intro to main structures of the thorax Flashcards
where does the heart lie
in the middle mediastinum of the inferior mediastinum
pericardium
divided into fibrous [outer] and serous [inner] parts which surround the heart
fibrous pericardium
tough and not distensible; attached to diaphragm by pericardiophrenic ligaments; blends into adventitia of great vessels
serous pericardium
comprises of visceral layer [epicardium] and parietal layer [lining fibrous pericardium]; potential space [pericardial cavity] between them
surfaces
anterior/sternocostal: formed mostly of right ventricle
inferior/ diaphragmatic: mostly L ventricle
posterior/ base: mostly L atrium and pulmonary vv
Pulmonary:
mostly L ventricle, in cardiac notch of L lund
heart markings
2,3,5,6
superior: from L cc2 to R cc3
Right: from R cc3 to R cc6, mainly R atrium with SVC and IVC
inferior: from R cc6 to L ics5; mainly R ventricle and part of L ventricle
Left: from ics5 to L cc2; mainly L ventricle and some of L atrium
valve positions
PAMT 3344 LLLR all valves are retrosternal in position and close to the midline. Pulmonary : medial to L cc3 Aortic: medial to L ics3 Bicuspid/mitral: medial to L cc4 Tricuspid: medial to R ics4
valve sounds
sounds are best heard downstream of valves
pulmonary: L ics2 near sternal edge- dup sound
aortic: R ics 2 near sternal edge- dup sound
bicuspid/mitral;: L ics5 at midclavicular line, lub sound,
tricuspid: L ics5/6 near lower sternal edge, lub sound
pleura
a serous membrane divided into parietal [outer] and visceral [ inner] layers which surround the lungs and contain the pleural cavities; layers also separated by a small layer of serous fluid
parietal pleura
lines thoracic cavity lateral to the mediastinum; supplied by intercostal and phrenic nn; sensitive to pain
visceral pleura
covers lung and follows lung fissures; supplied by autonomic nn
pleuritis
inflammation of the pleura- can hear pleural rub on stethoscope. leads to sharp chest pain
surfaces of the lungs
- mediastinal : slat, faces mediastinum and has impressions of mediastinal structures; contains the hilum and pulmonary ligament.
- diaphragmatic: concave and faces domes of diaphragm.
- costal: convex and faces ribs
- cervical: extends into neck, 2-3cm above medial third of clavicle, as apex, dome or cupola
what are pleural reflections?
the abrupt lines along which the pleura change direction ( reflect) from one wall of the pleural cavity to another.
occur when the costal pleura becomes continuous with the mediastinal pleura anteriorly and posteriorly , and with the diaphragmatic pleura inferiorly
surface anatomy of lungs and pleura
symmetry and close behind sternal angle [rib 2]
parallel down to rib 4.
L indented [cardiac notch] but R continues to cc6.
rib 8 at midclavicular line.
rib 10 at midaxillary line.
rib 12 at lateral border of erector spinae m
lobes of the right lung
has 3 lobes- superior, middle and inferior] separated by the oblique and horizontal fissures..
lobes of left lung
2 lobes- superior and inferior, separated by the oblique fissures
bronchopulmonary segments of right superior lobe
apical
posterior
anterior
bronchopulmonary segments of right middle lobe
lateral
medial
bronchopulmonary segments of right inferior lobe
apical/superior medial anterior lateral posterior
bronchopulmonary segments of left superior lobe
apical posterior anterior superior lingular inferior lingular
bronchopulmonary segments of left inferior lobe
apical/superior posterior anterior superior lingular inferior lingular
the aortic aa [right to left]
brachiocephalic trunk.
left common carotid aa.
left subclavian aa
