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Anatomy 6513 UNIT 3 > G: Thoracic Wall > Flashcards

G: Thoracic Wall Flashcards

1
Q

The thoracic cavity is enclosed by __ and __

A

thoracic wall and diaphragm

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2
Q

The thoracic cavity is subdivided into compartments: _____

A

left and right pleural cavities

& mediastinum

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3
Q

Thoracic wall boundaries:

posterior: ___
lateral: ___
anterior: ___

A

posterior: thoracic vertebrae
lateral: ribs and intercostal mm
anterior: sternum (all 3 parts)

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4
Q

what are the 3 parts of sternum

A

manubrium, body, xiphoid process

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5
Q

Manubrium has clavicular notch for ___ joint

A

sternoclavicular joint

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6
Q

Sternal body joins with manubrium at the ___

A

sternal angle (of louis)

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7
Q

___ is the lowest point on the sternum

A

xiphoid process

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8
Q

the head of the rib articulates with ____

A

2 vertebral bodie sand 1 disc

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9
Q

The tubercle of the rib articulats with ___

A

1 transverse process

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10
Q

The __ of the rib is the region of the greatest curve on the BODY

A

angle

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11
Q

The costal groove of the rib is formed by ____

A

intercostal a., v., n.

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12
Q

External to the anterior thoracic wall is the ___ region

A

pectoral

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13
Q

___ region anchors the upper limb to the trunk

A

pectoral

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14
Q

Pectoral region is divided into 2 compartments

A

superficial

deep

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15
Q

Pectoral region

superficial compartment contains ____

deep compartment contains ___

A

superficial - skin, superficial fascia, breasts

deep = muscles, associated structures

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16
Q

Breast is ___ in women; ___ _ in men

A

well developed in women

rudimentary in men

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17
Q

Breast tissue consists of ____ embedded in fatty matrix

A

secretory glands

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18
Q

Breast tissue consists of secretory glands embedded in ___

A

fatty matrix

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19
Q

Breast tissue consists of secretory glands embedded in fatty matrix, with overlying ___

A

skin and superficial fascia

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20
Q

Lateral blood supply to the breast consists of branches of ____

A

axillary artery

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21
Q

What branches of axillary artery supply lateral breast tissue?

A
  1. superior thoracic
  2. thoracoacromial –> pectoral branch
  3. lateral thoracic artery
  4. subscapular artery
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22
Q

Lateral thoracic artery runs with ____

what is clinical implication of this

A

long thoracic nerve

in mastictamy can injure - winged scapula

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23
Q

Medial blood supply comes from branches of ___

A

internal thoracic artery

and branches of 2nd and 4th intercostal artery

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24
Q

Lymphatics from the breast drain into __ nodes and __ nodes

A

parasternal nodes

axillary nodes

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25
Q

Innervation of breast is from ____ branches of ____

A

lateral and anterior branches of 2nd - 6th intercostal nerve

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26
Q

Lateral/anterior branches of 2nd-6th intercostal nerve provide ___ innervation for ___

A

cutaneous (general sensory) innervation to breast

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27
Q

What 2 muscles are found in the pectoral region

A

pectoralis minor

pectoralis major

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28
Q

Pectoralis major is divided into 2 heads.

  • what are names
  • are they superior/inferior
  • are they larger/smaller
A

smaller, superior clavicular head

lower, larger sternocostal head

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29
Q

pectoralis major/minor

which is deep/superficial

A

pectoralis minor is deep to pectoralis major

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30
Q

pectoralis minor is enveloped in ___

A

clavipectoral fascia

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31
Q

What are the muscles associated with the anterior thoracic wall?

A 
traversus thoracic
subcostal m
intermost intercostal m
internal intercostal m
external intercostal m
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32
Q

Transversus thoracic m run along the __ and to the ___

A

sternum

between the sternum and the costal cartilages

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33
Q

Subcostal muscle run in the same plane as the ___ mm.

Subcostal muscles generally span __ ribs

A

innermost intercostal m

2 ribs

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34
Q

What are the intercostal muscles of the thoracic wall?

A

external intcostal m

internal intercostal m

innermost intercostal m

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35
Q

____ fibers go DOWN TOWARDS MIDLINE

___ fibers go UP AWAY FROM MIDLINE

A

External intercostal m = DOWN TOWARDS MIDLINE

internal and innermost intercostal m = UP AWAY FROM MIDLINE

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36
Q

Neurovasculature to the thoracic wall runs between __ and __

A

internal m and innermost interncostal m

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37
Q

Anterior intercostal atrtery comes off of ____

A

internal thoracic artery

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38
Q

You can see the internal thoracic artery running ___

A

on either side of the sternum

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39
Q

Internal thoracic artery gives up branch ____

A

anterior intercostal artery

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40
Q

Posterior intercostal artery comes off of ___

A

thoracic aorta

*except first 2 posterior intercostal arteries

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41
Q

Most posterior intercostal arteries come off of ____

The first 2 posterior intercostal arteries come off of ____

A

most = thoracic aorta

first 2 = supreme intercostal artery (branch of costal cervical trunk, branch of subclavian artery)

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42
Q

Subclavian artery –> ____ -> _____ –> first 2 posterior intercostal arteries

A

Subclavian artery ->

Costal cervical trunk ->

supreme intercostal artery ->

first 2 branches of posterior intercostal artery

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43
Q

Intercostal vein, artery and nerve lie in the _____, along the inferior margin of the rib

A

costal groove

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44
Q

Intercostal vein, artery and nerve lie in the costal groove, along the ___ margin of the rib

A

inferior

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45
Q

Intercostal v., a., n. run along the costal groove along the inferior margin of the rib

These pass in the plane between ___ and __

A

internal intercostal m and innermost intercostal m

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46
Q

From superior to inferior, name the contents of the costal groove (intercostal v., a., n.)

A

SUPERIOR -> INFERIOR

VEIN -> ARTERY -> NERVE

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47
Q

Collateral nerves., artery and vein in teh thoracic wall arise from _____

A

intercostal n., a., v.

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48
Q

Collateral n., a., v. from intercostal n., a., v are located ____

A

at the superior margin of the rib below

below where the intercostal v., a., n are located

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49
Q

From superior to inferior, name the order of the collateral branches of intercostal v., a., n.

A

SUPERIOR -> INFERIOR

NERVE -> ARTERY -> VEIN

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50
Q

What is the relationship between anterior intercostal vasculature and posterior intercostal vasculature?

A

anastomose with each other

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51
Q

Deep to the intercostal space is the ____

A

pleural cavity/lungs

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52
Q

Pleural cavities are located on either side of the ___

A

mediastinum

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53
Q

Pleural cavities are POTENTIAL SPACE enclosed between __ and __

A

visceral and serous pleura

54
Q

Are the pleural cavities a real cavity?

What is it filled with?

A

no
potential space

a few mm of serous fluid

55
Q

Pleura is ____

A

serous secreting membranes that reduce friction

56
Q

Parietal pleura covers ___

Visceral pleura covers ___

A

Parietal pleura covers THORACIC WALL

Visceral pleura covers LUNGS

57
Q

What is the sensory nerve supply for parietal pleura vs. visceral pleura?

A

parietal pleura - intercostal n and phrenic n

visceral pleura - no sensory nerve supply

58
Q

The parietal pleura and visceral pleura are continuous at ___

A

the root of the lung

59
Q

What are the sub-categories of the parietal pleura?

A

cervical pleura
costal pleura
diaphragmatic pleura
mediastinal pleura

(associated w/ closest area)

60
Q

The pleural cavity is a POTENTIAL SPACE that normally contains a very thin layer of ___

A

serous fluid

61
Q

What is pleural effusion?

A

pathological accumulation of excess fluid within the pleural space

62
Q

What does pleural effusion lead to?

A

compressed lungs

difficulty breathing

63
Q

How does pleural effusion appear on chest films?

A

pleural effusions are visible on chest films

can obscure lungs on film

64
Q

What is pneumothorax?

What does this lead to?

A

accumulation of AIR in pleural cavity

collapse of lung due to it’s own elasticity

65
Q

What is hemothorax?

What does this lead to?

A

accumulation of blood in pleural cavity

may cause adhesions and infection if not removed

66
Q

What is pleurisy?

what does this lead to?

A

inflammation of pleura

leads to pleural adhesions between parietal and visceral pleura

can produce exquisite pain relative to PARIETAL PLEURA (bc visceral pleura doesn’t have sensory innervation)

67
Q

Thoracentesis aka ___

A

pleural tap

68
Q

What is pleural tap (thoracentesis)?

A

aspiration of fluid from pleural space

69
Q

Pleural taps are often done in what location?

A

mid-axillary line or slightly posterior

between intercostal space 6 or 7

70
Q

If a pleural tap (thoracentesis) needle is located in intercostal space 8 or 9, what can happen?

A

can pierce diaphragm, liver or spleen

so we place need in intercostal space 6 or 7

71
Q

While doing a pleural tap (thoracentesis), you have to position the needle to avoid ____

A

intercostal n., a., v

72
Q

The right lung has __ lobes

The left lung has ___ lobes

A

Right lung = 3 lobes (superior, middle, lower)

Left lung = 2 lobes (superior and inferior)

73
Q

Oblique (major) fissure is found on ___ lung

Horizontal (minor) fissure is found ___ lung

A

Oblique (major) fissure is on left and right lung

Horizontal (minor) fissure is on RIGHT only

74
Q

The right lung has impressions of the following structures _____

A 
esophagus
azygos vein
superior vena cava
inferior vena cava
heart
subclavian artery and vein
75
Q

The left lung has impressions of the following structures ____

A 
esophagus
thoracic aorta
heart
aortic arch
left brachiocephalic vein
left subclavian artery
76
Q

The root of the lung is a SHORT, TUBULAR collection of structures that connects the lungs to the ___

A

mediastinum

77
Q

The root of the lung consists of ___

A

bronchi and pulmonaruy artery and vein

78
Q

The root of the lung is covered in a sleeve of ___

A

pleura

79
Q

What is the pulmonary ligament?

A

thin, inferior fold of pleura continuing from inferior aspect of root of lung

80
Q

What is within the pulmonary ligament?

A

mostly empty and collapsed

contains only a few lymphatic vessels

81
Q

The opening to the root of the lung is called the ____

A

hilum

82
Q

The bronchus is composed of ____; so it is the ___ structure in the root of the lung

A

cartilage

thickest

83
Q

What is superior/inferior in the root of the lung:

pulmonary artery/vein

A

Pulmonary artery is ABOVE vein

84
Q

Pulmonary arteries carry ___ to ____

Pulmonary veins carry ___ to ___

A

Pulmonary artery carries deoxygenated blood to lungs

Pulmonary veins carry oxygenated blood to heart

85
Q

The pulmonary artery relative to the bronchu is different on R/L side

how do you remember where is it located?

A

RALS

RA = RIGHT pulmonary artery is ANTERIOR to bronchus

LS = LEFT pulmonary artery is SUPERIOR to bronchus

86
Q

The trachea splits into ____

A

2 primary (main) bronchi

87
Q

Primary (main) bronchi split into ____

A

RIGHT: 3 secondary (lobar) bronchi

LEFT: 2 secondary (lobar) bronchi

88
Q

Secondary (lobar) bronchi split into ___

A

RIGHT: 10 tertiary (segmental) bronchi

LEFT: 8 tertiary (segmental) bronchi

89
Q

Tertiary bronchi create partitions called ___

A

bronchopulmonary segment

90
Q

What is the bronchopulmonary segment

A

area of lung supplied by segmental (tertiary) bronchus

supplied by a single branch of pulmonary artery

smallest functionally independent regio

91
Q

Sympathetic trunk is located ____ to vertebral column

Contributes to ___ plexuses

___ bronchioles

A

paravertebral

contributes to anterior and posterior pulmonary plexuses

dilates bronchioles

92
Q

Vagus nerve pass ___ to root of lung

A

posteriorly

93
Q

The vagus nerves are closely applied to what structures?

A

trachae, esophagus, aorta

94
Q

Vagus nerves contribute to ____ plexuses

___ bronchioles

A

contribute to anterior/posterior pulmonary plexuses

constrict the bronchioles

95
Q

What neurovasculature is associated with the root of the lung?

A

vagus nn
phrenic nn
pericardiocophrenic vessels

96
Q

Vagus nn pass ____ to root of lungs

A

posteriorly

97
Q

Phrenic nn pass ___ to root of lungs

Closely applied to ____

A

anteriorly

pericardial sac

98
Q

Pericardiocophrenic vessels run with the ___

A

phrenic nn

99
Q

Pericardiacophrenic vessels are branches of ____ arteries and ___ veins

A

internal thoracic artery

brachiocephalic vein

100
Q

Bronchial arteries

supply nutrients to ____

branch of ____

A

supply nutrients to bronchi and lungs

branch of thoracic aorta or associated branch

101
Q

What lymph vessels and nodes are associated with the lungs?

A

tracheobronchial nodes

^^ these drain to –>

bronchomediastinal trunks

102
Q

Mediastinum is ____ separating the ___

A

broad, central partition separating the 2 pleural cavities

103
Q

Mediastinum is sub-divided into 4 smaller regions ___

A

superior

inferior (anterior, middle, posterior)

104
Q

____ divides the superior form inferior mediastinum

A

sternal angle

105
Q

The mediastinum extends:

__ superiorly to __ inferiorly

__ anteriorly to __ posteirorly

A

thoracic inlet (superior) to diaphragm (inferior)

Sternum (anterior) to thoracic vertebrae, down to T12 (posteriorly)

106
Q

Middle mediastinum contains what structures

A

pericardium and heart

phrenic nn applied to pericardium

pericardiacphrenic vv

roots of great vessle sto and from heart

107
Q

Pericardium is a tough __ sac lined with ___

A

fibrous sac

lined with serous membrane

108
Q

Describe the fibrous portion of the pericardium

A

tough connective tissue outer layer

attached to the diaphragm inferiorly

109
Q

Describe the serous portion of the pericardium

A

divided into parietal and visceral layers

110
Q

Pericardium encloses the __

A

heart

111
Q

Pericardium is pierced by __ vessels.

Name them.

A

8 vessels

superior vena cava
inferior vena cava
aorta
pulmonary trunk
4 pulmonary veins
112
Q

Overlying pectoralis major is _____

A

deep fascia (pectoral fascia)

113
Q

Secretory glands on top of deep fascia (which is on top of pectoralis major) are for ___ glands

A

lactiferous ducts

114
Q

Lactiferous ducts (ducts from secretory glands) come together to form _____

A

lactiferous sinuses

115
Q

___ individually open up into the nipple

A

lactiferous sinuses

116
Q

Anterior intercostal veins drain into ____

A

internal thoracic vein

117
Q

Internal thoracic vein drains into ___

A

brachiocephalic vein

118
Q

RIGHT posterior intercostal vein drains into ___

A

azygos vein

119
Q

LEFT posterior intercostal vein drains into ___

A

hemiazygos vein or accessory hemaiazygos vein

which BOTH drain into azygous vein

120
Q

which is superior / inferior: hemiazygous vein vs. accessory hemiazygous vein

where do they drain to?

A

hemiazogous is inferior

accessory hemiazygous is superior

both drain into azygous vein

121
Q

Right superior intercostal vein drains into ___

A

azygos vein

122
Q

Left superior intercostal vein drains into ___

A

left brachiocephalic

123
Q

Ducts from the secretory glands in breast adipose tissue are called ___

A

lactiferous ducts

124
Q

Lactiferous ducts open up into ___

A

lactiferous sinuses

125
Q

Anterior intercostal vein drains into ___

A

internal thoracic vein

126
Q

Internal thoracic vein drains into ___

A

brachiocephalic vein

127
Q

Right posterior intercostal vein drains into ___

A

azygos vein

128
Q

Left posterior intercostal vein drains into ____

A 
hemiazygos vein (inferiorly)
accessory hemiazygous vein (superiorly)

BOTH: drain into azygos vein

129
Q

Azygos vein drains into ___

A

superior vena cava

130
Q

Right superior intercostal vein drains into ___

A

azygos vein

131
Q

Left superior intercostal vein drains into ___

A

left brachicephalic vein

Anatomy 6513 UNIT 3 (13 decks)

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