vessels and Direct is medial to the Epigastric Vessels
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Thymus
It's job is to recognize receptors that hold molecules | It gets worse with age (Old people get sick easier)
95
Superior Mediastinum Contents from Superficial to Deep
Sternum-> Thymus-> Internal Thoracic Vessels-> Brachiocephalic Veins-> Brachiocephalic Trunk-> Paratracheal Lymph Nodes-> Common Carotid Artery-> Trachea-> Subclavian Artery-> Esophagus-> Thoracic Duct
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Left and Right Brachiocephalic Veins
Left is twice as long as the right as it crosses midline because the tilt causes it to need to travel a longer distance They unite to create the Superior Vena Cava
97
Arteries compared to Veins
Generally Posterior
98
Trachea
It is not part of the mediastinum
99
Aortic Annurism
Could cause vocal cord injury
100
Ligamentum Arteriosum
Attaches inferior to Aortic Arch from pulmonary trunk | Remnant of Ductus Arteriosus in the fetus (bypasses lungs)
101
Branches of Aortic Arch
Brachiocephalic Left Common Carotid Left Subclavian Around the areas of 1st rib/clavicle
102
Azygos System
On either side of vertebral column Drains the back, Abdominal walls, medistinal viscera Azygos, Hemiazygos, Accessory Hemiazygos
103
Splanchnic Nerves
3 Splanchnic Nerves: Greater Lesser, and Least
104
RBC path to Esophagus
Left Ventricle, Aortic Arch, Thoracic Aorta, Esophageal Aorta
105
Superior Mediastium from Posterior to Anterior
Esophageal Plexus then Thoracic Duct
106
Blood supply to Lungs, Trachea, and Esophagus
Lungs get their blood supply from the Bronchial Artery and returned via Pulmonary Veins- Comes from Thoracic Aorta Trachea gets its blood from the Bronchial Artery Esophagus gets its blood differently in different locations. The cervical portion is supplied by the inferior thyroid artery. The thoracic portion is supplied by bronchial and esophageal branches of the thoracic aorta. The abdominal portion is supplied by ascending branches of the left phrenic and left gastric arteries
107
Psoas Major
Origin: Sides of T12-L5 and discs between; Transverse Processes of all Lumbar Insertion: Lesser Trochanter of Femur Action: Flexes thigh at hip joint and stabilizes the joint Nerve: Anterior Rami of Lumbar Nerves (L1, L2, L3) Blood Supply: Lumbar branches of Iliolumbar Artery
108
Psoas Minor
Origin: Sides of T12-L1 and discs Insertion: Pectineal Line, Iliopectineal Eminence via Iliopectineal Arch Action: Flexes thigh at hip joint and stabilizes the joint Nerve: Anterior Rami of Lumbar Nerves (L1, L2) Blood Supply: Lumbar branches of Iliolumbar Artery
109
Iliacus
Origin: Iliac Crest, Iliac Fossa, Ala of Sacrum, and Anterior Sacroiliac Ligaments Insertion: Tendon of Psoas Major, Lesser Trochanter, and Femur Action: Flexes thigh at hip joint and stabilizes the joint Nerve: Femoral Nerve (L2,L3) Blood Supply: Iliac Branches of Iliolumbar Artery
110
Quadratus Lumborum
Origin: Medial Half of Posterior Iliac Crest and Iliolumbar Ligament Insertion: Transverse Processes of L1-L4 and Medial half of 12th Rib Action: Extends the Vertebral Column and also laterally flexes the vertebral column Nerve: Subcostal Nerve and Ventral Rami of L1-L4 Blood Supply: Lumbar Artery
111
Rectus Sheath
The rectus sheath is made up of two parts, known as the posterior sheath and the anterior sheath
112
External Oblique
Origin: External Surfaces of Ribs 5-12 Insertion: Linea Alba, Pubic Tubercle, Anterior Half of Iliac Crest Action: Compresses and Supports Abdominal Viscera, Flexes and Rotates Trunk Nerve: Ventral Rami of 6 Inferior Thoracic Nerves Blood Supply: Superior and Inferior Epigastric Arteries
113
Internal Oblique
Origin: Thoracolumbar Fascia, Anterior 2/3 of Iliac Crest, Lateral Half of Inguinal Ligament Insertion: Inferior Borders of Ribs 10-12, Linea Alba, Pubis via Conjoint Tendon Action: Compresses and Supports Abdominal Viscera, Flexes and Rotates Trunk Nerve: Ventral Rami of 6 Inferior Thoracic and First Lumbar Nerves Blood Supply: Superior and Inferior Epigastric and Deep Circumflex Iliac Arteries
114
Transverse Oblique
Origin: Internal Surfaces of Costal Cartilages 7-12, Thoracolumbar Fasic, Iliac Crest, Lateral Third of Inguinal Ligament Insertion: Linea Alba, Pubic Crest, and Pecten Pubis via Conjoint Tendon Action: Rotation, Flexion, and Lateral Flexion0 Nerve: Ventral Rmai of 6 Inferior Thoracic and First Lumbar Nerves Blood Supply: Deep Circumflex Iliac and Inferior Epigastric Arteries
115
Rectus Abdominis
Origin: Pubic Symphysis, Pubic Crest Insertion: Xiphoid Process, Costal Cartilages 5-7 Action: Flexes Trunk, Compresses Abdominal Viscera Nerve: Ventral Rami of 6 Inferior Thoracic Nerves Blood Supply: Superior and Inferior Epigastric Arteries
116
Pyramidialis
``` Origin: Body of Pubis, Anterior to Rectus Abdominis Insertion: Linea Alba Action: Tenses Linea Alba Nerve: Iliohypogastric Nerve Blood Supply: Inferior Epigastric Artery ```
117
Great Vessels that enter and leave the heart
Superior and Inferior Vena Cava Pulmonary Trunk Right and Left Pulmonary Veins Ascending Aorta
118
Drain into Superior Vena Cava
Right and Left Brachiocephalic Vein and Azygous Vein

Anatomy (12 decks)

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