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Anatomical Basis Of Clinical Practice > Gross anatomy of the thorax > Flashcards

Gross anatomy of the thorax Flashcards

1
Q

what heart chamber forms the base of the heart

A

left atrium

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2
Q

what chamber mainly forms the anterior (sternocostal) surface

A

right ventricle

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3
Q

which thorax vertebrae does the base of the heart lie opposite to

A

T5 - T8

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4
Q

what forms the diaphragmatic surface of the heart

A

mainly the left ventricle and partly by the right ventricle

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5
Q

what separates the two ventricles

A

posterior interventricular groove

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6
Q

describe the location of the pericardium in relation to the sternum, costal cartilagesand thoracic vertebrae

A
  • It lies posterior to body of sternum & 2-6 costal cartilages.
  • It lies anterior to 5-8 thoracic vertebrae
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7
Q

what are the main blood supply and drainage of the pericardium

A

pericardiacophrenic arteries and veins

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8
Q

what is the nerve supply of the fibrous pericardium

A

phrenic nerve

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9
Q

what is the nerve supply of the visceral layer of serous pericardium

A

branches of the sympathetic trunk and vagus nerves

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10
Q

how does fetal circulation differ from the adult one

A

The fetal circulation differs mainly from the adult one by the presence of 3 major vascular shunts:

  • Ductus venosus: between the umbilical vein and inferior vena cava.
  • Foramen ovale: between the right and left atrium.
  • Ductus arteriosus: between the pulmonary artery and arch of aorta.
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11
Q

how does Myocardial Ischaemia

occur and what are the two leading causes

A

Myocardial ischaemia occurs when the blood flow demands of the heart exceed the blood supplied by the coronary arteries.

The leading causes of myocardial ischaemia are:

  • atherosclerosis
  • blockage of coronary arteries due to the accumulation of lipid plaques and/or thrombus
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12
Q

in what direction do the fibres of the external intercostal muscle go

A

downward and forward

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13
Q

in which direction do the internal intercostal muscles go

A

downward and backward

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14
Q

what is the name of the nerve T12 and why is it called this

A

subcostal nerve because it arises below the ribs

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15
Q 
serratus posterior superior:
origin
insertion
innervation
action
A

spinous processes of C7-T3
superior borders of 2nd-4th ribs
2nd-5th intercostal nerves
elevate ribs

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16
Q 
serratus posterior inferior
origin
insertion
innervation
action
A

spinous processes of C7-L2 vertebrae
inferior borders of 8th-12th ribs near their angles
anterior rami to T9-T12 thoracic spinal nerves
depress ribs

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17
Q 
levator costarum
origin
insertion
innervation
action
A

transverse processes of C7-T11
subjacent ribs between tubercle and angle
posterior primary rami of C8-T11 nerves
elevate ribs

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18
Q 
external intercostal
origin
insertion
innervation
action
A

inferior border of ribs
superior border of ribs below
intercostal nerve
elevate ribs during forced inspiration

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19
Q 
internal intercostal
origin
insertion
innervation
action
A 
inferior border of ribs
superior border of ribs below
intercostal nerve
interosseous part: depresses ribs
interchondral part: elevates ribs
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20
Q 
innermost intercostal
origin
insertion
innervation
action
A 
inferior border of ribs
superior border of ribs below
intercostal nerve
interosseous part: depresses ribs
interchondral part: elevates ribs
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21
Q 
subcostal muscle
origin
insertion
innervation
action
A 
internal surface of lower ribs near their angles
superior border of 2nd or 3rd ribs below
intercostal nerve
interosseous part: depresses ribs
interchondral part: elevates ribs
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22
Q 
transverses thoracis
origin
insertion
innervation
action
A

posterior surface of lower sternum
internal surface of costal cartilages 2-6
intercostal nerve
weakly depress ribs

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23
Q

what is the foramen ovale

A

The FORAMEN OVALE is a hole between the right and left atria, allowing blood to pass from the right side to the left and not ever get pumped to the lungs.

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24
Q

what is the ductus arteriosus

A

The DUCTUS ARTERIOSUS allows blood to skip past the lungs and join up with the partially oxygenated blood that is being pumped out of the left ventricle.

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25
Q

which ribs are the “floating ribs”

A

11 and 12

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26
Q

between which thoracic vertebrae is the sternum placed

A

from T2-T9

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27
Q

which ribs are the typical ribs

A

3rd to 9th

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28
Q

describe the location of the superior mediastinum

A

from inlet of thorax to plane extending from level of sternal angle anteriorly to lower border of T4 vertebra posterioly

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29
Q

what are the contents of the superior mediastinum

A
  • Thymus
  • Three veins:
    > Left brachiocephelic v.
    > Right brachiocephelic v.
    > Superior vena cava
    > arch of aorta and its three branches (brachiocephalic trunk, left common carotid artery and left subclavian artery)
    > phrenic nerve
    > vagus nerve
    > trachea
    > oesophagus
    > thoracic duct
    > arch of azygos
    > left superior intercostal vein
    > left recurrent laryngeal nerve (branch of vagus)
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30
Q

describe the location of the anterior mediastinum

A

posterior to body of sternum and attached costal cartilages, anterior to heart and pericardium

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31
Q

what are the contents of the anterior mediastinum

A
  • fat
  • remnants of thymus gland,
  • anterior mediastinal lymph nodes
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32
Q

describe the location of the middle mediastinum

A

between anterior mediastinum and posterior mediastinum

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33
Q

what are the contents of the middle mediastinum

A
  • heart and pericardium
  • beginning or termination of great vessels
  • phrenic nerves
  • pericardiacophrenic vessels
  • lymph nodes
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34
Q

describe the location of the posterior mediastinum

A

posterior to heart and pericardium, anterior to vertebrae T5－T12

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35
Q

what are the contents of the posterior mediastinum

A

a) oesophagus
b) thoracic aorta
c) thoracic duct
d) azygos venous system

  • Sympathetic trunks
  • Thoracic splanchnic nerves
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36
Q

what is the function of the phrenic nerves

A

Both of these nerves supply motor fibres to the diaphragm and sensory fibres to the fibrous pericardium, mediastinal pleura, and diaphragmatic peritoneum.

37
Q

what are the structures and locations where the oesophagus can be compressed

A
  • the junction of the oesophagus with the pharynx in the neck;
  • in the superior mediastinum where the oesophagus is crossed by the arch of aorta;
  • in the posterior mediastinum where the oesophagus is compressed by the left main bronchus;
  • in the posterior mediastinum at the oesophageal hiatus in the diaphragm.
38
Q

describe the distribution of the sympathetic trunk

A
  • T1 – T4 = Thoracic viscera
  • T5 – T9 or T5 – T10 = Greater splanchnic n
  • T9 – T10 or T10 – T11 = Lesser splanchnic n
  • T12 = Least splanchnic n
39
Q

what are the two layers of pericardium

A
  • outer fibrous layer = Fibrous pericardium

- inner serous sac = serous pericardium

40
Q

which costal cartilages does the heart lie posteriorly to and which thoracic vertebrae does the heart lie anteriorly to

A
  • It lies posterior to body of sternum & 2-6 costal cartilages
  • It lies anterior to 5-8 thoracic vertebrae
41
Q

what is contained in the pericardial cavity and what is its function

A
  • Pericardial cavity contains pericardial fluid

- acts as a lubricant

42
Q

what is the thing that separates the two atria from the ventricles

A

The 2 atria are separated from ventricles by the atrioventricular groove ( coronary sulcus)

43
Q

what separates the two ventricles

A

The 2 ventricles are separated by the ant. & post. Interventricular grooves

44
Q

what forms the upper border of the sterno-costal surface of the heart

A

formed by 2-atria, mainly the left

45
Q

what forms the right border of the sterno-costal surface of the heart

A

formed only by right atrium

46
Q

what forms the lower border of the sterno-costal surface of the heart

A

formed mainly by the right ventricle but also by right atrium

47
Q

what forms the left border of the sterno-costal surface of the heart

A

mainly by the left ventricle & left auricle

48
Q

how many cusps does the aortic valve have

A

3

49
Q

is the standard view of an x-ray PA or AP

A

PA

50
Q

what is the normal size for a heart in a chest x-ray

A

Occupies up to 50% of the maximum internal thoracic diameter on a standard PA erect view

51
Q

between which structures is the tricuspid valve found

A

right atrium and right ventricle

52
Q

between which structures is the mitral valve found

A

left atrium and left ventricle

53
Q

what forms the right border of the heart

A

right atrium

54
Q

what forms the inferior border of the heart

A

left ventricle and right ventricle

55
Q

what forms the left border of the heart

A

left ventricle (and some of the left atrium)

56
Q

what forms the superior border of the heart

A

right and left atrium and the great vessels

57
Q

what makes up the anterior (or sternocostal) division of the heart

A

Right ventricle

58
Q

what makes up the posterior (or base) division of the heart

A

Left atrium

59
Q

what makes up the inferior (or diaphragmatic) division of the heart

A

Left and right ventricles

60
Q

what makes up the

right pulmonary division of the heart

A

Right atrium

61
Q

what makes up the left pulmonary division of the heart

A

Left ventricle

62
Q

The right lung contains a horizontal fissure. What rib does this fissure follow the course of?

A

4th

63
Q

The parasympathetic supply to the lungs is derived from which nerve?

A

Vagus nerve

64
Q

The mediastinum is divided into superior and inferior compartments by an imaginary line at what vertebral level?

A

T4

65
Q

What forms the posterior border of the superior mediastinum

A

Vertebral bodies T1-T4

66
Q

What are the nerve roots of the phrenic nerve

A

C3,4,5

67
Q

What is the posterior border of the anterior mediastinum?

A

Pericardium

68
Q

Which muscle forms the floor of the anterior mediastinum?

A

Diaphragm

69
Q

In adolescents, which organ can be found within the anterior mediastinum?

A

thymus

70
Q

The sternal angle is formed by the junction of which two bones?

A

Sternal body and manubrium

71
Q

Which muscle forms the inferior border of the middle mediastinum?

A

Diaphragm

72
Q

Which of the great vessels of the heart gives rise to the coronary arteries?

A

Ascending aorta

73
Q

What is the anterior border of the posterior mediastinum?

A

Pericardium

74
Q

Which part of the aorta is located within the posterior mediastinum?

A

Descending aorta

75
Q

Via which diaphragmatic hiatus does the thoracic duct enter the posterior mediastinum?

A

Aortic hiatus

76
Q

Which part of the sternum articulates with the clavicle?

A

Manubrium

77
Q

Which structures do the sternal articular facets articulate with?

A

Costal cartilage of the ribs

78
Q

What is the approximate vertebral level of the tip of the xiphoid process?

A

T10

79
Q

Which option correctly describes the contents of the costal groove?

a) Intercostal artery
b) Intercostal vein
c) Intercostal nerve
d) All of the above

A

d

80
Q

Which part of the vertebrae does the tubercle of each rib articulate with?

A

Transverse process

81
Q

Which structure does the central tendon of the diaphragm fuse with?

A

Pericardium

82
Q

Approximately which vertebral level is the oesophageal hiatus situated?

A

T10

83
Q

What is the innervation of the diaphragm?

A

Phrenic nerves

84
Q

Which of the following muscles is active during the inspiratory phase of breathing?

a) Internal oblique
b) Internal intercostals
c) External intercostals
d) Transversus thoracis

A

c

85
Q

Transversus thoracis extend from the inferior sternum to the internal costal cartilages of which ribs?

A

2-6

86
Q

A patient is undergoing a bronchoscopy for removal of a foreign object. At approximately which vertebral level does the trachea bifurcate?

A

T4

87
Q

Which nerve supplies sensory innervation to the mucosa of the trachea?

A

Recurrent laryngeal nerve

88
Q

At patient presents with a stab wound to the chest. A open thoracotomy is performed. In which of the following spaces can the superior vena cava be located?

a) Posterior mediastinum
b) Diaphragmatic caval hiatus
c) Entrance to left atrium
d) Superior mediastinum

A

Superior mediastinum

89
Q

The superior vena cava receives tributaries from which vessel?

A

Azygous vein

Anatomical Basis Of Clinical Practice (4 decks)

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