Organization of the Thoracic Viscera I & II Flashcards
thoracic skeleton:
___ & ___ form an ___
all ribs slope ___ from their vertebral attachment
rib cage, thoracic vertebral column, irregularly shaped cone
downward
superior thoracic aperture (thoracic outlet):
definition
3 boundaries
passageway for trachea, esophagus, many vessels & nerves
(1) first thoracic vertebra
(2) first pair of ribs & costal cartilages
(3) superior margin of manubrium sterni
inferior thoracic aperture:
boundaries (3)
closed by the ___ separating the ___
(1) 12th thoracic vertebrae
(2) costal margin
(3) xiphosternal joint
diaphragm, thoracic & abdominal viscera
thoracic cavity:
consists of ___
bounded by___
suprapleural membrane
two pleural cavities enclosing the lungs & the mediastinum
the thoracic wall, the diaphragm, & the suprapleural membrane
thickening of endothoracic fascia above the superior thoracic aperture which limits bulging of the lungs into the neck
pleurae:
___ membranes that cover the ___
line the ___
composed of ___ that produces ___
connective tissue is strong enough to support ___
thin serous, surface of the lungs
walls, roof, & floor of the pleural cavities
mesothelium (simple squamous epithelium), serous fluid & connective tissue
blood vessels, nerves, & lymphatic vessels
visceral pleura
covers the lungs
parietal pleura
lines the walls, roof, & floor of the pleural cavities
parietal & visceral pleura are ___ with each other around the ___ (___)
continuous
root of the lung (structures entering & leaving the lung & attaching the lungs to the mediastinum)
divisions of parietal pleura:
costal pleura
cervical pleura (cupola)
diaphragmatic pleura
mediastinal pleura
lines thoracic wall
extends through thoracic inlet into neck
covers diaphragm
covers the mediastinal surface of each pleural sac
pulmonary ligament:
___ pleura is reflected at the ___ to become continuous w/ the ___
at this point, it ___
___ layer of ___
mediastinal parietal pleura, the root of the lung, visceral pleura covering the lung
sags below the hilus as a shirt cuff might hang below a person’s wrist forming a potential space
double, pleura
lines of pleural reflection
sharp lines of reflection where costal pleura become continuous w/ the mediastinal & diaphragmatic pleura & limit the pleural cavities
pleural sacs:
far apart in the ___
converge as they’re traced ___ toward the ___ where they contact each other
region of the cupola
downward, sternal angle
right pleura:
continuous ___
swings ___
straight downward close to the midline
outward & downward along the 7th costal cartilage
left pleura:
anterior reflection deviates ___ at about the level of the ___
it’s usually lateral to the ___ at the level of the ___
it swings ___ along the ___
deviation of left pleura: ___
laterally, 4th rib
sternum, 5th & 6th intercostal spaces
outward & downward, 7th costal cartilage
cardiac notch
lower borders of pleural reflections (right & left):
crosses 8th rib at the ___
crosses 10th rib at the ___
crosses 12th rib ___
mid-clavicular line
mid-axillary line
adjacent to vertebral border
comparable surface markings for the lungs:
crosses 6th rib at the ___
crosses 8th rib at the ___
crosses 10th rib ___
mid-clavicular line
mix-axillary line
adjacent to vertebral border
pleural recesses:
in life, lungs don’t ___
therefore, the surface markings of the lungs & the ___ pleura ___
here, portions of the ___ pleura are in contact w/ ___
extend to limits of pleural cavities even during maximum inspiration
parietal, don’t coincide
parietal, each other
major recesses
costodiaphragmatic recesses - at the sharp reflection of the costal pleura onto the diaphragmatic pleura
costomediastinal recesses - at the sharp anterior reflections of the costal pleura onto the mediastinal pleura
left costomediastinal recess
___ than the right recess due to the ___
the ___ enters this recess during ___
larger, cardiac notch of the left lung
lingula of the left lung, deep inspiration
mediastinum:
___ b/n the ___
divided into ___ by ___ which passes through the ___ & the ___
mobile midline septum, pleurae & lungs
superior & inferior mediastinum, an imaginary plane, sternal angle, lower border of the 4th thoracic vertebra
superior mediastinum:
lies ___
limited superiorly by the ___
situated chiefly behind the ___
posterior boundary is the ___
above the imaginary plane
superior thoracic aperture
manubrium sterni
first four thoracic vertebrae
inferior mediastinum:
lies below the ___
limited inferiorly by the ___
further subidived into ___
imaginary plane (sternal angle)
diaphragm
anterior mediastinum, middle mediastinum, & posterior mediastinum
middle mediastinum
composed of pericardial sac & its contents
anterior mediastinum
area between pericardial sac & sternum
posterior mediastinum:
area between ___
situated behind ___ extending from the ___
vertebral bodies & pericardial sac
pericardial sac, 5th through 12th thoracic vertebrae
main contents of superior mediastinum (anterior to posterior) (10)
thymus gland brachiocephalic veins & superior vena cava aortic arch & 3 branches vagus & phrenic nerves cardiac plexus of nerves left recurrent laryngeal nerve (not the right)* trachea esophagus thoracic duct lymph nodes
main contents of posterior mediastinum (7)
esophagus esophageal plexus thoracic aorta thoracic sympathetic trunks (2 total) thoracic splanchnic nerves thoracic duct azygous system of veins
thymus gland (superior mediastinum):
lies immediately behind the ___ & may extend into the ___ & the ___
after puberty, it’s largely replaced by ___
manubrium sterni, base of the neck, anterior mediastinum
fat
trachea & esophagus (superior mediastinum):
fill ___ aperture in ___ plane b/n ___
trachea lies ___ esophagus & bifurcates ___
above root of lung, trachea & esophagus are crossed by ___ on the right & the ___ on the left
superior thoracic, median, apices of lungs
in front of, behind the sternal angle
azygous vein, arch of the aorta
carina (superior mediastinum):
cartilaginous ridge within the ___ that runs antero-posteriorly b/n the ___ at the site of the ___ at the lower end of the ___
this ridge lies to the ___ of the midline
trachea, two primary bronchi, tracheal bifurcation, trachea
left
arch of aorta (superior mediastinum):
commences at the right border of the ___, runs upward, backward, & to the left in front of the ___
passes downward to the left of the ___ & ___ & ends at the ___
contains the ___ & the ___ in its concavity
sternal angle, trachea
trachea, esophagus, sternal angle
right pulmonary artery, left principal bronchus
aortic knuckle (superior mediastinum)
left curve of the arch of the aorta creates this of posterior-anterior chest x-rays
usual branches of the arch of the aorta (superior mediastinum) (3)
all three are crossed anteriorly by the ___
brachiocephalic trunk
left common carotid artery
left subclavian artery
left brachiocephalic vein
brachiocephalic trunk (superior mediastinum):
passes upward & to the right of the ___ & divides into the ___ & ___ behind the ___ joint
trachea, right subclavian, right common carotid arteries, right sternoclavicular
left common carotid artery (superior mediastinum):
passes upward to the left of the ___ & enters the ___ behind the ___
trachea, neck, left sternoclavicular joint
left subclavian artery (superior mediastinum):
arises behind the ___
left common carotid
coarctation of the aorta:
aortic arch is abnormally ___ just beyond the ___ branch
for blood to reach that part of the aorta beyond the constriction, it must flow from branches arising ___ the constriction and follow ___ channels to reach branches arising ___ the constriction
the ___ arteries & the ___ channels become greatly ___ to accommodate the demands of the increased blood flow
a pulse can be found in the ___ spaces
the dilated ___ arteries press on the ___ border of the ribs causing localized areas of ___
these can be seen in x-ray films as ___ of the ___ border of the ribs
narrow/constricted, left subclavian
before, anastomotic, beyond
intercostal, anastomotic, dilated
intercostal
intercostal, inferior, resorption
notching, inferior
brachiocephalic veins (superior mediastinum):
right & left brachiocephalic veins are formed by the union of the ___ & ___ behind the ___
the left brachiocephalic vein passes obliquely downward & to the right & unites w/ the ___ to form the ___ behind the ___
subclavian, internal jugular veins, right & left sternoclavicular joints
right brachiocephalic vein, superior vena cava, sternal end of the first costal cartilage
superior vena cava (superior mediastinum):
descends & enters the ___ behind the ___
receives the ___ just before entering
right atrium of the heart, third right costal cartilage
azygous vein
vagus nerves (superior mediastinum):
at the root of the neck, both right & left vagus nerves lie b/n the ___ & the ___
both descend in front of the ___
both descend in the ___ behind the ___
internal jugular vein, common carotid arteries
first part of the subclavian arteries
thorax, roots of the lungs
recurrent laryngeal nerves (superior mediastinum):
arise from each of the ___ & ascend to supply the ___
vagus nerves, larynx
left recurrent laryngeal nerve* (superior mediastinum):
hooks around the ___ behind the ___
ascends in a groove b/n the ___ & ___
left side of the arch of the aorta, ligamentum arteriosum
trachea, esophagus
right recurrent laryngeal nerve* (superior mediastinum):
hooks around the ___ in the root of the ___
not found in the ___
right subclavian artery, neck
mediastinum
phrenic nerves (superior mediastinum)
formed from the ___
both nerves enter the superior mediastinum b/n the ___ & ___ & lateral to the ___
both nerves descend ___ of the roots of the lungs*
ventral rami of C3, C4, & C5
subclavian artery, vein, vagus nerves
in front of
innervation of phrenic nerves (superior mediastinum):
somatic efferent (___) (1)
somatic afferent (___, ___) (5)
(motor)
- diaphragm
(sensory, pain sensation):*
- fibrous pericardium
- parietal serous pericardium
- mediastinal parietal pleura
- central part of the diaphragmatic parietal pleura
- central part of the diaphragmatic parietal peritoneum
esophagus (posterior mediastinum):
begins as a continuation of the ___ at the level of ___
enters the superior mediastinum b/n the ___ & the ___ & behind the ___
enters the posterior mediastinum to the right of the ___ & behind the ___ & ___
deviates to the left crossing in front of the ___ just before it passes through the diaphragm at the level of ___*
pharynx, C6
trachea, vertebral column, left principal bronchus
aorta, pericardium, left atrium
aorta, T10*
esophageal constrictions (superior to inferior) (posterior mediastinum):
where the ___ joins the upper end
where it contacts the ___
where it contacts the ___
the ___ of the diaphragm
pharynx
arch of the aorta
left principal bronchus
esophageal hiatus
esophageal plexus (posterior mediastinum):
as the vagus nerves reach the esophagus, each nerve ___ & there is an interchange of ___ b/n the nerves forming the esophageal plexus
a little above the diaphragm, the plexus usually gives rise to two ___
the one on the left turns forward & is referred to as the ___
the one on the right turns backward & is referred to as the ___
breaks up into several trunks, branches
two nerve trunks
anterior vagal trunk
posterior vagal trunk
descending throacic aorta (posterior mediastinum):
begins as a continuation of the ___ at the left side of the ___
it descends downward at first on the left side of the ___ & then gradually approaches the ___
it passes through the ___ of the diaphragm at the level of ___
arch of the aorta, sternal angle
vertebral bodies, midline
aortic hiatus, T12
thoracic branches (posterior mediastinum) (5)
lower nine posterior intercostal arteries subcostal arteries bronchial arteries esophageal arteries superior phrenic arteries
azygous venous system (posterior mediastinum)
primary purpose is to ___
system receives blood from ___
provides an alternative root for ___
drain blood from the body wall
some of the thoracic viscera
venous return from the lower parts of the body should the main venous channel be obstructed
azygous venous system (posterior mediastinum):
vessels on two sides of body are ___
longitudinal channel on right is called the ___
on the left, the channel usually consists of two veins: the ___ & the ___
considerable ___ in azygous system
vessels on two sides of body are assymmetric
longitudinal channel on right is called the azygous vein
hemiazygous, accessory hemiazygous
variation
azygous venous system: major tributaries (posterior mediastinum) (5)
most of posterior intercostal veins bronchial veins esophageal veins pericardial veins mediastinal veins
thoracic duct (posterior mediastinum):
begins in ___ as a dilated sac called the ___
ascends through ___ & passes upward on right side of ___ b/n ___ & ___
at about the level of ___, begins crossing toward the left & reaches the left border of the ___ at level of ___
runs upward into the root of the ___ & empties into the venous system at the junction of the ___ & ___
abdomen, cysterna chyli
aortic hiatus, aorta, aorta, azygous vein
T5, esophagus, sternal angle
neck, left subclavian, left internal jugular veins
