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MRAD 2235 Anatomy > The Chest > Flashcards

The Chest Flashcards

1
Q

Mediastinum

A

Where is it? Central compartment of the thoracic cavity between the lungs.

What does it do? Serves as a passageway and protective region for vital thoracic structures.

What does it contain? Heart, great vessels, esophagus, trachea, thymus, lymph nodes, and nerves (e.g., phrenic, vagus).

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2
Q

Superior Mediastinum

A

Where is it? Upper part of the mediastinum, above a horizontal line from the sternal angle to the T4–T5 intervertebral disc.

What does it do? Transmits structures between the neck and thorax.

What does it contain?
Thymus
Great vessels (aortic arch, brachiocephalic veins, superior vena cava)
Trachea, esophagus
Thoracic duct
Vagus and phrenic nerves
Left recurrent laryngeal nerve

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3
Q

Inferior Mediastinum

A

Where is it? Below the plane of the sternal angle to the diaphragm; divided into anterior, middle, and posterior compartments.

What does it do? Houses and protects the heart and thoracic organs.

What does it contain? Varies by compartment (see next flashcards).

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4
Q

Anterior Compartment

A

Where is it? Between the sternum and pericardial sac.

What does it do? Contains fat and connective tissue; minimal functional content in adults.

What does it contain?
Loose connective tissue
Fat
Lymphatic vessels and nodes
Sometimes the inferior portion of the thymus in children

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5
Q

Middle Compartment

A

Where is it? Centrally located, surrounding the heart.

What does it do? Contains and protects the heart and roots of the great vessels.

What does it contain?
Heart enclosed in the pericardial sac
Ascending aorta
Pulmonary trunk
Superior vena cava
Pulmonary veins
Phrenic nerves
Main bronchi
Pericardiacophrenic vessels

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6
Q

Posterior Compartment

A

Where is it? Behind the pericardium and in front of the vertebral column.

What does it do? Passageway for structures from the thorax to the abdomen.

What does it contain?
Descending thoracic aorta
Esophagus
Thoracic duct
Azygos and hemiazygos veins
Vagus nerves
Sympathetic trunks

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7
Q

Pericardial Sac (Pericardium)

A

Where is it? Encloses the heart in the middle mediastinum.

What does it do? Protects the heart, provides frictionless movement, anchors it within the thorax.

What does it contain?
Fibrous pericardium (outer layer)
Serous pericardium (inner layer: parietal and visceral)
Pericardial cavity (with serous fluid between layers)

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8
Q

Where is the heart located?

A

In the inferior middle mediastinum within the pericardial sac.

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9
Q

How is the heart oriented in the thorax?

A

It tilts posteriorly with the apex directed inferiorly, anteriorly, and to the left.

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10
Q

What proportion of the heart lies to the left of midline?

A

Two thirds of the heart lies left of midline.

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11
Q

To show the heart with the least magnification, which lateral chest x-ray should be performed?

A

Left lateral.

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12
Q

What structures comprise the right side of the heart pump?

A

Right atrium and right ventricle.

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13
Q

What type of blood does the right heart pump and where does it send it?

A

Deoxygenated blood to the lungs via pulmonary arteries.

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14
Q

What structures comprise the left side of the heart pump?

A

Left atrium and left ventricle.

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15
Q

What type of blood does the left heart pump and where does it send it?

A

Oxygenated blood to the body via the aorta.

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16
Q

What are the major veins of the heart?

A

Superior vena cava and inferior vena cava.

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17
Q

What are the major arteries of the heart?

A

Ascending aorta, arch of aorta, pulmonary trunk, and pulmonary arteries.

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18
Q

What vessels return oxygenated blood from the lungs to the heart?

A

Pulmonary veins.

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19
Q

What does the ascending aorta become at its most superior point?

A

The arch of the aorta.

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20
Q

What is the continuation of the aortic arch as it turns inferiorly?

A

The descending (thoracic) aorta.

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21
Q

Where are the lungs located in relation to the mediastinum?

A

On either side of the mediastinum.

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22
Q

Which lung is typically larger?

A

The right lung.

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23
Q

Why is the left lung smaller than the right lung?

A

Because the mediastinum bulges into the left side.

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24
Q

How many lobes does the right lung have?

A

Three lobes (superior, middle, inferior).

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25
What fissure separates the superior and middle lobes from the inferior lobe in the right lung?
The oblique fissure.
26
From which vertebral and rib levels does the right lung’s oblique fissure run?
From T4 posteriorly to rib 6 anteriorly.
27
What fissure separates the right lung’s middle lobe from the superior lobe?
The horizontal fissure.
28
How many lobes does the left lung have?
Two lobes (superior and inferior).
29
What fissure separates the lobes of the left lung?
The oblique fissure.
30
What is the carina?
The point where the trachea bifurcates into the left and right main bronchi.
31
At what vertebral level is the carina located?
At the T4/T5 level.
32
What do the main bronchi divide into once inside the lungs?
Lobar bronchi and segmental bronchi.
33
Which main bronchus is wider and more vertical?
The right main bronchus.
34
What structures enter the lungs at the hilum?
Main bronchi, pulmonary arteries, and pulmonary veins.
35
Where is the hilum located on each lung?
On the medial border.
36
What covers the hilum of each lung?
A sleeve of pleura.
37
What structure separates the thoracic cavity from the abdominal cavity?
The diaphragm.
38
What are the anterior attachment points of the diaphragm?
The xiphoid process.
39
What are the posterior attachment points of the diaphragm?
The lumbar vertebrae.
40
What are the lateral attachment points of the diaphragm?
The costal margins and ribs 11 and 12.
41
What is the sloped region where the diaphragm meets the ribs called?
Costophrenic angles.
42
What is a clinical use of observing the costophrenic angles on a radiograph?
To assess for pleural effusions.
43
What happens to the diaphragm during expiration?
It relaxes and elevates.
44
To which rib level do the domes of the diaphragm rise during expiration?
Posterior rib #8.
45
How does the thoracic volume change during expiration?
It is reduced.
46
What happens to the diaphragm during inspiration?
It contracts and moves inferiorly.
47
To which rib level do the domes of the diaphragm move during inspiration?
Posterior rib #10.
48
How does the thoracic volume change during inspiration?
It expands.
49
What happens to the ribs during inspiration?
They elevate and move outward.
50
What happens to the abdominal organs during inspiration?
They are compressed inferiorly.
51
What happens to the ribs during expiration?
They return to their normal position.
52
What happens to the abdominal organs during expiration?
They expand.
53
Why might a chest x-ray be taken in the supine position instead of erect?
The patient is too weak or has a contraindication to standing (e.g., fractured hip or neck injury).
54
How do the lungs appear in width on a supine chest x-ray compared to erect?
Wider by approximately 3 cm.
55
How are the clavicles positioned on a supine chest radiograph?
Diagonally, superimposing the apices.
56
How are the scapulae positioned on a supine chest radiograph?
They superimpose the lung fields.
57
How do the lungs appear in density on a supine chest radiograph?
More gray, with soft tissue blending into the lung fields.
58
How does the length of the lungs compare on an erect chest x-ray?
They appear longer by approximately 3 cm.
59
How are the clavicles positioned on an erect chest radiograph?
Horizontally.
60
How are the scapulae positioned on an erect chest radiograph?
Cleared or almost fully cleared from the lung fields.
61
How do the lungs appear in density on an erect chest radiograph?
More black, with clearer differentiation of soft tissue structures.
62
What term describes individuals with long and slender lungs?
Asthenic.
63
What term describes individuals with short and broad lungs?
Hypersthenic.
64
How does body habitus affect chest imaging?
It determines imaging plate orientation and collimation to avoid clipping anatomy.
65
What imaging plate orientation is used for asthenic patients?
Portrait.
66
How should collimation be adjusted for asthenic patients?
Longer (height) than wide.
67
What imaging plate orientation is used for hypersthenic patients?
Landscape.
68
How should collimation be adjusted for hypersthenic patients?
Wider than long (height).
69
How does the size of the heart in pediatric patients compare to adults?
It appears proportionally larger.
70
How does lung volume in infants compare to that in older children?
Lung volume is smaller in infants.
71
How does bone structure appear in pediatric chest radiographs?
Less ossified and more radiolucent (less dense).
72
At what age does the heart appear especially large relative to the chest cavity on x-ray?
Around 3 days old.
73
What is one key radiographic difference between a 2-year-old and a 3-day-old?
The 3-day-old has a larger heart size relative to chest, lower lung volume, and more radiolucent bones.
74
What does the cardiothoracic (CT) ratio assess?
Heart enlargement/pathology.
75
What is the normal cardiothoracic ratio for an adult on a PA chest x-ray?
≤ 50% of the thoracic diameter.
76
What is the normal cardiothoracic ratio for a neonate?
≤ 66% of the thoracic diameter.
77
What effect does incorrect SID have on chest radiographs?
It can magnify or minify structures, possibly leading to misdiagnosis.
78
What SID is typically used for a PA chest x-ray?
180 cm.
79
What imaging modality allows viewing of anatomy in multiple planes?
Computed Tomography (CT).
80
Which structure is visible as a gas shadow under the left hemidiaphragm?
Stomach gas bubble (meganblase).
81
What structure lies between the lungs and contains the heart, trachea, and great vessels?
Mediastinum.
82
What is the name for the top portion of the lungs visible on a chest x-ray?
Apices.
83
What are the sharply pointed angles formed by the diaphragm and chest wall?
Costophrenic angles.
84
Which bony structures are visible behind the chest cavity and help assess rotation in a lateral image?
Posterior ribs.
85
What part of the lung contains the main pulmonary vessels and bronchi?
Hilum.
86
What structure appears as a vertical air-filled tube in the midline?
Trachea.
87
What is the large muscle that separates the thoracic and abdominal cavities?
Diaphragm.
88
What bone is seen in the midline anteriorly and can help assess patient rotation?
Sternum.
89
Which vertebral level shows the trachea as round and the aortic arch visible?
Thoracic vertebra 4 (T4).
90
What round airway structure is seen at the level of T4?
Trachea.
91
What major vascular structure is seen arching at the level of T4?
Aortic arch.
92
At which vertebral level does the trachea begin to bifurcate and lose its roundness?
Between T4 and T5.
93
What two vascular structures become visible as the aortic arch divides between T4–T5?
Ascending aorta and descending aorta.
94
At which vertebral level does the tracheal bifurcation complete into main bronchi?
Thoracic vertebra 5 (T5).
95
What two airway branches become visible at the level of T5?
Right and left main bronchi.
96
At what vertebral level does the pulmonary trunk start to appear?
Between T5 and T6.
97
What three key structures are visible between T5–T6?
Pulmonary trunk, right main bronchus, left main bronchus.
98
At what vertebral level do the pulmonary arteries branch?
Thoracic vertebra 6 (T6).
99
What vascular branches are seen at T6?
Right and left pulmonary arteries.
100
What is another name for the pharynx?
The throat.
101
What are the three sections of the pharynx?
Nasopharynx, oropharynx, and laryngopharynx.
102
What are the two primary functions of the pharynx?
It protects the upper respiratory tract and connects it to the digestive tract.
103
How long is the pharynx approximately?
About 12.5 cm.
104
Where does the pharynx extend from and to?
From the posterior/internal nares to the mid neck.
105
Where is the pharynx located in relation to the nasal and oral cavities and cervical spine?
Behind the nasal and oral cavities, anterior to the cervical spine.
106
What type of tissue forms the pharynx?
Skeletal muscle lined with a mucous membrane.
107
What part of the pharynx lies above the soft palate and behind the nasal cavity?
The nasopharynx.
108
What is the function of the nasopharynx?
Respiratory only.
109
With which structure does the nasopharynx communicate to equalize ear pressure?
The eustachian tubes.
110
What is another name for the larynx?
The voice box.
111
What does the larynx connect?
The pharynx to the trachea.
112
What is the vertebral range of the larynx?
From C3 (hyoid) to C6 (trachea).
113
What is the only function of the larynx?
Respiratory.
114
What cartilage in the larynx prevents food from entering the airway during swallowing?
The epiglottis.
115
To which cartilage does the epiglottis attach inferiorly and anteriorly?
The thyroid cartilage (C4/C5).
116
Where does the epiglottis project superiorly to?
The approximate level of the hyoid bone (C3).
117
How many cartilages form the walls of the larynx?
Nine.
118
What is the largest cartilage of the larynx?
The thyroid cartilage.
119
What is another name for the thyroid cartilage?
Adam's apple or laryngeal prominence.
120
At which vertebral levels is the thyroid cartilage located?
C4–C5.
121
What cartilage marks the inferior border of the larynx?
The cricoid cartilage.
122
Which cartilage is thicker posteriorly and forms a complete ring?
Cricoid cartilage.
123
What are the false vocal cords called?
Vestibular folds.
124
What are the true vocal cords called?
Vocal folds.
125
Where is sound produced in the larynx?
In the true vocal cords (vocal folds).
126
What is another name for the trachea?
The windpipe.
127
What is the length of the trachea?
Approximately 11 cm.
128
What is the only function of the trachea?
Respiratory.
129
Where is the trachea located in relation to the esophagus?
Anterior to the esophagus.
130
From where to where does the trachea extend?
From the larynx to the level of T4–T5.
131
What is the name of the site where the trachea bifurcates?
The carina.
132
What supports the walls of the trachea structurally?
C-shaped cartilaginous rings.
133
What is the function of the C-shaped rings in the trachea?
To keep the trachea open.
134
What radiographic exam is typically used to locate foreign bodies in the pharynx?
Soft Tissue Neck (lateral image).
135
What technical adjustments are made for a Soft Tissue Neck exam?
Adjustments to kVp and mAs to best visualize soft tissues.
136
Where do foreign bodies commonly lodge in the upper airway?
In the pharynx.
137
What forms the posterior boundary of the superior thoracic aperture?
T1 vertebra.
138
What forms the lateral boundaries of the superior thoracic aperture?
First ribs.
139
What forms the anterior boundary of the superior thoracic aperture?
Manubrium of the sternum.
140
What major structure passes through the superior thoracic aperture?
The trachea.
141
Which thoracic opening allows lung apices to project above it?
Superior thoracic aperture.
142
What may tracheal impingement on a chest x-ray suggest?
Pathological changes at the thoracic inlet.
143
What forms the posterior boundary of the inferior thoracic aperture?
T12 vertebra.
144
What forms the lateral boundaries of the inferior thoracic aperture?
Lower ribs and their costal cartilages.
145
What forms the anterior boundary of the inferior thoracic aperture?
Xiphisternum.
146
What structure forms the base of the inferior thoracic aperture?
The diaphragm.
147
What glands can cause tracheal deviation if enlarged or tumorous?
Thyroid and parathyroid glands.
148
During which fluoroscopic exam might tracheal deviation be observed?
Modified Barium Swallow.

MRAD 2235 Anatomy (9 decks)

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