Introduction to the main structures of the thorax Flashcards
Where is the heart and the pericardium positioned in relation to the mediastinum
Inferior middle part of mediastinum
What is the endocardium
Inner lining of the heart
What is the epicardium
Thin, external layer formed by the visceral layer of the serous pericardium
What is the myocardium
Thick middle muscle layer of the heart (cardiac muscle)
What is the heart surrounded by
Fibrous pericardium
What is the fibrous pericardium attached to
-By what
The diaphragm
-Pericardiophrenic ligaments
what does the fibrous pericardium blend into
Adventitia of great vessels
What does the serous pericardium comprise of
Visceral layer (epicardium) and parietal layer (lining fibrous pericardium)
What is the pericardial cavity
Potential space between epicardium and parietal layer
What is the anterior/sternocostal surface of the heart made of
Mostly right )with a bit of left) ventricle
What is the inferior or diaphragmatic surface made of
Mostly left (with a bit of right) ventricle
What is the posterior or base surface of the heart made of
Mostly left (and bit of right) atrium and pulmonary vein
What is the pulmonary surface of the heart made of
Mostly Left ventricle, in cardiac notch of L lung
What is the apex surface of the heart made of
Left ventricle
Where is the apex
usually posterior to left ics5 In adults
What is the superior border of the heart
Left costal cartilage 2 to right costal cartilage 3
What is the right border of the heart
Convex to R;from Right costal cartilage 3 to right costal cartilage 6; Mainly right atrium with superior vena cava and inferior vena cava
Where does the inferior border of the heart lie
On diaphragm central tendon
From right costal cartilage 6 to left intercostal space 5
Mainly right ventricle and part of left ventricle
Where does the left border of the heart lie
Convex to left
From left intercostal space 5 and back to left costal cartilage 2
Mainly left ventricle and maybe some left atrium
What are pulmonary and aortic valves called
Semilunar valves
What are Biscupid (Mitral)and Tricuspid valves called
atrioventricular valves
For valve positions, what to remember
PAMT 3344
For valve auscultation sites (listening), what to remember
2256
Where is the pulmonary valve found
Medial to Left costal cartilage 3
Where is the aortic valve found
Medical to left intercostal space 3
Where is the bicuspid/mitral valve found
Medial to left costocartilage 4
Where is the tricuspid valve found
Medial to right intercostal space 4
Where to listen to the sounds of the pulmonary valve
Left intercostal space 2 near sternal edge
Where to listen to sounds of the aortic valve
Right intercostal space 2 near sternal edge
Where to ,listen ti bicuspid/mitral valve
Left intercostal space 5 at midclavicular line
Where to listen to tricuspid valve
Left intercostal space 5/6 near lower sternal edge
Which of the pleura of the lungs are sensitive to pain
Parietal pleura
What nerves is the parietal pleura supplied by
Intercostal and phrenic
What supplies the visceral pleura
Autonomic nerves
What are the surfaces of the lung
Mediastinal
Diaphragmatic
Costal
Cervical
What does the mediastinal surface of the lung contain
Hilum and pulmonary ligament
Where is the cervical surface of the lung
2-3cm above medial third of clavicle, as apex, dome or cupola
Where are pleural reflections
Occur where the costal pleura becomes continuous with the mediastinal pleura anteriorly and posteriorly, and with the diaphragmatic pleura inferiorly
which ribs are the pleural reflections
2,4,6,8,10 (+12 for parietal)
Pleural reflections 2-6 (visceral)
Reflctions closest at plane of sternal angle (rib 2)
Parallel down to rib 4
L indented (cardiac notch) but R continues to cc 6
Pleural reflections 8-10 (visceral)
Cross rib 8 at midaxillary line
Cross rib 10 at lateral border of erector spinae muscle
Where are the parietal pleura reflections
2,4,6,8,10,12
pleural reflections ribs 2-6
Assymetry and close behind sternal angle (rib 2)
Parallel down to rib 4
L indented (cardiac notch) but R continues to cc6
Pleural reflections 8-12
Rib 8 at midclavicular line
Rib 10 at mid axillary line
Rib 12 at lateral border of erector spinae muscle
In the right lung, where does the oblique fissure run
From T2 vertebra posteriorly to rib 6 anteriorly
In the right lung, where does th horizontal fissure run
From rib4 o oblique fissure
Where to listen to the superior and middle lobes
Anterior
Where to listen to the inferior lobe
Mainly posterior
Where to put stethoscope to listen to superior part of the superior lobe
Above the clavicle
Where does trachea bifurcate (carina)
T4 -T5
Difference between left main bronchus and right main bronchus
Left- wider and more horizontal
Right- More vertical and less wide
What does a wider bronchus mean
Things ar more likely to go down the left bronchus
How are bronchi classed
Main bronchus- secondary bronchi - Tertiary bronchi
What do secondary bronchi do
Supply lobes
What do tertiary bronchi do
Supply segments
What does each lobe have
-why is this beneficial
9 or 10 bronchopulmonary segments
-if there is a tumor, you can just remove the segment and not the whole lobe
How many segments does the right lung have
10
How many segments does the left lung have
9 or 10
In supine patients (ones lying down for long periods of time), where foes fluid tend to accumulate
Apical and posterior segments of the inferior lobe
What does the azygous system do
Drainage of the posterior thoracic wall
