The Thoracic Wall, Lungs and Middle Mediastinum Flashcards
What are the 3 main parts of the Sternum?
Manubrium = head of sternum, has clavicular notch for sternoclavicular joint.
Body = joins manubrium at sternal angle (Of Louis)
Xiphoid process = lowest point of sternum
What are the 4 main parts of the ribs?
Head = articulates with 2 vertebral bodies & 1 disc
Tubercle = Articulates with 1 transverse process
Body = Region of greatest curve = angle
Costal Groove = formed by intercostal V. A. & N.
What are the 4 main parts of the ribs?
Head = articulates with 2 vertebral bodies & 1 disc
Tubercle = Articulates with 1 transverse process
Body = Region of greatest curve = angle
Costal Groove = formed by intercostal V., A. & N.
Internal Thoracic A & V run from _____ to ____.
2nd to 4th intercostal space
Lymphatics of the Pectoral region drain to where?
To parasternal nodes & axillary nodes
Lat. & Ant. Nerve of 4th to 6th intercostal nerves carry __________ innervation.
Cutaneous
What muscles make up the Pectoral Region?
Pectoralis major and Minor
__________ is divided into clavicular and sternocostal heads.
Pectoralis major
_______ is enveloped in clavipectoral Fascia.
Pectoralis minor
What are the structures of the Ant. Thoracic Wall?
- Breasts
- Ribs & sternum
- Pectoral, intercostal & subcostal.
What are the structures of the Ant. Thoracic Wall?
- Breasts
- Ribs & sternum
- Pectoral, intercostal & subcostal.
- Intercostal vessels & nerves.
- Internal Thoracic Vessels
How many ribs are there?
12 per side
What are the 3 intercostal muscles?
External
Internal
Innermost
Where is the Collateral Nerve, artery and vein located?
Superior edge of ribs (below the intercostal A,V & N because its on inferior edge of the rub above.)
What is the Pleura?
Serous secreting membranes that reduce friction.
What are the 2 main Pleura membranes?
Parietal Pleura
- Covers Thoracic walls
- Very Sensitive to Pain
Visceral Pleura
- Covers lungs
- NOT Sensitive (no sensory supply)
T or F, both Pleura membranes remain separate at the root of the lung.
False
T or F, both Pleura membranes remain separate at the root of the lung.
False they are continuous
What are pleural cavities?
are potential cavities.
- can become actual.
- pathological fluid = effusion; may fill space.
- may compress lungs.
- pleural effusions visible on chest films.
- can obscure lung in film.
What are pleural cavities?
are potential cavities.
- can become actual.
- pathological fluid = effusion; may fill space.
- may compress lungs.
- pleural effusions visible on chest films.
- can obscure lung in film.
_____ is an accumulation of air in pleural cavity.
Pneumothorax
- Collapses lung due to its own elasticity.
______ is accumulation of blood in pleural cavity.
Hemothorax
- May cause adhesions & infection if not removed.
What is Pleurisy?
Inflammation of the pleura.
- leads to formation of pleural adhesions
- between paritetal and visceral
- Can produce exquisite pain relative to partial pleura.
What is Pleurisy?
Inflammation of the pleura.
- leads to formation of pleural adhesions
- between parietal and visceral
- Can produce exquisite pain relative to partial pleura.
what is a plural tap?
Aspiration of fluids
- Taken at IC space 6 or 7 at Midaxillary line.
- If needle is inserted at 8 or 9 may pierce diaphragm, liver or spleen.
Divisions of right lung?
Upper
Middle
Lower
Divisons of Left lung?
Upper & Lower
Where is the oblique fissure?
On both lungs
Where is the Horizontal fissure?
On right lung only because it has 3 lobes
_____ connects the lung to mediastinum.
Root of the lungs
- covered in sleeve of pleura
- consists of bronchi & pulmonary vessels
Inferiorly, the sleeve of pleura that covers the root of the lung becomes ________.
Pulmonary Ligament
*has only a few lymph vessels in it at this point
Trachea splits into _______, which splits into _________, which splits into ______.
into 2 primary main bronchi —–> splits into 2 or 3 secondary bronchi —–> splits into 8 or 10 tertiary (segmental) bronchi
In General what is the neurovasculature of the root of the lungs?
Sympathetic trunks
- Paravertebral
- dilates Bronchioles
Vagus Nerve
- Pass posteriorly to roots of lungs
- Closely applied to trachea, esophagus & aorta.
- Contribute to ant. & post. pulmonary plexuses.
- Constrict the bronchioles
What is the Neurovascualture of the RIGHT Root of lung?
- Vagus nn. (pass post. to root of lungs)
- Phrenic nn (Pass ant. to roots of lungs)
- Pericardiacophrenic vessels (Run with phrenic nn.)
What is the Neurovascualture of the LEFT root of lung?
- Vagus nn.
- Phrenic nn.
- Pericardacophrenic vessels.
____ supplies nutrients to bronchi & lungs.
Bronchial aa.
Lymph is drained from the lungs via ________.
Tracheobronchial nodes & R/L bronchomediastinal trunks.
________ is a broad central partition separating 2 pleural Cavities.
Mediastinum
What are the 4 subdivisions of the mediastinum?
Superior Inferior Anterior Middle Posterior
The Mediastinum extends from ____ to _____ & from ______ to _______.
Thoracic inlet to diaphragm
Sternum to 12th Thoracic Vertebra
What structures are found in the region of the Middle Mediastinum?
- Pericardium & Heart
- Phrenic nn. applied to pericardium
- Pericardiacophrenic vessels
- Roots of great vessels to & from heart.
______ is a tough fibrous sac lined with serous membrane.
Pericardium
What are the 2 portions of the Pericardium?
Fibrous portion - attached to the diaphragm inferiorly
Serous portion - divided into parietal and visceral layers
_____ encloses the heart & is Pierced by roots of 8 vessels.
Pericardium
- SCV
- IVC
- Aorta
- Pulm. trunk
- 4 pulm vv.
What is the Pericardial Cavity?
Inside pericardial sac
- Potential space between layers serous & Parietal layers.
- only carries small amount of serous fluid.
What is pericardial Effusion?
Accumulation of excess fluid in pericardial cavity .
- results in compression of heart.
- Common in conjunction with congestive heart failure.
What is Hemoperricardium?
Accumulation of blood in pericardial cavity
- Associated with penetrating heart wounds or perforated heart muscle following MI.
- Arterial bleeding into cavity leads to Cardiac tamponade = compression of heart and roots of great vessels.
