Internal thorax Flashcards
Source of sym innervation
T1-L2
Source of parasymp innervation
brain stem and S2,3,4
contents of middle mediatinum
pericardium, heart, origins of great vessels
borders of middle mediastinum
ant, post, sup
contents of ant mediastinum
internal thoracic vessels + thymus
contents of sup mediastinum
esoph, trach, aortic arch, brachiocehpalic veins, SVC, brach. trunk (art) left common carotid + left subclavian, phrenic, vagus, L recurrent laryngeal
order of sup mediastinum vessels
veins, arteries, wind, water - ant to post
course of vagus nerve (X)
runs down along esophagus
contents of post mediastinum
symp trunk, throracic duct, azygous(es), dec aorta, esoph, primary bronchi
4 portions of parietal lung pleura and their innervation
cupola - supraclavicular
mediastinal - phrenic
costal - intercostals
diaphragmatic - intercostal (ext) and phrenic (int)
level of tracheal bifurcation
T4/5
vessels that loop over trach
L - aorta
R - azygous
bronchi branches
primary (main)>secondary (lobar)> tertiary (segmental > intrapulmonary
surfaces of lung
apex, base, costal, mediastinal
pulmonary ligament
fold at the inferior reflection of root of lung
level of pulm artery branches
T4/5
Blood supply to lung
bronciole arts (aorta+intercostals) and veins (azygous +hemiazygous)
Lymph drainage path from deep to superficial
pulmonary nodes>bronchopulmonary nodes>tracheopulmonary nodes>bronchiomediastinal lymph trunks
Lung innervations
from symp trunk and vagus via pulmonary plexus
air or blood in pleaura
pneumothorax and hemothorax
suface reflection - pleural borders
R - sternocalvicular joint to sternal angle>down to rib 6>lateral to rib 8 in midclavicular line>to 10 in midaxiallary>12 in back
L - sternocalvicular joint to sternal angle>down to rib 4> laternal to edge of sternum>down to rib 6>lateral to rib 8 in midclavicular line>to 10 in midaxiallary>12 in bacl
surface reflection - lung borders
R - neck of first rib>down mid sternum to rib 6> along 6 to midclavicular>8 in mid axillary>10th in back (2 below plearal border)
L - neck of first rib, down mid-sternum to 4, along 4 to midclavicular, then down to 6 in mid-clavicular>to 8 in midaxiallary>10 in back
two lung recesses
costodiaphragmatic, costomediastinal
3 methods of chest expansion
vertical - diaphram down
anterior post - intercostal muscles contract
transverse - intercostals
point of reflection of serous pericardium
outflow of great vessels -transverse sinus
inflow vessels - oblique sinus
cardiac tamponade
too much pressure in pericardial cavity
conection b/w aorta and pulm trunk
ligametum arteriosum - was ductus arteriosus
difference between somatic and autonomic signals
somatic - single nerve
autonomic - double nerve w synapse
location autonomic synapse
peripheral ganglion
location of preganglionic cell neurons
grey matter in lateral horn of spinal cord
anatomic diff between symp and para symp
symp - in T1-L2, post gang in symp chain
para - in cranial or S, post gang close to organ
location of prevertebral plexus
anterior to vert column all down thorax and abdo
Grey vs white rami communicantes
grey - postganglionic fibers from sym ganglia
white - preganglionc fibers from ant primary rami
names of syp splanchnic nerves
greater, lesser, least, lumbar, sacral
path of symp innervation to abdo organs
lateral horn>through ganglion (no synapse)>down splanchnic nerve>to prevertebral plexus (synapse)> to organ
para innervation as far as SMA
vagus nerve
types of afferents in para vs symp fibers
para - special senses (blood pres)
symp - referred to body surface
path of throacic duct
cysterna chyli>up along vert passing R to L>into brachiocephalic
branches of the aorta
R brachiocephalic to R subclavian and carotid L carotid and subclavian intercostals esophageal branches bronchial arteries
level esophagus starts
C6
potential blocks of esophagus
C6 - cricoid cartelege
T4/5 by aortic arch
T10 by diaphragm
blood supply and drainage of esophag
- broncial, esphageal, L gastic art
- azygous and hemiazygous veins, gastic veins
3 drainages of esoph lymph
upper- internal jugular node
middle - mediastinal nodes
lower- celaic nodes
