Heart Breast Rib Flashcards
Where does the breast span from?
2-6 intercostal
two regions of breast
circular and axillary running along inferior lateral edge of pec major to axillary fossa
What are mammary glands
modified sweat glands 15-20. Lobule are mult alveoli drained by a single lactiferous duct converging on a nipple
What is stroma?
supporting structure around mammary gland what is fibrous and fatty. Fibrous is cooper which attach and secure breast and dermis.
What does the breast sit on?
pectroal fascia of pec major. There is a retromammary space.
Vasculature of breast?
medial: internal thoracic artery which is a branch of subclavian artery. Lateral: part recieves from 4 lateral rhoracic and thoracoacromial lateral mammary mammary. Vein drain into axillary and internal thoracic
Lymph of breast
metastasis importance. 3 groups that recieve. The axillary recieves 75%, parasternal 20%, posterior intercostal 5%.
Skin drains to axillary, inferior deep cervical
Nipple drains to subareorlary
Nerve
anterior and lateral cutaneous branches of 4th to 6th. Not milk. Prolactin which is secreted to anterior pituitary glands
What is the pericardium?
the pericardium is a fibroserous, fluid filled sack that surrounds the muscular body of the heart and the roots of the great vessels (the aorta, pulmonary artery, pulmonary vein and the superior and inferior vena cava).
What does the pericardium do?
fixes the heart to the medistinum
prevents overfilling of heart
Lubricates the movement
protects from infection
What is the pericardium made of?
Two layers - tough external layer known as fibrous pericardium, and thin internal layer known as serous.
Fibrous is continuous with ceentral tendon of diaphragm made of tough connective tissue.
Serous is divided in two - outer parietal lining internal surface of fibrous. Internal visceral forming outer layer of heart epicardium. Each has a single sheet of epithelial cells known as mesothelium.
In between is the pericardial cavity lubricating.
what is FPSV
fibrous layer
PArietal layer of serious
Serous
Vesceral layer of serous
What is the transverse pericardial sinus?
passage through transverse pericardial sinus located posteriorly to ascending aorta and pul trunk anterior to SVC and sup to left atrium
Heart innervation
phrenic C3-5 reffered pain shoulder.
Where is the aorta
base of left ventricle. coronary arteries branch off. After this is the arch of aorta which divides into brachiocephalic trunk, left common carotid artery, left subclavian artery.
pulmonary arteries?
recieve deoxygenatedblood from right entricl and go to lunges. The pulmonary valve which is anterior and medial to right aatrium
What level does the pulmonary trunk split
T5-6
How many pulmonary veins are there
superior and inferior for each lung entering pericardium to drain into the sup left atrium.
What is the coronary sinus?
collection of veins joined to form large vessel that cellects blood from heart..
There are two pericardial sinuses transverse and oblique.
Transverse - between aorta and pulmonary artery anterior.
`the Coronary sinus starts at the junction of the great cardiac vein and oblique vein of the left atrium.
Where is the apex beat?
lateral and inferior point at which you can feel the beat. 5th ICS MCL left of sterum.
Order of valves?
PAMT Pulmonary 3 cc Aortic 3 IC M 4CC T 4th IC
3344
How do we listen to the valves?
Aortic 2nd ICS right of sternum
Pulmonary 2nd ICS left of sternum
Borders of heart
right - 3 - 6 cc
left - 2 l cc to 5 l ics
lower - 6 right cc to 5th left ics mcl
upper - 2nd l cc to 3rd r cc
valve locations
pulmonary - 3rd left cc retro
aortic valve - 3rd left ics retro
mitral - 4th left cc retro
tricuspid - 4th right ics retro
ausculations points
pulmonary valve - 2nd left ics
aortic - 2nd right ics
mitral - 5th left incs mcl
apex beat - 5th left ics mcl
tricuspid valve - 4 left ics
left brachiocephalic
runs obliquely from left sternal clav joint to join right brachiocephalic behind 1st cc
1st cc
formation of superior vena cava
2nd CC
azygos vein drains into SVC
3rd CC
SVC DRAINS INTO RIGHT ATRIA
arch of aorta
sternal angle of louie
pulmonary trunk
T4
What is at level T4
bifurcation of the trachea. Bifurcation of pulmonary trunk. Azygos termination Ligamentum arteriousum. Ductus arteriosum.
where is the cephalic vein
in the deltopectoral groove
Pec minor attach
coracoid process and ribs 345
subclavius muscle
clavical to 1st rib
Breast extends from
mid axiallary line to ribs 2-6
bumps on areola?
montgomery follicles
Describe aortic valve
3 semilunar. right cusp, left cusp, posterior non coronary cusp. Nodule in middle
What else is into the aorta
right and left airotic sinuses which are the openings of the right and left coronary arteries.
Where is the SA node
junction of SVC and right atrium
Where is the AV node
atrial septum near the opening of the coronary sinus
what does the right coronary artery give rise to
marginal and posterior intrventricular
Where does the SA nodal artery come from
the anterior right atrial branch of the right coronary artery
Where is the right conornary artery
the coronary sulcus AV groove
The left main coronary artery gives rise to which major branches
circumflec and anterior interventricular (left anterior descending)
What supplies left ventricl walls
LAD which runs in the interventricular groove.
Where do all the major cardiac veins terminate in which structure?
Coronary sinus in the posterior coronary sulcus drains into right atrium
Which vein goes with posterior descending
right marginal artery
middle cardiac vein
small cardiac vein
what is in the anterior interventricular sulcus with the LAD artery
great cardiac vein
men the nipple is?
the fourth ics
Where does milk flow
lactiferous duct to lactiferous sinus to nipple
3 major arteries that supply blood to the breast
perforating branches of internal thoracic
lateral thoracic
pectoral
lymph
most is lateral axially 75%
parasternal
lymph between pec major minor
rotters
defining features of cervical
spinous process bifurcates into two parts
two transverse foramina one in each transverse process for vertebral arteries
vertebral foramen is triangular
Defining features or thoracic
demi facets on each side which articulate with rib and inferior rib.
Transverse process has costal facet for rib
spinous porcess are slanted inferiorly and anteriorly for prtoection.
Vertabral foramina is circular
Lumbar features
large
triangular foramina
