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Regional Gross Anatomy > Region 1 - Thorax > Flashcards

Region 1 - Thorax Flashcards

1
Q

What are the boundaries of the superior thoracic aperture?

A

Body of T1
1st pair of ribs and their cartilages
Superior border of manubrium

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2
Q

What is the function of the superior thoracic aperture?

A

Passage of structures between thorax and neck/upper limb

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3
Q

What are the boundaries of the inferior thoracic aperture?

A

Body of T12
11th and 12th pairs of ribs
Costal cartilages of ribs 7-10 (costal margin)
Xiphisternal joint

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4
Q

What is the function of the inferior thoracic aperture?

A

Passage of structures between thorax and abdomen

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5
Q

What are the name and type of joints between vertebral articulate processes?

A

Zygopophysial (facet) joints

Synovial plane

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6
Q

What do the heads of the typical ribs articulate with?

A

Body of own vertebra
Body of vertebra above
IV disc (via crest)

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7
Q

What do the tubercles of the typical ribs articulate with?

A

Articulate part with transverse process of own vertebra

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8
Q

What is the function of the non-articular part of a typical rib?

A

Costotransverse ligament attachment

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9
Q

What are the numbers of the typical ribs?

A

3-9

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10
Q

What separates the articulate facets on the head of a typical rib?

A

Crest

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11
Q

What defines a true rib? What numbers are the true ribs?

A

Connect directly to sternum via own cartilage

1-7

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12
Q

What defines a false rib? What numbers are these?

A

Connects to sternum indirectly via cartilage of ribs above

8-10

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13
Q

What defines a floating rib? What numbers are these?

A

Does not connect to sternum

11 and 12

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14
Q

What is the name for the most curved part of the body of a rib?

A

Costal angle

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15
Q

Where is the costal groove found on the rib?

A

Internal surface of the inferior border of the body of the rib

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16
Q

What is the function of the costal groove?

A

Protects intercostal NVB

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17
Q

What are the atypical features of rib 1?

A

Single facet in head for T1 (C7 has no articulate surface)
Grooves for subclavian vessels
- On superior surface

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18
Q

What is the function of the scalene tubercle?

A

Separates grooves for subclavian vessels on superior surface of rib 1
Attachment point for anterior scalene muscle

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19
Q

What is the function of the rough area on the superior surface of rib 2?

A

Tuberosity for serrated anterior

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20
Q

What ribs don’t have a neck or tubercle?

A

11th and 12th ribs

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21
Q

What type of cartilaginous joints are the IV discs and what is the other name for this type of joint?

A

Secondary

Symphysis

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22
Q

What type of joint does rib 1 have with the sternum?

A

Primary cartilaginous (synchondrosis)

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23
Q

What types of joints do ribs 2-7 have with the sternum?

A

Synovial plane

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24
Q

What types of joints are the interchondral joints?

A 
Synovial plane (between 6+7, 7+8 and 8+9)
Fibrous joint (between 9+10)
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25
Q

What is the axis of the upper ribs (1-6) and how does this affect their movement during respiration? What is the movement called?

A

More lateral

Ribs move up and out (anteriorly) - Pump handle movement

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26
Q

What is the axis of the lower ribs (7-12) and how does this affect their movement during respiration? What is the movement called?

A

More anteroposterior

Ribs flare out more laterally - bucket handle movement

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27
Q

What are the changes in dimension during respiratory movements and how are hose achieved?

A

Anteroposterior - Sternum moves anteriorly and superiorly
Lateral - Lower rib cage moves outwards
Vertical - Diaphragm descends

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28
Q

What are the secondary muscles of respiration?

A

Scalene muscles

Serrated posterior superior and inferior

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29
Q

What nerve(s) innervate the pectoralis major?

A 
Medial pectoral (C8, T1)
Lateral pectoral (C5-C7)
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30
Q

What nerve(s) innervate pectoralis minor?

A

Media pectoral nerve (C8, T1)

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31
Q

What nerves supply the external oblique and rectum abdominis?

A

Anterior rami of T7-T12

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32
Q

What supplies serratus anterior?

A

Long thoracic nerve (C5-C7)

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33
Q

What supplies serratus posterior superior?

A

2nd-5th intercostal nerves

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34
Q

What supplies the serratus posterior inferior?

A

Anterior rami T9-T12

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35
Q

What innervates the anterior scalene muscle?

A

Anterior rami C3-C7

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36
Q

What innervates the middle scalene muscle?

A

Anterior rami C4-C7

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37
Q

What innervates the posterior scalene muscle?

A

Anterior rami C5-C7

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38
Q

What direction do the external intercostal muscles move in?

A

Downwards and forwards (hands in pockets)

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39
Q

Where do the external intercostal muscles run from and to?

A

From tubercles of ribs to costochondral junction

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40
Q

What are the external intercostal muscles replaced by anteriorly?

A

External intercostal membrane

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41
Q

What function do the external intercostal muscles serve?

A

Raise the ribs on inspiration

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42
Q

What direction do the internal intercostal muscles move in?

A

Downards and backwards

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43
Q

Where do the internal intercostal muscles run from and to?

A

Sternum to angle of rib

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44
Q

What are the internal intercostal muscles replaced by posteriorly?

A

Internal intercostal membrane

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45
Q

What are the functions of the internal intercostal ribs?

A 
Depress ribs (interosseous part)
Raise ribs (interchondral part)
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46
Q

Where do the innermost intercostal muscles lie?

A

Deep to lateral part of internal intercostals

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47
Q

What direction do the innermost intercostal muscles run in?

A

Downwards and backwards

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48
Q

Where are the subcostal muscles found?

A

Near angle of ribs

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49
Q

How can the subcostal muscles be differentiated from intercostal muscles?

A

Span 1 or 2 intercostal spaces

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50
Q

What muscle radiates from the sides of the sternum to costal cartilages 2-6?

A

Transversus thoracis

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51
Q

What are the contents of an intercostal space?

A 
Intercostal muscles
Neurovascular bundle:
- Intercostal vein (most superior)
- Intercostal artery
- Intercostal nerve (most inferior)
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52
Q

Where does the intercostal neurovascular plane run?

A

In the costal groove of the rib between the internal and innermost intercostal muscle layers

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53
Q

From what artery do the 1st and 2nd posterior intercostal arteries from? Where does this artery originate?

A

Supreme intercostal artery from costocervical trunk (branch of subclavian)

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54
Q

Where do posterior intercostal arteries 3-11 and the subcostal artery arise from?

A

Thoracic aorta

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55
Q

Where do the 1st-6th anterior intercostal arteries arise from?

A

Internal thoracic artery (branch of subclavian)

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56
Q

Where do the 7th-9th anterior intercostal arteries arise from?

A

Musculophrenic artery (from internal thoracic)

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57
Q

Where does the superior epigastric artery arise from?

A

Internal thoracic artery

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58
Q

Where do the anterior intercostal veins drain to?

A

Internal thoracic veins

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59
Q

Where do the posterior intercostal veins on the right side from the 2nd-4th spaces drain to?

A

Right superior intercostal vein (draining to azygos)

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60
Q

Where do the posterior intercostal veins on the right side from the 2nd and 3rd spaces drain to?

A

Left superior intercostal vein (draining to left brachiocephalic +/- accessory hemiazygos)

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61
Q

What veins drain the 1st intercostal spaces?

A

Supreme intercostal veins (drain to brachiocephalic veins)

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62
Q

Where does venous blood drain to from posterior intercostal spaces on the right side (5-11 and subcostal)?

A

Azygos vein

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63
Q

Where does venous blood drain to from posterior intercostal spaces on the left side (9-11 and subcostal)?

A

Hemiazygos vein

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64
Q

Where does venous blood drain to from posterior intercostal spaces on the left side (4-8)?

A

Accessory hemiazygos

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65
Q

Where do lateral mammary branches arise from?

A

Lateral thoracic artery (from axillary)

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66
Q

Where do medial mammary branches arise from?

A

Internal thoracic artery

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67
Q

Where does 75% of lymph from the breast drain to?

A

Axillary nodes

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68
Q

Where else can breast lymph drain to?

A 
Parasternal nodes
(Abdominal nodes)
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69
Q

What are the four parts of the parietal pleura?

A

Cervical
Costal
Diaphragmatic
Mediastinal

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70
Q

What is the pulmonary ligament and what is its function?

A

Sleeve of pleura hanging below lung root

Allows for hilar structures to expand

71
Q

What does the endothoracic fascia do?

A

Attaches costal parietal pleura to the thoracic wall

72
Q

What is the function of the fibrous suprapleural membrane?

A

Prevents lung expansion into neck

73
Q

What are the attachments of the fibrous suprapleural membrane?

A

1st rib

C7 transverse process

74
Q

What is the fibrous suprapleural membrane continuous with?

A

Endothoracic fascia

75
Q

What are the surface markings of the lungs/visceral pleura?

A

Midclavicular line - Rib 6
Midaxillary line - Rib 8
Scapular line - Rib 10

76
Q

What are the surface markings of the parietal pleura?

A

Midclavicular line - Rib 8
Midaxillary line - Rib 10
Scapular line - Rib 12

77
Q

What forms the costodiaphragmatic recess?

A

Parietal pleura extending over dome of diaphragm

78
Q

Why is the left costomediastinal recess bigger than the right?

A

Large cardia impression

79
Q

What are the three surfaces of each lung?

A

Costal
Diaphragmatic
Mediastinal

80
Q

What are the three borders of each lung?

A

Anterior
Posterior
Inferior

81
Q

Where do the pulmonary veins lie in the lung hilum?

A

Most anterior and inferior

82
Q

Where are the pulmonary arteries located in the lung hilum?

A

Superiorly

83
Q

Where is the bronchus located in the lung hilum?

A

Posteriorly

84
Q

Where does the phrenic nerve run in relation to the lung hilum?

85
Q

Where does the vagus nerve run in relation to the lung hilum?

86
Q

What does the left recurrent laryngeal nerve loop under?

A

Arch of aorta

87
Q

What does the right recurrent laryngeal nerve loop under?

A

Right subclavian artery

88
Q

Where does the azygos vein lie in regards to the lungs?

A

Posterior to the right hilum

89
Q

Where does the SVC run in regards to the lungs?

A

Anterior to the right hilum

90
Q

How many segmental bronchi are there in the right lung lobes?

A

5 in lower lobe
3 in upper lobe
2 in middle lobe

91
Q

How many segmental bronchi are there in the left lung lobes?

A

5 in upper lobe

5 in lower lobe

92
Q

What do the segmental bronchi divide into?

A

Bronchioles:

  • Conducting
  • Terminal
  • Respiratory
93
Q

What do the bronchioles divide into?

A

Alveolar ducts

94
Q

What are the boundaries of the anterior mediastinum?

A 
Body of sternum
Pericardium
Transverse thoracic plane
Diaphragm
(Pleural laterally)
95
Q

What is the transverse thoracic plane?

A

Line from sternal angle to T4/5 IV disc

96
Q

What are the contents of the anterior mediastinum?

A

Loose connective tissue
Fat
Lymphatics
Thymus

97
Q

What are the contents of the middle mediastinum?

A 
Heart and pericardium
Roots of great vessels:
- Lower half SVC
- Pulmonary trunk
- Ascending aorta
- Right and left pulmonary veins
Phrenic nerves
Lung root structures
98
Q

Where does the right phrenic nerve run in relation to the heart?

A

Over the pericardium of the right atrium

99
Q

Where does the left phrenic nerve run in relation to the heart?

A

Over pericardium of left atrium and ventricle

100
Q

What does the fibrous pericardium blend with?

A

Superiorly - Tunica adventitia of great vessels

Inferiorly - Central tendon of diaphragm

101
Q

What is the other name for the visceral serous pericardium?

A

Epicardium

102
Q

Where is the pericardial cavity?

A

Between the parietal and visceral serous pericardium

103
Q

What is the transverse pericardial sinus?

A

Passage between venous and arterial mesocardia

104
Q

What vessel(s) lie anterior to the transverse pericardial sinus?

A

Aorta

Pulmonary trunk

105
Q

What vessel(s) lie posterior to the transverse pericardial sinus?

106
Q

What is the space behind the heart called?

A

Oblique pericardial sinus

107
Q

What forms the superior border of the heart?

A

Right and left atria and auricles

108
Q

What forms the right border of the heart?

A

Right atrium

109
Q

What forms the left border of the heart?

A

Left ventricle and left auricle

110
Q

What forms the inferior/diaphragmatic surface of the heart?

A

Right ventricle

111
Q

What forms the apex of the heart?

A

Left ventricle

112
Q

What rough shape is the heart?

A

Trapezoidal

113
Q

What is the ligamentum arteriosum?

A

A fibrous remnant of ductus arteriosis

114
Q

What structure runs posterior to the ligamentum arteriosum in adults?

A

Left recurrent laryngeal nerve

115
Q

What are the main branches of the right coronary artery?

A

SA nodal
Right marginal
Posterior interventricular
AV nodal

116
Q

What are the main branches of the left coronary artery?

A 
Anterior interventricular:
- Diagonal branch
Circumflex:
- Left marginal
(- SA nodal)
(- Posterior interventricular)
117
Q

What parts of the heart does the right coronary artery supply?

A

Right atrium and most of right ventricle
SA (usually) and AV nodes
Posterior third of IV septum
Part of left ventricle

118
Q

What parts of the heart does the left coronary artery supply?

A

Left atrium and most of left ventricle
Anterior 2/3 of IV septum
AV bundle
Part of right ventricle

119
Q

What cardiac veins drain directly to the right atrium?

A

Anterior cardiac veins

120
Q

Where do the other cardiac veins drain to first?

A

Coronary sinus

121
Q

What vein runs alongside the anterior IV artery?

A

Great cardiac vein

122
Q

What vein runs alongside the posterior IV artery?

A

Middle cardiac vein

123
Q

What vein rungs alongside the right marginal artery?

A

Small cardiac vein

124
Q

What is the sinus venarum?

A

Smooth, posterolateral, internal surface of the right atrium

125
Q

What is found in the sinus venarum?

A

Orifices for SVC, IVC and coronary sinus

126
Q

What are the muscular ridges in the atrial and auricle walls called?

A

Musculi pectinati

127
Q

What is the junction between the sinus venarum and pectinate muscles in the right atrium called and what is found here>

A 
Crista terminalis
SA node (near SVC opening)
128
Q

What is the fossa ovalis?

A

Remnant of foramen ovale

129
Q

What structure is unique to the right ventricle and what is its function?

A 
Septomarginal trabecula (moderator band)
Carries part of right bundle branch to anterior papillary muscle
130
Q

What are the muscular ridges in the ventricular walls?

A

Trabeculae carneae

131
Q

Where heart valves are semilunar?

A

Pulmonary and aortic

132
Q

What are the cusps of the pulmonary valve?

A

Left, right and anterior

133
Q

What are the cusps of the aortic valve?

A

Left, right and posterior

134
Q

When do the semilunar valves close?

A

Under low ventricular pressure (backflow of blood in pulmonary trunk and aorta close the valve)

135
Q

When do the cuspid valves close?

A

Under high ventricular pressure (ie systole)

136
Q

What is the function of the fibrous skeleton in the heart?

A

Supports valves

Electrical insulation between atria and ventricles

137
Q

What nerves innervate the SA node?

A

Autonomic from cardiac plexus

138
Q

What supplies PNS innervation to the heart?

A

Vagus nerve

139
Q

What supplies SNS innervation to the heart?

A

T1-T5/6 spinal nerves via cervical and superior thoracic paravertebral ganglia

140
Q

What are the boundaries of the superior mediastinum?

A 
Manubrium
Bodies of T1-T4 vertebrae
Transverse thoracic plane
Thoracic inlet
Parietal pleura
141
Q

What are the contents of the superior mediastinum?

A 
Thymus
Brachiocephalic veins and SVC
Arch of aorta (and its 3 branches)
Trachea
Oesophagus
Phrenic and vagus nerves
Lymphatics and thoracic duct
142
Q

What structures are ONLY found in the superior mediastinum in adults?

A

Thymus
Brachiocephalic veins
Arch of aorta
Trachea

143
Q

Where does the right vagus nerve run in the superior mediastinum?

A

Anterior to right subclavian artery

144
Q

Where does the left vagus nerve run in the superior mediastinum?

A

Between left common carotid and left subclavian arteries

145
Q

What plexuses does the vagus nerve give branches to in the thorax?

A 
Cardiac plexus (deep to arch of aorta)
Right and left pulmonary plexuses (on right and left main bronchi)
146
Q

What vagus nerve forms most of the anterior oesophageal vagal plexus?

147
Q

What vagus nerve forms most of the posterior oesophageal vagal plexus?

148
Q

What do the oesophageal vagal plexuses continue as?

A

Vagal trunks

149
Q

What are the root values of the phrenic nerve?

A

C3, C4 and C5

150
Q

What is the right phrenic nerve related to?

A

Right brachiocephalic vein
SVC
Pericardium over right atrium
Right lung hilum (anterior to it)

151
Q

Where does the right phrenic nerve pierce the diaphragm and at what level?

A

Near caval opening

T8

152
Q

Where does the left phrenic nerve lie?

A

Between left subclavian artery and vein
To the left of the arch of aorta anterior to vagus
Anterior to left hilum

153
Q

Where does the left phrenic nerve pierce the diaphragm?

A

To the left of the pericardium

154
Q

Where does the trache begin?

A

C6/7 (below larynx)

155
Q

What is the name for the division of the trachea and at what level is this?

A

Carina

T4/5 (transverse thoracic plane)

156
Q

What is the structure of the trachea anteriorly?

A

C-shaped cartilages

157
Q

What lies posterior to the trachea? What is its function?

A

Trachealis muscle

Accommodates expansion of oesophagus

158
Q

Where does the oesophagus begin?

A

C6 (continuation of pharynx)

159
Q

Where does the oesophagus lie in relation to the aorta?

A

Initially to the right

Crosses anteriorly prior to piercing diaphragm?

160
Q

At what level does the oesophagus pierce the diaphragm?

161
Q

What structures cause the three constrictions of the oesophagus?

A

Arch of aorta
Left bronchus
Diaphragm

162
Q

What are the boundaries of the posterior mediastinum?

A 
Transverse thoracic plane
Bodies of T5-T12 vertebrae
Pericardim
Diaphragm
Parietal pleura
163
Q

What are the contents of the posterior mediastinum?

A 
Thoracic part of descending aorta
Azygos vein
Hemiazygos and accessory hemiazygos veins
Vagus nerves
Greater, Lesser and Least splanchnic nerves
Sympathetic chain
Oesophagus
Thoracic duct
Lymphatics
164
Q

At what level does the aorta pass through the diaphragm?

165
Q

What sympathetic trunk level ganglia contribute to the greater splanchnic nerve?

166
Q

What sympathetic trunk level ganglia contribute to the lesser splanchnic nerve?

A

T10 and T11

167
Q

What sympathetic trunk level ganglia contribute to the least splanchnic nerve?

168
Q

What do the thoracic splanchnic nerves carry? Where to?

A

Presynaptic SNS fibres to abdominal viscera

169
Q

What abdominal ganglia do the greater splanchnic nerves supply?

A

Coeliac

Superior mesenteric

170
Q

What abdominal ganglia do the lesser splanchnic nerves supply?

A

Superior mesenteric

Aorticorenal

171
Q

What abdominal ganglia do the least splanchnic nerves supply?

A

Aorticorenal

172
Q

What structures pass through the aortic hiatus? What level is this at?

A

Aorta, thoracic duct and azygos vein

T12

173
Q

What structures pass through openings in the diaphragmatic crura?

A

Greater and lesser splanchnic nerves

174
Q

What structures pass behind the medial arcuate ligament (of the psoas major)?

A

Least splanchnic nerve

Sympathetic trunk

Regional Gross Anatomy (14 decks)

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