Final Gross - Thoracic Wall, Lungs, and Middle Mediastinum Flashcards
This range of ribs are known as the true ribs, having their own costal cartilage/attachment to the sternum
ribs 1-7
This range of ribs are the falst ribs, do not have their own costal cartilage attachment
ribs 8-12
These are the floating ribs, they are not attached to the sternum
ribs 11 and 12
This part of the sternum has the clavicular notch for sternoclavicular joint
manubrium
This part of the sternum joins the manubrium at sternal angle (of Louis)
body
This is the lowest point of the sternum
xiphoid process
This joint is a secondary cartilaginous joint symphysis = slightly movable
manubriosternal joint
This is a primary cartilaginous joint synchrondriosis = immovable joint
xiphosternal joint
What can become of the manubriosternal and xiphosternal joint as we age
they may fuse (ossify)
This part of the ribs articulates with 2 vertebral bodies and 1 disc
head
This part of the ribs articulates with 1 transverse process
tubercle
This region of the ribs is the of the greatest curve (angle is found here)
body
This part of the ribs is formed by intercostal vein, artery, and nerve
costal groove
This is the region of muscle attachment between upper limb and anterior chest
the pectoral region of the thoracic wall
What muscles compose the pectoral region
pectoralis major and minor
This muscle is divided into clavicular and sternocostal heads
pectoralis major
This muscle is enveloped in clavipectoral fascia
pectoralis minor
What bones and muscles are found in the anterior thoracic wall
ribs and sternum
pectoral, intercostal, and subcostal muscles
What vessels/nerves are found in the anterior thoracic wall
intercostal vessels and nerves
internal thoracic vessels
What are the different intercostal muscles
external
internal
innermost
These are located in the costal groove along the inferior rib superiorly
intercostal vein, artery, and nerve (in that order from superior to inferior)
These are located just superior to the superior part of a rib, or the inferior most part of an intercostal space
collateral nerve, artery, and vein (in that order from superior to inferior)
What vessles/nerve branches to give the collateral vessels/nerve
intercostal
The collateral and intercostal vessels re-join to form what
anterior perforating branches of intercostal vessels
Where do the anterior perforating branches branch at
just medial to internal thoracic artery and vein (closer to sternum)
This is the serous secreting membranes that reduce friction
pleura
This pleura covers the thoracic wall and is very sensitive to pain
parietal pleura
What nerves innervate the parietal pleura
intercostal and phrenic nerves
This pleura covers the lungs and is not sensitive to pain
visceral pleura
Where are both pleural layers continuous at
at the root of the lung
What are the four portions of the parietal pleura
cervical
costal
diaphragmatic
mediastinal
The pleural cavities are potential spaces of which can be filled with effusion (pathological fluid) and cause what damages
may compress lungs
difficulty breathing
pleural effusions are visible on chest radiographs
This is accumulation of air in the pleural cavity causing the collapse of the lung due to its own elasticity
pneumothorax
This is accumulation of blood in the pleural cavity and may cause adhesions and infection
hemothorax
This is inflammation of the pleura and usually leads to the formation of pleural adhesions between the parietal and visceral pleura; also can cause pain
pleurisy
This is the aspiration of fluids in the lungs
pleural tap; thoracentesis
Where is the best location for a thoracentesis
midaxillary line or slightly posterior
ICS of 6 or 7, in order not to pierce the diaphragm, liver/spleen, and to avoid the intercostals and collaterals.
Which lung has three lobes
right lung
upper, middle, and lower
Which lung has two lobes
left lung
upper and lower
What major fissure is found on both lungs
oblique
What minor fissure is found on the right lung one, separating the upper and middle lobes
horizontal
Where is the bronchus in the hilum of the right lung
it is always superior to pulmonary vessels
Where are the pulmonary veins located in the hilum of both lungs
most anterior/inferior
Where is the pulmonary artery in the hilum of the left lung
it is the most superior
This connects the lung to the mediastinum and is covered in a sleeve of pleura
root of the lungs
What is located in the root of the lungs
bronchi and pulmonary vessels
This is located inferior as the sleeve of pleura around the root of the lungs is mostly empty and collapsed, contains only a few lymph vessels
pulmonary ligament
This nerve passes anteriorly to the roots and is closely applied to pericardial sac
phrenic nerve
These vessels run with the phrenic nerve and are branches of internal thoracic artery and brachiocephalic vein
pericardiacophrenic vessels
This nerve passes posterior to roots and is closely applied to the trachea, esophagus, and aorta
vagus nerve
What does the vagus nerve pass anteriorly to near the left lung
anterior to arch of aorta
This artery supplies nutrients to bronchi and lungs
bronchia artery
Where do the sympathetic nerves come from that innervate the lungs
sympathetic trunk; T1-T5
Where do the parasympathetic nerves come from that innervate the lugns
vagus
The splits into the 2 primary bronchi
trachea
The primary bronchi split into what
2 (L) or 3 (R) secondary (lobar) bronchi
The secondary bronchi spilt into what
8 (L) or 10 (R) tertiary (segmental) bronchi
This is the median space between the 2 pleural sacs extending from thoracic inlet to diaphragm and from sternum to 12th thoracic vertebrae
mediastinum
What are the divisions of the mediastinum
superior
anterior
middle
posterior
This division of the mediastinum is above the sternal angle and T4-T5 IV disc
superior
This division of the mediastinum is between the sternum and pericardium (thymus found here)
anterior
This division of the mediastimun contains the pericardium and related structures
middle
This division of the mediastinum is between the pericardium and T5-T12 vertebrae
posterior
What structures does the middle mediastinum contain
pericardium and heart
phrenic nerve applied to pericardium
pericardiacophrenic vessels
roots of great vessels to and from heart
This is the tough fibrous sac line with serous membrane enclosing the heart and pierced by the roots of 8 vessels
pericardium
This portion of the pericardium is attached to the diaphragm interiorly
fibrous portion
This portion of the pericardium is divided into the parietal and visceral layers
serous portion
What are the 8 vessels that pierce the pericardium
SVC IVC aorta pulmonary trunk 4 pulmonary vessels
This lines the out fibrous pericardium
parietal pericardium
This covers the surface of the heart
visceral pericardium (epicardium)
The is the complete inner pericardial membrane (parietal and visceral layers)
pericardial sac
This is inside the pericardial sac and is a potential space between the serous and parietal layers containing only a small amount of serious fluid
pericardial cavity
This is the accumulation of fluid in pericardial cavity resulting in the compression of the heart, common with congestive heart failure
pericardial effusion
This is the accumulation of blood in the pericardial cavity associated with penetrating heart wounds or perforated heart muscles following MI
hemopericardium
Arterial bleeding into pericardial cavity leads to what
cardiac tamponade; compression of the heart and roots of great vessels
