Extra Flashcards

1
Q

Where does the internal thoracic artery bifurcate and what is formed?

A

Rib 6

Into superior epigastric artery and musculophrenic artery

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2
Q

Where is the serratus anterior muscle?

A

Superior broder of the first 8-9 ribs

It inserts into the scapula

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3
Q

What does the serratus anterior muscle do?

A

It pulls the scapula towards the thoracic wall

Helps to abduct the arm esp if greater than 90 degress - scapula moves upwards and laterally

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4
Q

Where is pectoralis minor found?

A

Anterior - ribs 3-5 to the caracoid process

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5
Q

What does pectoralis minor do?

A

Depresses the tip of the shoulder to protect the scapula

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6
Q

Where is pectoralis major?

A

Covers anterior surface of the chest wall and it has two heads - sternocostal and clavicular

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7
Q

Where does pectoralis major insert itself?

A

Into the intertubular sulcus of the humerus after forming a flat tendon

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8
Q

What does pectoralis major do?

A

It adducts and medially rotates the arm

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9
Q

Where is the subclavius?

A

It is a triangle shaped muscle
It passes laterally from the junction between rib 1 and the CC on the inferior surface of the middle third of the clavicle

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10
Q

What does the subclavius do?

A

It pulls the clavicle medially to stabilise the sternoclavicular joint

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11
Q

What are the 2 heads of pec major?

A

sternocostal and clavicular

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12
Q

What joint is formed between the vertebrae and the ribs?

A

synovial

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13
Q

What joint is formed between the CC and the sternum?

A

synovial

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14
Q

What joint is formed between the CC and the ribs?

A

Primary cartilagenous joint

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15
Q

What happens to the posterior branch of the intercostal artery at the mid axillary line?

A

divides to form a lateral cutaneous branch

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16
Q

What happens to the posterior and anterior intercostal arteries anteriorly?

A

anastomoses

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17
Q

Give some features of the cervical vertebrae

A

transverse foramen
C2- has a dens
split spinous process

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18
Q

Give some features of the thoracic vertebrae

A

long spinous process
heart shaped
transverse process is posterior facing

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19
Q

Give some features of the lumbar vertebrae

A

kidney shaped

short, broad spinous process

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20
Q

What is coarctation?

A

congenital malformation in which the aorta is constricted (normally region of left subclavian)

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21
Q

What is the clinical significance of coarctation?

A

intercostal arteries enlarge so blood can get to the lower parts of the body leading to notching of the ribs

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22
Q

What is a costovertebral joint?

A

synovial joints between the head of a rib and the costal facets of a vertebra

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23
Q

What is a costotransverse joint?

A

synovial joints between the tubercle of a rib and the transverse process of a vertebra

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24
Q

At what levels does the trachea start and end?

A

C6 - T4/5

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25
Q

At which level do the primary bronchi form?

A

T4

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26
Q

What is found at the hilum of the lungs?

A
  • Pulmonary artery
  • Pulmonary vein
  • Primary bronchus
  • Lymph nodes and vessels
  • Pulmonary plexus
  • Bronchial artery
  • Bronchial vein
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27
Q

What is the diaphragm attached to?

A

Lumbar vertebrae
Costal margin
Xiphoid process
Ends of ribs 11/12

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28
Q

Where does the internal thoracic artery branch?

A

rib 6

7-9 intercostal spaces are supplied by the branches of the internal thoracic artery

29
Q

Are intercostal arteries found in the last 2 intercostal spaces?

A

NO

30
Q

Where do the intercostal nerves come from (which rami)?

A

anterior primary rami of the first 11 thoracic nerves

31
Q

At which vertebral level is the sternal angle?

A

T4 (marks top of aortic arch and where the trachea bifurcates)

32
Q

What is the male nipple in line with?

A

Male- 4th ICS at mid clavicular line

Female -

33
Q

What is C7 known for?

A

First palpable vertebra

34
Q

What is the importance of T2, T3 and T7?

A

superior angle of the scapula, medial ends of scapula and inferior angle of scapula

35
Q

What is the importance of L4?

A

Level with iliac crest

36
Q

What is the importance of T12?

A

Midpoint of iliac crest and end of scapula

37
Q

Where do the tips of each vertebral spin lie relative to the body?

A

one space below

38
Q

How would the costal margin outline be drawn?

A

From 6th costal cartilage go down to the 8th rib medial to the mid clavicular line. Then go down to the 10th rib at the mid axillary line
Floating ribs are inferior to the costal margin

39
Q

How would the left parietal pleura be marked?

A

same as the right but at the 4th CC a notch of 4-5cm between 4-7 CC should be added

40
Q

How would the right parietal pleura be marked?

A
  • 2 cm above the medial 3rd of the clavicle
  • 6th CC straight line
  • cross the mid clavicular line at the 8th rib
  • cross the mid axillary line at rib 10
  • horizontal line just above the costal margin to T12
  • line to the apex
41
Q

What is normal breathing known as?

A

vesicular

42
Q

Near the trachea what happens to the sound of breathing?

A

louder and more high pitched

43
Q

How is the oblique fissure drawn?

A

posterior lung margin just below the spine of T3 to the 6th CC anteriorly

44
Q

How is the horizontal fissure drawn?

A

start anteriorly at the 4th CC running horizontally to the oblique fissure (meet at mid axillary)

45
Q

What would the superior lobe of the lung sound like?

A

most resonant

46
Q

What would the inferior lobe of the lung sound like (percussion)?

A

most dull sounding

47
Q

How would the outline of the lungs be drawn?

A

anterior: lateral to pleura to the 6th CC then follow the costal margin 2 ribs superior to the pleural line
posterior: horizontal to the vertebral colum at rib 10 level

SAME CAVITY FOR MEDIASTINUM

48
Q

costodiaphragmatic recees

A

inferiorly on both sides this exists and the sharp inferior border of the lung can expand as the diaphragm flattens

49
Q

costomedial recess

A

space on the left between the pleura and lung at the mediastinal side

50
Q

What does the anterior border of the lung seperate?

A

seperates the costal from the mediastinal surface

51
Q

How is the triangle of safety drawn?

A

between 2nd and 5th ICS

  • one point at base of the axilla
  • one at the lateral edge of the latimus dorsi
  • one at the inferior border of the 4/5th ICS
  • one at the lateral edge of pectoralis major
52
Q

What is the sulcus terminalis?

A

seperates the rough anterior muscle from the smooth posterior muscle
It is external, the internal one is called the crista terminalis

53
Q

Is the sulcus terminalis and crista terminalis found in the left or right atrium?

A

right

54
Q

At which vertebral level does the oesophagus pierce the diaphragm?

A

T10

55
Q

What is an atrial appendage/auricle?

A

extension appearing like an ear from each atria

56
Q

How is the mediastinum divided?

A

horizontal line from between T4 and 5 to the sternal angle - seperates into inferior and superior

The inferior is divided into anterior, posterior and middle by the pericardium

57
Q

What is the superior boundary of the superior mediastinum?

A

an oblique line from the jugular notch to the superior border of T1

58
Q

Which vertebral level does the superior mediastinum end?

A

T4

59
Q

What does the mediastinum contain?

A
thymus
R&L brachiocephalic veins
superior vena cava
arch of aorta and branches
trachea
oesophagus
phrenic nerves
vagus nerves
left recurrent laryngeal
thoracic duct
60
Q

Which veins drain into the IVC?

A
inferior prhenic
hepatic
suprarenal
renal
gonadal
lumbar
61
Q

Which two veins form the IVC?

A

right and left common iliac (each made of an external and internal iliac vein- right and left)

62
Q

What does the ascending aorta branch into?

A

The right an left coronary artery

The right branches into the posterior interventriular and marginal branch

The left branches into the anterior interventricular and circumflex branch

63
Q

What are all three branches of the aortic arch crossed by and where?

A

left brachiocephalic vein at their origin

64
Q

Describe the pathway of the brachiocephalic trunk?

A

originates behind manubrium and slightly anterior to other branches. Ascends posteriorly to the right and when reaching the sternoclavicular joint branches

65
Q

Describe the pathway of the left common carotid

A

slightly posteior to brachiocephalic trunk and ascend to the left of the trachea

66
Q

Describe the pathway of the left subclavian artery

A

slightly posterior to left common carotid and ascends along to the left of the trachea

67
Q

Describe the relations of the aorta, brachiocephalic trunk and left common carotid artery to the airways

A

aorta rises anterior to trachea and arches over left main bronchus at lung root

trachea is between the brachiocephalic and left common carotid

68
Q

What does each common carotid divide into and what do they supply?

A

internal - supplies brain

external - supplies skin of head

69
Q

What are the names of the 4 pulmonary veins?

A

right and left superior and inferior