Introduction to the main structures of the thorax

Question 1

Where is the heart and the pericardium positioned in relation to the mediastinum

Answer 1

Inferior middle part of mediastinum

Question 2

What is the endocardium

Answer 2

Inner lining of the heart

Question 3

What is the epicardium

Answer 3

Thin, external layer formed by the visceral layer of the serous pericardium

Question 4

What is the myocardium

Answer 4

Thick middle muscle layer of the heart (cardiac muscle)

Question 5

What is the heart surrounded by

Answer 5

Fibrous pericardium

Question 6

What is the fibrous pericardium attached to

-By what

Answer 6

The diaphragm

-Pericardiophrenic ligaments

Question 7

what does the fibrous pericardium blend into

Answer 7

Adventitia of great vessels

Question 8

What does the serous pericardium comprise of

Answer 8

Visceral layer (epicardium) and parietal layer (lining fibrous pericardium)

Question 9

What is the pericardial cavity

Answer 9

Potential space between epicardium and parietal layer

Question 10

What is the anterior/sternocostal surface of the heart made of

Answer 10

Mostly right )with a bit of left) ventricle

Question 11

What is the inferior or diaphragmatic surface made of

Answer 11

Mostly left (with a bit of right) ventricle

Question 12

What is the posterior or base surface of the heart made of

Answer 12

Mostly left (and bit of right) atrium and pulmonary vein

Question 13

What is the pulmonary surface of the heart made of

Answer 13

Mostly Left ventricle, in cardiac notch of L lung

Question 14

What is the apex surface of the heart made of

Answer 14

Left ventricle

Question 15

Where is the apex

Answer 15

usually posterior to left ics5 In adults

Question 16

What is the superior border of the heart

Answer 16

Left costal cartilage 2 to right costal cartilage 3

Question 17

What is the right border of the heart

Answer 17

Convex to R;from Right costal cartilage 3 to right costal cartilage 6; Mainly right atrium with superior vena cava and inferior vena cava

Question 18

Where does the inferior border of the heart lie

Answer 18

On diaphragm central tendon

From right costal cartilage 6 to left intercostal space 5

Mainly right ventricle and part of left ventricle

Question 19

Where does the left border of the heart lie

Answer 19

Convex to left

From left intercostal space 5 and back to left costal cartilage 2

Mainly left ventricle and maybe some left atrium

Question 20

What are pulmonary and aortic valves called

Answer 20

Semilunar valves

Question 21

What are Biscupid (Mitral)and Tricuspid valves called

Answer 21

atrioventricular valves

Question 22

For valve positions, what to remember

Answer 22

PAMT 3344

Question 23

For valve auscultation sites (listening), what to remember

Answer 23

2256

Question 24

Where is the pulmonary valve found

Answer 24

Medial to Left costal cartilage 3

Question 25

Where is the aortic valve found

Answer 25

Medical to left intercostal space 3

Question 26

Where is the bicuspid/mitral valve found

Answer 26

Medial to left costocartilage 4

Question 27

Where is the tricuspid valve found

Answer 27

Medial to right intercostal space 4

Question 28

Where to listen to the sounds of the pulmonary valve

Answer 28

Left intercostal space 2 near sternal edge

Question 29

Where to listen to sounds of the aortic valve

Answer 29

Right intercostal space 2 near sternal edge

Question 30

Where to ,listen ti bicuspid/mitral valve

Answer 30

Left intercostal space 5 at midclavicular line

Question 31

Where to listen to tricuspid valve

Answer 31

Left intercostal space 5/6 near lower sternal edge

Question 32

Which of the pleura of the lungs are sensitive to pain

Answer 32

Parietal pleura

Question 33

What nerves is the parietal pleura supplied by

Answer 33

Intercostal and phrenic

Question 34

What supplies the visceral pleura

Answer 34

Autonomic nerves

Question 35

What are the surfaces of the lung

Answer 35

Mediastinal Diaphragmatic Costal Cervical

Question 36

What does the mediastinal surface of the lung contain

Answer 36

Hilum and pulmonary ligament

Question 37

Where is the cervical surface of the lung

Answer 37

2-3cm above medial third of clavicle, as apex, dome or cupola

Question 38

Where are pleural reflections

Answer 38

Occur where the costal pleura becomes continuous with the mediastinal pleura anteriorly and posteriorly, and with the diaphragmatic pleura inferiorly

Question 39

which ribs are the pleural reflections

Answer 39

2,4,6,8,10 (+12 for parietal)

Question 40

Pleural reflections 2-6 (visceral)

Answer 40

Reflctions closest at plane of sternal angle (rib 2) Parallel down to rib 4 L indented (cardiac notch) but R continues to cc 6

Question 41

Pleural reflections 8-10 (visceral)

Answer 41

Cross rib 8 at midaxillary line Cross rib 10 at lateral border of erector spinae muscle

Question 42

Where are the parietal pleura reflections

Answer 42

2,4,6,8,10,12

Question 43

pleural reflections ribs 2-6

Answer 43

Assymetry and close behind sternal angle (rib 2) Parallel down to rib 4 L indented (cardiac notch) but R continues to cc6

Question 44

Pleural reflections 8-12

Answer 44

Rib 8 at midclavicular line Rib 10 at mid axillary line Rib 12 at lateral border of erector spinae muscle

Question 45

In the right lung, where does the oblique fissure run

Answer 45

From T2 vertebra posteriorly to rib 6 anteriorly

Question 46

In the right lung, where does th horizontal fissure run

Answer 46

From rib4 o oblique fissure

Question 47

Where to listen to the superior and middle lobes

Answer 47

Anterior

Question 48

Where to listen to the inferior lobe

Answer 48

Mainly posterior

Question 49

Where to put stethoscope to listen to superior part of the superior lobe

Answer 49

Above the clavicle

Question 50

Where does trachea bifurcate (carina)

Answer 50

T4 -T5

Question 51

Difference between left main bronchus and right main bronchus

Answer 51

Left- wider and more horizontal Right- More vertical and less wide

Question 52

What does a wider bronchus mean

Answer 52

Things ar more likely to go down the left bronchus

Question 53

How are bronchi classed

Answer 53

Main bronchus- secondary bronchi - Tertiary bronchi

Question 54

What do secondary bronchi do

Answer 54

Supply lobes

Question 55

What do tertiary bronchi do

Answer 55

Supply segments

Question 56

What does each lobe have -why is this beneficial

Answer 56

9 or 10 bronchopulmonary segments -if there is a tumor, you can just remove the segment and not the whole lobe

Question 57

How many segments does the right lung have

Answer 57

10

Question 58

How many segments does the left lung have

Answer 58

9 or 10

Question 59

In supine patients (ones lying down for long periods of time), where foes fluid tend to accumulate

Answer 59

Apical and posterior segments of the inferior lobe

Question 60

What does the azygous system do

Answer 60

Drainage of the posterior thoracic wall