Gross Anatomy- THORAX Flashcards
Rib heads articulate with corresponding vertebrae and the one above EXCEPT
1,10,11,12 (all that contain “1” correspond with ONE vertebrae)
ribs 1-10 tubercles articulate with the same level ___ process
transverse
ribs 11,12 DO NOT articulate with
transverse processes
atypical ribs
1,2,11,12 [if it contains a “1” or a “2” its atypical (weird people come in 1st or 2nd) ]
typical ribs
3,4,5,6,7,8,9
true ribs
1-7 (articulate with the sternum directly)
false ribs
8-12
floating ribs
11,12 (no cartilage)
Suprasternal notch landmarks
TV 2,3
sternal angle landmark
manubriosternal jt, angle of Louis)
lower border of T4 (t4/5 disc)
xiphisternal joint landmark
TV 9
diploid process
TV 10,11
the thoracic cage is formed by
thoracic vertebrae, ribs, costal cartilage, and sternum
Openings in the diaphragm
I 8, 10 Eggs, At 12
T8- IVC, R. Phrenic Nerve, Lymph
E10- Esophagus, Vagus nerve, Esophageal branch of left gastric vessels
Aortic T12- Aorta, Thoracic Duct, Azygos Vein
Right Dome of Diaphragm level
Upper border of RIB 5
Left Dome of diaphragm
lower border of Rib 5
T/F the from of the diaphragm is lower than the back of the diaphragm
False, the back is lower
drop your backside low
blood supply of the diaphragm
Musculophrenic
Sup and Inf Phrenic
Pericardiophrenic
Post Intercostal
motor enervation of the diaphragm
phrenic nerve
sensory innervation of the diaphragm
phrenic (central portion) and Intercostal nerves (T5-12)- Peripheral portion
what dermatome is the nipple
T4
what dermatome is the umbilicus
T10
Dorsal Rami provides sensory to
back and posterior neck
ventral rami provides sensory to
the rest, not including the back and posterior neck.
what’s a dermatome
sensory innervation of an area or skin supplied by a spinal nerve (dorsal root) via dorsal and ventral primary rami
What is inspiration (anatomically)
CONTRACT the diaphragm (C3-C5) Ribs ELEVATE (transverse and AP)
Bucket handle
Transverse axis rib elevation
pump handle
A-P axis Rib elevation
Expiration is (anatomically)
the relaxation of contracted muscles
passive, while inhalation is active
Superior Mediastinum
begins at thoracic inlet Arch of Aorta (brachycephalic trunk, left common carotid, left subclavian) brachiocephalic vein Superior vena cava thymus in children esophagus trachea thoracic duct nerves: vagus, phrenic, L.recurrent laryngeal
anterior mediastinum
between sternum and pericardium
Fatty tissue
thymus in infants is MOST anterior
lymph nodes
middle mediastinum
between pleural cavities heart roots of great vessels main bronchi pericardium phrenics
posterior mediastinum
between pericardium and vertebral bodies esophagus thoracic aorta azygos system thoracic duct vagus nerves splanchnic nerves
what is the most anterior in the superior mediastinum
thymus (fat) children
what is the second most anterior in the superior mediastinum
the LEFT brachiocephalic VEIN
sternal angle
costal cartilage of rib 2 lower border of T4 (T4/5) trachea bifurcation pulmonary trunk bifurcates beginning and and of the aortic arch cardiac plexuses ligamentum arteriosum left recurrent laryngeal nerve
subcostal nerve, not intercostal nerve, does not run in intercostal space
T12
ventral (anterior) primary rami intercostal nerves
T1-11
what s the order of the neurovasculature in the intercostals
VAN - Vein artery nerve
closest to rib-vein
furthest from rib-nerve
what are the layer of the intercostal nerves and vessels between
between internal and innermost intercostal muscles and travel in the costal groove on the inf. surface of the rib.
the intercostal nerves have both cutaneous and muscular branches T/F
True
intercostal arteries
anterior and posterior intercostals
anterior intercostals
internal thoracic artery (space 1-6) musculophrenic artery (space 7-9)
posterior intercostal 1(2)
highest (superior/ supreme) intercostal artery which is a branch of the costocerevical trunk
posterior intercostal 2(3)-11
posterior intercostal arteries branch from thoracic aorta)
subcostal artery (12) branches from
thoracic aorta
layers of penetration from (mid axillary line)
Skin Superficial Fascia Deep Fascia Serratus Anterior Esternal Internal Innermost intercostal Endothoracic Fascia Parietal pleura pleural cavity visceral pleural lungs
Visceral Pleura
covers organ
blood supply- bronchial artery (aorta)
innervated by Vagus (sketch and respiratory reflex)
insensitive to pain
parietal pleura
lines cavity wall(costal, mediastinal, diaphragmatic)
blood- intercostal and internal thoracic arteries
nerve- intercostal, subcostal, and phrenic
SENSTIVE TO PAIN
which pleura does not feel pain
visceral pleura
cupola
parietal pleura over the lung apex
pleural cavity
potential space between parietal and visceral pleura, contains a film of fluid that lubricates the pleural surfaces and facilitates movement
end-thoracic fascia
loose connective tissue that separates parietal pleura from thoracic wall
supra pleural membrane (Gibson’s fasciae) extension of end-thoracic fascia that covers lung apex.
costodiaphragmatic recess (space)
formed by the reflection of the costal and diaphragmatic pleura, can accumulate fluid
allows lung expansion
Thoracocentesis
9th intercostal space, midaxillary line.
internal thoracic artery arises from
1st part of subclavian artery
internal thoracic artery supplies
pleura, pericardium, diaphragm, anterior thoracic wall and muscles, abdominal wall muscles
branches of internal thoracic artery
pericardiophrenic
anterior intercostal arteries (upper 6 intercostal spaces, 2 in each space)
musculophrenic: sends arteries to intercostal spaces 7-9, ends
superior epigastric: anastomoses with inferior epigastric artery
which artery forms an anastomoses with the inferior epigastric artery
superior epigastric artery.
what attaches the lungs to the heart and trachea
the root and pulmonary ligament
arteries of the lung
bronchial and pulmonary
what supplies non respiratory tissue with blood
bronchial arteries
what supplies blood for gas exchange
pulmonary arteries
veins of the lung
bronchial and pulmonary
bronchial is minor
neural innervation of the lungs
vagus nerve (pulmonary plexus) and sympathetic (T2-5)
left lung
2 lobes (upper lower)
oblique issue
lingual
prominent cardiac notch and impression
right lung
3 lobes
oblique and horizontal issues
shorter and wider than the left
15-20 C shaped cartilages make up the
trachea
the trachea extends from
CV 6 to TV 4
carina
last tracheal cartilage, separates primary bronchi openings
Right Bronchus
Wider, Shorter, more vertical
3 secondary bronchi, one each lobe (lobar bronchi)
Eparterial bronchus (superior lobar bronchus)
inferior and middle lobar bronchi
10 bronchopulmonary segments
azygos vein arches over
Left bronchi
narrower, longer, more horizontal
2 secondary bronchi (superior and inferior lobar bronchi)
-8(9) bronchopulmanary segments
runs anterior to thoracic aurora and inferior to aortic arch
bronchopulmanary segment
subdivision of lung
tertiary bronchus
segmental artery and vein
can be removed without disrupting neighboring tissue
lung root contains
bronchus
pulmonary artery (less oxygenates blood going from heart to lungs)
pulmonary veins (more oxygenated blood going from lungs to heart)
bronchial arteries and veins
lymphatics and nodes (bronchopulmanary)
nerves
hilum of the lung
area of the lung where the root of the lungs enters and exits, also where the parietal and visceral pleura meet
left lung root and hilum
bronchi are posterior
arteries are superior
veins are inferior (and anterior)
right lung roots and hilum
bronchi are posterior
eparterial bronchus (right superior lobar bronchus) is superior
arteries are anterior
veins are inferior and anterior
midclavicular
lung Rib 6
Pleura Rib 8
midaxillary
lung rib 8
pleura rib 10
posteriorly
lung rib 10
pleura rib 12
oblique fissure is at what level
begins at 2.5” from the apex of the lung, about the level of T4
ends at rib 6 costal cartilage
horizontal issues level
only on the right side
level of rib 4 and its costal cartilage
apex of the lung projects…
2.5cm above clavicle
lung and pleura (cupula) in this region are susceptible to injury
