Neurovasculature of the Thoracic Cavity Flashcards
Superior vena cava and inferior vena cava
Major veins bringing blood back to the heart
Aorta
Major artery bringing blood out of the heart
Common trunk (brachiocephalic trunk)
Branches into the right subclavian _ right common carotid arteries
2 pulmonary arteries (left and right)
carry deoxygenated blood to the lungs
4 pulmonary veins (2 left, 2 right)
carry oxygenated blood to the lungs
Left and right subclavian arteries
The 11 intercostal spaces on each side of the thoracic cage are supplied by…
posterior and anterior intercostal arteries from the aorta
Posterior and anterior intercostal arteries travel between …
internal and innermost intercostals
Internal thoracic arteries branch off of the …
subclavian artery
The internal thoracic arteries branch out into…
anterior intercostal arteries
Superior epigastric artery
disregard for the rest of the block (makes its way down to the abdomen)
Musculophrenic artery
Follows costal margin and pierces the diaphragm
More substantial blood supply to the thoracic wall comes from…
?* check out the summary slide
The posterior intercostal arteries inferior to the 12th ribs are called… because…
subcostal arteries (because they are no longer between ribs)
Describe the breast blood supply
Medial mammary branches from the internal thoracic artery
Lateral mammary branches from lateral thoracic artery
Azygos vein
Unpaired vein (only on the right side of the body) - all right posterior intercostal veins and right subcostal vein drain into the azygos vein which then connects to the superior vena cava.
Accessory hemiazygos vein
Drains spaces 4 through 8 on the left
Hemiazygos vein
Drains spaces 9-11 on the left an left subcostal vein
Both the accessory hemiazygos and hemiazygos vein drain into…
the azygos vein
Root of lung structures
Diaphragm vasculature encompasses 4 types of arteries
- pericardiacophrenic arteries
- musculophrenic arteries
- superior phrenic arteries
- inferior phrenic arteries
Describe venous drainage of the diaphragm
?
How many spinal segments make up our spinal cord?
31 segments, each witha. pair of mixed spinal nerves
Name the 31 spinal segments
8 cervical (C1-C8)
12 thoracic (T1-T12)
5 lumbar (L1-L5)
5 sacral (L1-L5)
1 coccygeal (Co)
Each spinal segment is associated with a … and a …
Each spinal segment is associated with a dermatome (sensory) and a myotome (motor)
How does the spinal cord terminate?
What is a nerve?
A nerve is a bundle of sensory and motor neuron axons in the PNS
Rootlets, roots, spinal nerves
Rami
Division of the spinal nerve (posterior ramus and anterior ramus)
What do the posterior and anterior rami innervate?
Name the key trunk dermatomes
T2: sternal angle
T4: nipples
T6: xiphoid process
T10: umbilicus (belly button)
These are sensory landmarks in terms of dermatomes
What disease does the herpes zoster virus trigger?
Shingles
In a person suffering from shingles, the affected region of the skin is unilateral (on one side only). Why?
Because the spinal nerves only carry….*?
The anterior rami of T1-T11 are renamed the intercostal nerve as they travel…????
Intercostal vein, artery and nerve run in a predictable pattern (VAN). When delivering anesthetic
How are chest tubes placed?
Using the top edge of costal bone as a guide
What innervates the diaphragm?
The phrenic nerves (both sensory and motor innervation)
What are the spinal levels of the the phrenic nerves?
C3, C4 and C5
The phrenic nerve is a branch of…
the cervical plexus
What happens when one of the phrenic nerves is damaged?
During inspiration, when we breathe in, the side of the diaphragm that is no longer properly innervated goes UP. If one side of our diaphragm is no longer contracting, abdominal organs push into that diaphragm, which is what causes it to go up.
Describe paradoxical ascension of paralyzed hemidiaphragm
What innervates the visceral pleura?
Visceral nervus system via pulmonary plexus
What innervates the parietal pleura?
Somatic nervous system - phrenic nerve and intercostal nerves
Referred pain…
What is the lymphatic system?
Network of nodes, vessels and other structures that collect excess interstitial fluid.
3 functions of the lymphatic system
Right lymphatic duct and thoracic duct
Describe the stepwise lymphatic draining of the lungs…
- Inside lung tissue: pulmonary nodes
- Hilum: bronchopulmonary (hilar) nodes
- Bifurcation of trachea: tracheobronchial nodes
- Trachea: paratracheal nodes
- ??? : bronchomediastinal trunks
Name the two divisions of the peripheral nervous system (PNS).
Somatic nervous system (skeletal muscle)
Autonomic (aka visceral) nervous system (cardiac muscle, smooth muscle, glands)
What are the two divisions of the autonomic nervous system?
Sympathetic: fight or flight
Parasympathetic: rest and digest
What would we want to do to our airways if we are running away from danger?
We would want to dilate the airways to take in more oxygen (sympathetic stimulation)
When we are taking a nap, what happens to our airways?
They constrict (parasympathetic stimulation)
