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anatomy of the thorax > nerves of the thorax > Flashcards

nerves of the thorax Flashcards

1
Q

somatic nerves

A

supply skeletal muscles only

11 pairs of intercostal nerves and 1 pair phrenic nerves

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2
Q

somatic sensory nerves

A

sensation from the skin muscles and bones and parietal pleura of peicardium
much non-cutaneous sensation is proprioceptive - feedback on function in muscles, tendons, and joints

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3
Q

autonomic

A

supply sm, cardiac muscle, exocrine glands (heart muscles, bv, bronchi, bronchila glands, sweat gland)

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4
Q

autonomic sensory fibres

A

carry sensory info from viscera

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5
Q

sympathetic nerves

A

motor to sm and cardiac muscle, exocrine glands and carry pain sensation from viscera

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6
Q

chest wall sympathetic innevation

A

from spinal nerves T1-11

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7
Q

thoracic viscera innevation

A

from spinal nerves T3-T6

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8
Q

parasympathetic nerves

A

motor- sm, cardiac pacemaker sstem, exocrine glands and carry sensory information providing functional feedback (enteroception) from the viscera
only to viscera

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9
Q

parasympathetic supply to thoracic viscera

A

from brainstem in vagus nerves - 10th pair of cranial nerves

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10
Q

intercostal nerves

A

T1-11
segmental nerves - each pair supplies single body segment containing single vertebrae and associated muscles and skin
forms roots from spinal cord
ventral - motor
dorsal - sensory
cell bodies of sensory in ganglion on posteror root just before spinal nerve
cell bodies of motor - in anterior horn in spinal cord
ganglion and junction of roots is in intervertebral foremen
spinal nerve divide into rami
smaller rami is posterior - imnervates posterior muscles and skin
anterior is larger - runs between internal and innermost IC muscles suppluing muscles to midline and branches that innervate skin (2 branches from each nerve - one lateral and 1 anterior)

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11
Q

intercostal nerves

A

nerves from the anterior rami

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12
Q

dermatome

A

area of skin supplied by spinal nerve

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13
Q

myotome

A

muscles supplied by a particular spinal nerve

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14
Q

what is the overlap between dermatomes

A

50%

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15
Q

phrenic nerves

A

from anterior rami of 3 adjoining cervical spinal nerves C3, 4, 5
C4 main contributor

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16
Q

effect of damage to motor tracts above C4

A

disconnects diaphragm
breathing cant occur
asphyxia

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17
Q

plexi

A

areas of shared distribution of several pairs of spinal nerves - cervical plexus is from C2 - 5

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18
Q

path of phrenic nerve

A

down neck on muscles from cervical transverse process
pass through diaphragm, either side of the mediastinum
R - follow path of great veins (R brachiocephalic - SVC - fibrous pericardium covering sinus venous and inferior vena cava
L crosses arch of aorta and then runs across fibrous pericardium overlaying the L ventricle

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19
Q

what does each phrenic nerve supply

A

the muscles on its side of the diaphragm

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20
Q

difference between the autonomic and somatic motor nerve

A

somatic - axons of lower motor neurons extend from spinal cord to their end plates
autonomic - preganglionic in brain and spinal cord, post ganglionic go to target tissue - reduces cell bodies in CNS, but also reduces precision

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21
Q

SNS

A

preganglionic T1 - L2
simple segmntal spinal nerves
to body wall travel with somatic but have ganglia
preganglionic leave the spinal cord - synapse in sympathetic chain
postganglionic then return to the spinal nerves

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22
Q

rami communicantes

A

bundles of nerves joining the sympathetic ganglia to spinal nerves

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23
Q

SNS preganglionic fibres ramus communican

A

wrapped in white coloured myelin sheath - form white ramus communican

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24
Q

SNS postganglionic fibres ramus communican

A

not myelinated - grey

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25
sympathetic chain
formed from the ganglia joined by bundles of nerves | extend beyond T1-L2 from mid cervical to pelvis
26
purpose of the sympathetic chain
allow preganglionic fibres to run up/down for one or more segments before synapsing therefore provide innervation to the whole body
27
Visceral SNS
pass to white rami but don't synapse | instead they synapse closer to the target organ
28
SNS supplies to heart and lungs
reach cardiac and pulmonary plexi and synapse here
29
where do teh thoracic visceral supplies arise from
T3-6
30
where does the sympathetic supply to the heart arise
T2 - 4
31
PNS
have preganglionic neurons | supply ganglia containing larger number of postganglionic cells
32
difference with PNS and SNS
no somatic supply in PNS | the entire supply is from the vagus
33
vagus nerves
also affect head and neck leave the skull with the internal jugular veins through jugular foramina and run down whole length of neck with internal jugular veins and internal carotid and common carotid arteries - take through the thoracic inlet into superior mediastinum - L and R vagi have different relations
34
path of the R vagus nerve
posterior to SVC, root of R lung break into plexus surrounding oesophagus abdomen
35
path of L vagus nerve
cross aortic arch posterior to lung root - join R vagus form oesophagael plexus abdomen
36
what does the oesophagael plexus supply
oesophagus
37
vagi and heart/lungs
vagi contribute branches to pul and cardiac plexi - synapse in small ganglia before reaching their targets
38
sensory visceral fibres in the vagus
more numerous than motor fibres | sensory info about CVS, respiratory and alimentary system to vital centres in the brainstem
39
features of the heart
anterior, sternocostal face (RA) inferior/diaphragmatic surface from RV posterior surface - LA apex - LA
40
when does the IVC enter teh RA
just after entry into the thorax | lower region
41
what is teh coronary sinus
a vein that drains the heart - entering the RA close to IVC
42
what is the R auricle
ear like extension of the RA | overlaps teh root of pul trunk on R side
43
what is the line of demarcation between RA and RV
atrioventricular groove | R coronary artery lies here
44
where does the pul trunk leave the heart
RV passes superiorly adn then L divide into R and L pul arteries beneath the arch of the aorta
45
where is teh anterior interventricular groove
obliquely inferiorly to L from root of pul trunk separates the surfaces of the ventricles there is also a coronary artery
46
where does the aorta leave
superior aspect of LV | under cover of pul trunk - emerges on its R
47
what is the outward bulge in the aortic wall
3 aortic sinuses | accomodate cusps of aortic valve in systole
48
where do the R and L coronary arteries originate from
2 of the cusps of the aortic valve
49
path of the R coronary artery
in atrioventricular groove to diaphragmatic border descends as posterior interventricular artery marginal artery is a branch of the R coronary artery - along inferior region of the heart
50
path of the L coronary artery
atrioventricular groove to division of 2 branches anterior intrventricular branch - in groove to apex and then to diaphragmatic surface circumflex branch t L margin and to diaphragmatic surface
51
cardiac veins
accompany arteries tributaries of coronary sinus great cardiac vein accompanies the anterior interventricular artery middle cardiac vein running with the posterior interventricular artery small cardiac vein accompanies the marginal artery
52
angina pectoris
chest pain caused by transient ischaemia from narrowing arteries MI - occlusion of arteries and necrosis of myocardium
53
what are the fossa ovalis
the remnant of foramen ovale
54
why does the RV look different to the L
thick muscular projections - papillary muscles which the chordae tendineae are attached
55
describe the cusps in the pul valve
nodular thickening at medial edge of each cusp | allow it to close properly on diastole
56
how many pulmonary veins are there
4
57
what leads into the aorta
smooth walled outflow tract
58
why do teh 4 valves lie in a plane
they are in the fibrous plaque that separates the atria from the ventricles
59
where is the aortic arch
in the superior mediastinum
60
landmarks of the aortic arch
begin and end at 2nd CC | top is midway between jugular notch and sternal angle
61
landmarks of the brachiocephalic trunk
from aortic arch superolaterally to R sternoclaviacular joint here it splits int R subclavian and R common carotid
62
landmarks of the R subclavian artery
laterally from R sternoclavicular joint | arch over 1st rib
63
R common carotid artery
ascends into neck on R side of trachea under sternocleidomastoid line from R sternoclavicualr joint to lobe of ear
64
left common carotid artery
``` from aortic arch posterior and L of BC trunk line to L sternocavicular joint L of trachea L of SCM muscle to L ear lobe ```
65
left subclavian artery
from L sternoclavicular joint arching over 1st rib
66
internal jugular veins
lateral to common carotid to reach sternoclavcular joints
67
subclavian veins
parallel to SC arteries behind sternoclavicualr joints
68
R BC vein
from R sternoclavicular joint to inferior border of 1st CC
69
L BC vein
L sternoclavicular joint to inferior border of 1st CC
70
SVC
R 1st CC to R 3rd CC | behind the r side of the manubrium and sternum to join R atrium
71
what plane are the valves in
the atrioventricular plane | from medial end of L 3rd CC to medial 4th ICS
72
landmarks for the valves
3rd CC pul 3rd ICS aortic 4th CC mitral 4th ICS tricuspid
73
how do you hear soun from 1 valve
stethoscope downstream of given valve
74
auscultation of tricuspid
L 5th ICS - sternum lub (bell then diaphragm)
75
auscultation of mitral
L 5th ICS at mid clavicular line | lub
76
auscultation of pul valve
L 2nd ICS - sternum | dub
77
auscultation of aortic
R 2nd ICS near sternum | dub
78
info from palpation of arterial pulse
1) pulse rate 2) rhythm 3) character 4) volume 5) any delays between major arteries (e.g. radiofemoral delay)
79
how do you plapate
pulps of forefinger and middle finger
80
palpation in the common carotid artery
in the neck, between the lateral side of thyroid | cartilage and medial border of sternocleidomastoid muscle).
81
palpation in the superficial temporal artery
in front of the tragus of the ear. This vessel is a | terminal branch of the external carotid artery).
82
palpation in the subclavian artery
in the supraclavicular region, at the angle between | clavicle and sternocleido mastoid muscle.
83
palpation in the axillary artery
the medial side of humerus, | posterior to the tendon of short head of biceps
84
palpation of the brachial artery mid arm
along middle third of humerus , in the medial | bicipital groove behind the medial border of biceps
85
palpation of teh brachial artery pulse in cubital fossa
on the medial side of tendon of biceps on a fully | extended elbow)
86
palpation of radial artery
at the wrist over the distal end of radius)
87
palpation of teh femoral artery
the midinguinal point,
88
palpation of teh popliteal artery
inferior part of the popliteal fossa, against the | posterior surface of tibia
89
palpation of the posterior tibial artery
behind medial malleolus-bony prominence on the medial side of ankle joint
90
palpation of the dorsalis pedis artery
dorsum of the foot, lateral to extensor hallucis longus | tendon -tendon of the big toe

anatomy of the thorax (14 decks)

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