The Thorax Flashcards

1
Q

What separates the thorax from the abdomen

A

The diaphragm

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2
Q

What protects the thorax

A

thoracic cage

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3
Q

Contents of the thorax

A
  • Heart
  • Great vessels
  • Lungs
  • Airways
  • Supporting circulatory and nerve networks
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4
Q

Define Mediastinum

A

the space between the lungs

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5
Q

3 Functions of the chest wall (thoracic cage)

A
  1. Protection of the thoracic and abdominal contents
  2. Breathing
  3. Attachements for the upper limb are located at the sternoclavicular joint
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6
Q

Explain how breathing occurs

A

Breathing occurs when the diaphragm contracts and relaxes, allowing air to enter and leave the lungs. When exertion is required the diaphragm is assisted by the intercostal, arm and neck muscles.

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7
Q

Where is the breast attached?

A

between ribs 2 and 6 (covering the pectoralis major)

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8
Q

Contents of the thoracic cage

A
  • 12 ribs
  • 12 vertebrae
  • the sternum
  • Inlet
  • Outlet
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9
Q

Where is the throacic cage widest?

A

at ribs 7 and 8

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10
Q

What is the inlet

A

The inlet is the 1st thoracic vertebra posteriorly, the 1st ribs (at the sides) and the superior aspect of the manubrium sterni

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11
Q

List structures that pass through the inlet (7)

A
  • Esophagus
  • Trachea
  • Common Carotid and Subclavian Arteries
  • Jugular and Subclavian Veins
  • Left and Right Vagus Nerves
  • Left and Right Phrenic Nerves
  • Left and Right Sympathetic Trunks
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12
Q

What is the outlet

A

The 12th thoracic vertebra, the 12th ribs passing into the 11th ribs and then the costal margin, which is the fused costal cartilage of ribs 7-10

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13
Q

List structures passing through the outlet (6)

A
  • Esophagus
  • Descending Aorta
  • Inferior Vena Cava
  • Left and Right Vagus Nerves
  • Left and Right Sympathetic Trunks
  • Thoracic Duct
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14
Q

Three components of the sternum

A
  • Manubrium
  • Body
  • Xiphoid process
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15
Q
A

Manubrium

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16
Q
A

Body

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17
Q
A

Xiphoid process

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18
Q

What joint unites the manubrium and body of the sternum?

A

Manubriosternal joint

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19
Q

What joint unites the body and xiphoid process of the sternum?

A

The xiphisternal joint

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20
Q

The groove at the top of the manubrium is called:

A

The suprasternal or jugular notch

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21
Q

Where does the second rib articulate with?

A

The angle of Louis on one side and the manubriosternal joint on the other side

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22
Q

What is the sterna angle (of Louis)

A

The angle in the anteroposterior plane that is created by the manubrium joining the body

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23
Q

Which costal cartilages articulate laterally with the sternal body?

A

3, 4, 5, 6

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24
Q

How does the 7th rib articulate with the sternum

A

By way of its cartilage, it articulates between the body and the xiphoid process

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25
Q

True ribs

A

The upper 7 ribs that are directly attached to the sternum by means of its costal cartilage

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26
Q

False ribs

A
  • The lower 5 pairs of ribs
  • Ribs 8, 9, and 10 attach indirectly to the costal cartilage of rib 7
  • Ribs 11 and 12 are floating ribs because their costal cartilages do not articulate at all
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27
Q

Which rib is the widest, shortest and flattest?

A

1st rib

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28
Q

Where does rib 1 articulate?

A

It articulates with the body of its own vertebra (T1)

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29
Q

Scalene tubercle

A

the small bump in the centre of rib 1’s upper surface

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30
Q

What passes through the scalene tubercle?

A

The subclavian vein and artery pass infront of and behind this tubercle, respectively

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31
Q

Components of a rib (5)

A
  • Head
  • Neck
  • Tubercle
  • Shaft
  • Distal end
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32
Q

Describe how the head of a rib articulates with a vertabra

A

The head is pointed and has a demifacet, which articulates with the bodies of its own vertebra and the one above

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33
Q

Which vertebrae would rib 6 articulate with?

A

T5 abd T6

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34
Q

Which ribs articulate ONLY with their own vertebra?

A

1, 11, 12

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35
Q

How many facets does T1 have?

A

1.5

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36
Q

How many facets does T2-T9 have?

A

2

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37
Q

How many facets does T11 and T12 have?

A

1

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38
Q

The neck of the rib leads to the:

A

tubercle

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39
Q

2 parts of the tubercle

A
  • articular surface

- non-articular part

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40
Q

The articular surface of the tubercle artoculates with which joint?

A

the costotransverse joint

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41
Q

The shaft of the rib

A

is flat and features the subcostal groove

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42
Q

The angle of the rib

A

1/3 around the shaft where the rib starts to point forward and downward

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43
Q

Where does the distal end of the rib attach?

A

its costal cartilage attaches to the sternum by means of the costosternal joint

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44
Q

What type of joint is the costosternal joint?

A

synovial

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45
Q

How does the head of a rib articulate with vertebrae?

A

The head of the rib typically has 2 demifacets that articulate with the equivalent demifacets on the bodies of two adjacet vertebrae (its own and the one above)

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46
Q

How is the head of the rib held in place?

A
  • The radiate ligaments which are located anteriorly

- The intra-articular ligament deep in the joint secures the tip of the head with the disc

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47
Q

The tubercle of the ribs articulates with:

A

the articular part of the transverse (vertebral) process

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48
Q

How is the joint of the tubercel and transverse process strengthened?

A

by a large medial and smaller lateral costotransverse ligaments

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49
Q

Ligament of the neck

A

the medial ligament

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50
Q

Superior costotransverse ligament

A
  • reinforces the joint of the tubercle and transverse process
  • runs between the neck of the rib and the transverse process
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51
Q
A

Lateral costotransverse ligament

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52
Q
A

Superior costotransverse ligament

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53
Q
A

Lateral costotransverse ligament

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54
Q
A

Medial costotransverse ligament

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55
Q
A

Radiate ligament

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56
Q
A

Tubercle

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57
Q
A

Disc

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58
Q
A

Intra-articular ligament

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59
Q
A

Medial costotransverse ligament (ligament of the neck)

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60
Q

3 layers of intercostal muscles of the rib cage

A
  1. External intercostals (superficial)
  2. Internal intercostals (middle)
  3. Innermost intercostals (deep)
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61
Q

How do the fibers of the external intercostals point?

A

down and forward

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62
Q

Describe the composition of the external intercostals

A
  • the posterior and lateral parts are muscular

- the anterior section is aponeurotic

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63
Q

How do the fibers of the internal intercostals point

A

down and posteriorly

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64
Q

Describe the composition of the internal intercostals

A

the aponeurosis is posterior and the muscular part is lateral and anterior

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65
Q

What are the 3 parts of the innermost intercostals

A
  1. Anterior (AKA the transversus thoracis)
  2. Lateral
  3. Posterior
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66
Q

What joins the 3 parts of the innermost intercostals?

A

they are joined by thin aponeuroses

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67
Q
A

Innermost intercostals

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68
Q
A

Intercostal space

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69
Q
A

Internal intercostals

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70
Q
A

External intercostals

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71
Q

Subcostal space

A

The area below the 12th rib

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72
Q

Intercostal space location

A

is located between the internal and innermost layers of muscles

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73
Q

What does the intercostal space contain?

A

intercostal vein, artey and nerve nestled in the subcostal groove

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74
Q

The anterior rami of the spinal nerves

A

are the 11 pairs of intercostal nerves (T1-T11)

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75
Q

Which intercostal nerve helps make up the brachial plexus?

A

T1

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76
Q

What do the collaterals supply

A

the sensory innervation for the skin

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77
Q

What do the collateral merge with?

A

penetrating branches from the dorsal rami and the anterior cutaneous nerves

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78
Q

2 sets of arteries supplying the intercostal spaces:

A

anterior and posterior intercostal arteries

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79
Q

Majority of posterior intercostal arteries arise from the:

A

aorta

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80
Q

Which arteries do not arise from the aorta? Where do they arise from?

A

arteries 1 and 2 arise from the supreme intercostal artery

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81
Q

The anterior intercostal arteries are branches of the:

A

internal thoracic (internal mammary) artery

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82
Q

The internal thoracic is a branch of the:

A

subclavian artery

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83
Q

The internal thoracic runs where? with what?

A

It runs down lateral to the sternum behind the costal cartilages, accompanied by its venae comitantes

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84
Q

Where does the internal thoracic branch bifurcate?

A

in the costal margin

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85
Q

Where do the cartilages of ribs 7-10 fuse?

A

the costal margin

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86
Q

The internal thoracic branch bifurcates into the:

A

superior epigastric and musculophrenic arteries

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87
Q

The upper 6 anterior intercostal arteries come off of the:

A

internal thoracic

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88
Q

The lower 4 anterior intercostal arteries come off of the:

A

musculophrenic artery

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89
Q

Perforating branches of which arteries supply the skin of the chest wall?

A

the anterior and posterior intercostal arteries

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90
Q
A

Vein

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91
Q
A

Artery

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92
Q
A

Nerve

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93
Q
A

External intercostal

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94
Q
A

Internal intercostal

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95
Q
A

Innermost intercostal

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96
Q

Where do the posterior intercostal veins run?

A

back in the upper part of the intercostal space

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97
Q

Where do the intercostal veins on the right side of the thorax empty?

A

into the azygos vein

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98
Q

Where does the thorax drain?

A

into the hemiazygos veins which themselves drain into the azygos vein

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99
Q

Where do the anterior intercostal veins drain?

A

into the venae comitantes of the internal throacic artery and eventually into the brachiocephalic veins

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100
Q

What is the diaphragm

A

a thin musculotendinous partition separating the contents of the thorax from those of the abdomen

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101
Q

What passes through the diaphragm

A
  • esophagus
  • aorta
  • inferior vena cava
  • vagi and sympathetic nerve
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102
Q

What innervates the diaphragm?

A

The left and right phrenic nerves (C3, 4, 5 keep the diaphragm alive)

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103
Q

What are the 3 origins of the diaphragm?

A

lumbar, costal and sternal

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104
Q

Where do the 2 crura of the lumbar component of the diaphragm arise from? what is formed?

A

the first 3 vertebrae and form an arch to allow the aorta to pass through

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105
Q

Where are the medial and lateral arcuate ligaments

A

lateral to the crura of the lumbar portion of the diaphragm

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106
Q

Which abdominal muscles do the medial and lateral arcuate ligaments bridge across?

A

the quadratus lumborum and the psoas

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107
Q

Where does the costal origin of the diaphragm travel from and to?

A

the costal origin continues from the lateral arcuate ligament along rib 12 and onto the lower 6 costal cartilages and then passes onto the xyphoid process (sternal origin)

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108
Q

What is formed as the diaphragm rises from the sternal origin?

A

a dome on each side of the thorax

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109
Q

How high does the right dome rise?

A

1 cm below the right nipple (in the male)

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110
Q

Where do the fibers of the dome insert?

A

central tendon

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111
Q

What happens to the diaphragm during inspiration?

A

The fibers of the dome contract, pulling the central tendon (dome) downward, thus flattening the diaphragm and expanding the vertical ‘diameter’ of the thoracic cavity

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112
Q

Where is the costodiaphragmatic recess

A

lateral to the dome of the diaphragm

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113
Q

Where does the aorta peirce the diaphragm

A

between the crura at level T12

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114
Q

Where does the esophagus and vagi (vagus nerve) pierce the central tendon?

A

T10

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115
Q

Where does the inferior vena cava pierces the central tendon?

A

T8

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116
Q
A

Inferior vena cava

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117
Q
A

Esophagus

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118
Q
A

Aorta

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119
Q
A

Right crus

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120
Q
A

Quadratus lumborum

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121
Q
A

Psoas

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122
Q
A

Lateral arcuate ligament

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123
Q
A

Medial arcuate ligament

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124
Q
A

Left crus

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125
Q
A

Central tendon

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126
Q

What is the job of the circulatory system? (4)

A
  • bring oxygenated blood to all regions of the body
  • deliver hormones for the endorine system
  • transport nutrients from the GI tract to the liver
  • carry carbon dioxide to the lungs and oxygen from the lungs
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127
Q

Systemic circulation

A

is the totality of the vessels serving the organs and tissues of the body except the lungs and the liver

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128
Q

Pulmonary circulation

A

delivers deoxyganted blood to the lungs and returns oxygenated blood to the heart

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129
Q

What is the portal system made up of and what does it do?

A

The portal system is made up of the portal vein and its tributaries delivering nutrients from the GI tract to the liver

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130
Q

What drives the circulatory system

A

the heart

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131
Q

Where is the heart located

A

in the middle mediastinum

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132
Q

What type of tissue is the heart made of?

A

cardiac muscle (a unique contractile tissue) and connective tissue

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133
Q

Pathway of blood through the heart to lungs

A
  1. Venous blood enters right atrium from superior and inferior vena cava
  2. Blood passes through the tricuspid valve into the right ventricle
  3. The right ventricle contracts, sending blood through the pulmonary valve into the pulmonary trunk
  4. The pulmonary trunk bifurcates into the left and right pulmonary arteries, which deliver blood to the left and right lungs
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134
Q

Pathway of blood through the heart from the lungs

A
  1. The oxygenated blood returns from the lungs in the pulmonary veins which empty into the left atrium
  2. The blood passes through the mitral valve into the left ventricle
  3. The left ventricle contracts and blood passes by the aortic valve into the aorta
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135
Q

The 3 regions of the aorta in order

A

arch of the aorta, descending (thoracic) aorta, and the abdominal aorta

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136
Q

3 major branches of the arch of the aorta

A
  1. brachiocephalic artery
  2. left common carotid artery
  3. left subclavian artery
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137
Q

the brachiocephalic artery bifuractes into

A
  • right common carotid

- right subclavian artery

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138
Q

the right common carotid supplies

A

the head and neck

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139
Q

the right subclavian arteries supply

A

the right upper limbs

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140
Q

When does the descending aorta become the abdominal aorta

A

when it passes through the diaphragm

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141
Q

The abdominal aorta bifurcates into the

A

left and right common iliac arteries

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142
Q

The left and right common iliac artieries supply

A

the pelvis and lower limbs

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143
Q

The pericardium

A

a 3 layered protective sac around the heart

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144
Q

3 layers of the pericardium

A
  1. Fibrous pericardium
  2. Parietal layer
  3. Visceral layer
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145
Q

The parietal layer and visceral layer are what type of pericardium

A

serous pericardium

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146
Q

The fibrous pericardium is made up of

A

dense connective tissue

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147
Q

The fibrous pericardium surrounds

A
  • the heart
  • serous pericardia
  • roots of the great vessels
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148
Q

The base of the fibrous pericardium is fused with

A

the central tendon of the diaphragm

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149
Q

How many layers is the fibrous pericardium

A

1

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150
Q

The serous pericardium is fused with

A

the inside of the fibrous pericardium

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151
Q

How many layers is the serous pericardium

A

2

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152
Q

The parietal layer is fused with the

A

fibrous pericardium

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153
Q

The visceral layer is fused to

A

the myocardium (muscle of the heart)

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154
Q

Epicardium

A

the outer layer of the heart between the pericardium and the heart

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155
Q

What allows for the free movement of the two serous layers during contraction of the heart

A

Between the serosa is a lubricating fluid manufactured by the serous pericardium

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156
Q
A

Fibrous pericardium

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157
Q
A

Pericardial space

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158
Q
A

Serous pericardium

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159
Q
A

Epicardium

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160
Q

From the front, the right border formed by

A

forms a verticle line with the vene cavae, and is largely formed by the right atrium

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161
Q

From the front, the inferior border formed by

A

the right ventricle

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162
Q

From the front, the left border formed by

A

left ventricle and the left atrial apendage (auricle)

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163
Q

From the front, the apex is formed by

A

the tip of the left ventricle

164
Q

From the front, the superior border formed by

A

the base of the heart, where the roots of the great vessels arise

165
Q

Atrioventricular sulcus is seen

A

anterior face of the heart

166
Q

Interventricular sulcus is seen

A

anterior face of the heart

167
Q

From the back, the left border formed by

A

the left ventricle

168
Q

From the back, the right border formed by

A

the right ventricle and right atrium

169
Q

Where are the atriums in respect to the atrioventricular sulcus?

A

above it

170
Q

What separates the ventricles?

A

the interventricular sulcus

171
Q

Pulmonary veins enter the

A

left atrium

172
Q

The right atrium is formed by the

A

venae cavae and the smooth surface between them

173
Q

Where is the right atrioventriculuar orifice

A

it is contained in both the interatrial septum and the right atrioventricular septum, which are within the right atrium

174
Q

Where do the venae cavae empty

A

they empty toward each other into a smooth walled section of the atrium

175
Q

Where is the crista terminalis

A

it is located on the anterior wall of the right atrium, separating the smooth from muscular wall

176
Q

Pectinate muscles

A

a set of parallel ridges apart of the crista terminalis, which run into the atrial appendage or auricle

177
Q

Pectinate muscles

A

a set of parallel ridges apart of the crista terminalis, which run into the atrial appendage or auricle

178
Q

Where and what are the auricles

A

they are vestigial flaps that project forward around the root of the aorta

179
Q

Where is the opening to the coronary sinus

A

at the left of the IVC opening

180
Q

Function of the coronary sinus

A

to drain the myocardium

181
Q

Fossa ovalis

A

a prominent depression in the interatrial septum

182
Q

The fossa ovalis used to be

A

the foramen ovale as a feature of the fetal circulation

183
Q

Are the walls thicker in the ventricle or atrium

A

ventricle

184
Q

How does blood enter the right ventricle

A

blood enters via the atrioventricular orifice and passes the tricuspid valve

185
Q

Where does the blood go once the right ventricle contracts

A

the tricuspid valve closes and the blood rushes up the smooth infundibulum and passes the pulmonary valve into the pulmonary trunk

186
Q

How come the flaps of the tricuspid valve don’t flip inside out

A

cords called the chordae tendinae prevent the flaps from evaginating

187
Q

What controls the chordae tendinae

A

these cords are held down and controlled by papillary muscles

188
Q

Trabeculae carnae

A

ridges of muscle that augment the thickened walls of the right ventricle

189
Q

Moderator band

A

a round bundle of muscle fibres that link the interventricular septum with the ventricular wall

190
Q

The lower portion of the septum is _______, which the upper part is ________

A
  • muscular

- membranous

191
Q

The base of the heart is formed by the

A

left atrium

192
Q

the left atrium is supplied by

A

various pulmonary veins (on average 2 per side)

193
Q

The left atrium feeds the

A

left ventricle

194
Q

Where is the left auricle

A

in the left atrium and it points around the left side of the aortic arch

195
Q

The left atrium empties into the ___________ via the __________

A
  • left ventricle

- left atrioventricular orifice

196
Q

What is thicker, the left or right ventricle

A

The left ventriculalr wall is 3 times as thick as the of the right ventricle

197
Q

Where is the highest pressure in the systemic circulation

A

left ventricle

198
Q

Main difference between left and right ventricle

A

The left venticule has the bicuspid/mital valve, which only has 2 flaps, and its chordae tendinae, papillary muscles, and trabeculae carnae are more robust

199
Q

In which ways are the aortic valves and pulmonary valves similar

A

they both have three semilunar, sac-like cusps which fill upon relaxation of the heart (diastole) and close onto each other thus preventing regurgitation of the blood with the help of nodules in the centre of each cusp

200
Q

Where are the roots of the great vessels located

A

they lie within the fibrous pericardium, lined with serous pericardium

201
Q

Where does the pulmonary trunk rise from

A

the top of the right ventricle

202
Q

The pulmonary trunk divids into

A

the left and right pulmonary arteries

203
Q

Where is the ascending aorta

A

to the right of the pulmonary trunk, it rises several centimeters and then turn backwards becoming the arch of the aorta

204
Q

Where do the coronary arteries arise

A

from two of the aortic sinuses

205
Q

Where are the pulmonary and aortic sinuses

A

at the root of the pulmonary trunk and the aorta there are 3 sinuses each located above the cusps of the pumlonary and aortic valves

206
Q

Where do the coronary arteries arise and where do they go

A

the left and right coronary arteries arise from their aortic sinuses and run forwards under the cover of the left and right auricles

207
Q

Where does the right coronary artery run to

A

it runs to find the anterior atrioventricular sulcus, then runs backwards in the atrioventricular sulcus as far as the posterior interventricular sulcus in which it descends as the posterior descending artery

208
Q

Right marginal branch

A

a branch of the posterior descending artery which supplies part of the right ventricular wall

209
Q

The left coronary artery branches into the

A

anterior descending artery

210
Q

Where does the anterior descending artery run

A

it runs down the anterior interventricular sulcus and the left circumflex artery

211
Q

Where is the left circumflex artery

A

is passes behind the anterior decending artery in the atrioventricular sulcus

212
Q

The circle and loop scheme is formed by

A

the anterior descending artery and the left circumflex artery anastomosing with each other

213
Q

Pathway of the great cardiac vein

A

It passes the interventricular sulcus where it goes around the left border and then as it passes to the back of the heart it enlarges and becomes the coronary sinus

214
Q

The coronary sinus empties into the

A

right atrium

215
Q

The coronary sinus is supplied by

A

the middle cardiac vein for the posterior interventricular sulcus

216
Q

Pathway of the small cardiac vein

A

it runs up the right border of the heart and passes around the back in the atrioventricular sulcus to join the coronary sinus just before it enters the right atrium

217
Q

Innervation of the heart

A

the heart is innervated by efferent autonomic fibres via the cardiac plexus

218
Q

Where is the cardiac plexus

A

it lies posterior to the heart and anterior to the bifurcation of the trachea

219
Q

Sympathetic innervation of the heart is derived from

A

T1-4

220
Q

Two specialized nodes that control the contraction of the heart

A

Sinoatrial node and the atrioventricular node

221
Q

Location of the sinoatrial node

A

located in the right atrium near the superior caval opening

222
Q

What supplies the sinoatrial node

A

supplied by the autonomic nervous system

223
Q

Location of the atrioventricular node

A

located in the lower part of the interatrial septum

224
Q

Location of the Atrioventricular bundle (of His)

A

The atrioventricular node sends fibers down the interventricular septum and around to the ventricular walls

225
Q

Does the atrioventriculr bundle (of His) bifurcates

A

Yes, into the left and right bundle branches, which supply each of the ventricles

226
Q

What is the pleura

A

a double walled serous membranous sac that contains each of the lungs

227
Q

Each lung invaginated the pleural sac early on in the embryo and finally gives rise to 2 layers:

A

the parietal and visceral pleura

228
Q

the parietal and visceral pleura surround:

A

the lungs, except for the area called the hilus

229
Q

What is the hilus

A

the root of the lung where the airways and blood vessels enter and leave

230
Q

Pleural sac (cavity)

A

the space between the parietal and visceral pleura

231
Q

type of fluid in the pleural sac (cavity)

A

serous exudate

232
Q

The parietl pleura cover the:

A

three surfaces of the lung

233
Q

The costal pleura covers the:

A

large, curved lung-surface defined by the rib cage

234
Q

The mediastinal surface covers the:

A

medial surface of the lungs, the mediastinum being the space between the lungs

235
Q

The diaphragmatic pleura covers the:

A

base of the lungs

236
Q

The visceral pleura is attached to:

A

the lung surface including those inside the fissures

237
Q

The right and left lungs are separated by the:

A

mediastinum

238
Q

Oblique fissure

A

divides the left lung into a superior and inferior lobe

239
Q

Cardiac notch

A

an indentation in the left lung which the heart occupies

240
Q

Lingula

A

a flap of lung tissue that wraps anteriorly around the front of the heart

241
Q

Cupola

A

The top, dome-shaped, part of the lung which extends up into the root of the neck

242
Q

Why is the right lung bigger than the left?

A

The right lung has an extra fissure, the horizontal fissure

243
Q

Lobes of the right lung

A

superior, middle, and inferior

244
Q

Hilus location

A

medial surface of the lung

245
Q

The hilus contains branches of:

A
  • the pulmonary artieries (superior)
  • the pulmonary veins (inferior)
  • bronchi (posterior)
246
Q

The trachea splits in the chest into

A

The left and right primary bronchi

247
Q

The right primary bronchi splits into

A

3 secondary bronchi, one for each lobe

248
Q

The left main bronchus splits into

A

2 secondary bronchi, one for each lobe

249
Q

Each secondary bronchi bifurcates into

A

2-3 tertiary bronchi

250
Q

the tertiary bronchi supply

A

a subdivision of each lobe called a bronchopulmonary segment

251
Q

Bronchial arteries function

A

deliver blood supply to the connective tissue of the lungs

252
Q

What effect do the phrenic nerves have on the diaphragm

A

the phrenic nerves cause the diaphragm to contract

253
Q

What happens to blood in the alveoli

A

the blood is oxygenated and decarbonated

254
Q

Primary muscle of respiration

A

the diaphragm

255
Q

The primary muscle of respiration is assisted by the

A

intercostal scalene (in the neck) and pectoral muscles

256
Q

Pulmonary sympathetic outflow arises from:

A

T2-4

257
Q

Pulmonary sympathetic outflow synapses at:

A

T2-4

258
Q

Pulmonary innervation travels through the

A

pulmonary plexus

259
Q

The pulmonary parasympathetic innervation is via ______, which synapses in the _______

A
  • the vagus (CN 10)

- pulmonary plexus

260
Q

The vagi effect on the bronchioles

A

constriction

261
Q

The sympathetic nerves effect on the bronchioles

A

dilation

262
Q

The mediastinum

A

central part of the thorax, defined as the space between the lung

263
Q

The mediastinum is divided into the 4 parts:

A

superior, anterior, middle and posterior portions

264
Q

Which portions comprise the inferior mediastinum

A

the anterior, middle, and posterior portions

265
Q

Where is the superior medistinum

A

This region is above the level of T4/5

266
Q

The superior mediastinum

A
  • superior vena cava + its tributaries
  • aortic arch + its branches
  • trachea
  • esophagus
  • left and right vagus
  • phrenic nerves
267
Q

Where is the anterior mediastinum

A

This is the area below T4/5, and anterior to the heart

268
Q

The anterior mediastinum contains

A

fat and the thymus

269
Q

Where is the middle mediastinum

A

behind the anterior mediastinum

270
Q

The middle mediastinum contains the

A
  • heart and its pericardia
  • ascending aorta
  • pulmonary trunk
  • lower superior vena cava
271
Q

The posterior mediastinum contains the

A
  • descending aorta
  • lower esophagus
  • the root of the lungs
  • the posterior thoracic wall structures
272
Q

The great veins of the thorax are formed as follows:

A

the left and right jugular veins descend from the neck and join the left and right subclavian vein to form the left and right brachiocephalic veins

273
Q

The left and right brachiocephalic veins come together to form the

A

superior vena cava

274
Q

The superior vena cava is joined by the ______________ as it descends into the right atrium

A

arch of the azygos vein

275
Q

The ascending aorta arises from

A

the left ventricle

276
Q

The ascending aorta has two branches:

A

coronary arteries

277
Q

When does the ascending aorta become the arch of the aorta

A

as it leaves the pericardium

278
Q

The first branch of the arch of the aorta

A

brachiocephalic artery

279
Q

The brachiocephalic artery bifurcates into

A

the right common carotid and right subclavian arteries

280
Q

The second branch of the arch of aorta

A

left common carotid arteries

281
Q

The third branch of the arch of the aorta

A

left subclavian arteries

282
Q

Where do the common carotids enter

A

the base of the neck on either side

283
Q

The common carotid arteries supply

A

the head and, with the vertebral arteries, the brain

284
Q

The subclavian arteries supply

A

the upper limbs

285
Q

Lingammentum arteriosum location

A

runs down from beneath the arch of the aorta to the top of the “T” of the pulmonary trunk

286
Q

The ligamentum arteriosum used to be the

A

ductus arteriosus

287
Q

Descending aorta location

A

runs down the thorax to the left of the vertebral bodies in close proximity to the trachea and esophagus which are situated to the right of it

288
Q

The descending aorta gives off 3 sets of arteries:

A
  • Intercostal arteries (most posterior pair)
  • Bronchial arteries (anterior to above)
  • Esophageal arteries
289
Q

The bronchial arteries supply the:

A

connective tissue of the lungs

290
Q

The esophageal arteries supply

A

the esophagus

291
Q

Esophagus

A

muscular tube carrying food from the pharynx to the stomach

292
Q

Location of the esophagus

A

lies behind the trachea and to the right of the aorta

293
Q

The esophagus penetrates the diaphragm at

A

T10

294
Q

Which nerves surround the esophagus

A

On its left is the left vagus nerve, on its right is the right vagus nerve

295
Q

Thoracic duct location

A

sits posteriorly and to the right of the esophagus

296
Q

Where does the trachea enter in the throax

A

through the inlet anterior to the esophagus

297
Q

What is the trachea made up of

A

horseshoe shaped cartilages and connective tissue

298
Q

Where does the trachea bifurcate

A

T4/5

299
Q

carina

A

The underside of the trachea bifurcation

300
Q

The main nerves in the mediastinum

A

the two vagi and the paired phrenic nerves

301
Q

Where does the left vagus enter the thorax

A

anterior to the left subclavian artery

302
Q

Left reccurent laryngeal nerve (is a branch of what?, where does it lead?)

A

branch of the left vagus which goes up the neck to the larynx, wraps around the arch of the aorta, and continues to the esophagus

303
Q

Which nerve loops around the arch of the aorta an the ligamentum ateriosum

A

the left recurrent laryngeal nerve

304
Q

Where does the right vagus enter the thorax

A

in front of the right subclavian artery

305
Q

Right reccurent laryngeal (what is it a branch of, where does it go to?)

A

branch of the right vagus which recurs around the subclavian artery and acends on the right side of the esophagus to the larynx

306
Q

Where do the phrenic nerves arise

A

in the neck from roots C3, 4, 5

307
Q

Where do the phrenic nerves enter the thorax

A

lateral to the vagi

308
Q

Where do the phrenic nerves attach when on their way to the diaphragm

A

they attach to each side of the pericardium

309
Q

3 important structures of the posterior wall of the thorax

A
  • the unpaired thoracic duct
  • the paired sympathetic trunks
  • the sort of paired azygos and hemi-azygos veins
310
Q

The largest lymphatic vessel in the body

A

thoracic duct

311
Q

Where does the thoracic duct arise from

A

arises in the upper abdomen from a ‘hoding-tank,’ the cisterna chyli

312
Q

Where does the thoracic duct enter the thorax

A

through the aortic hiatus

313
Q

The thoracic duct enters which vein at T1/2

A

enters subclavian vein and joins the internal jugular vein

314
Q

Where are the paired sympathetic trunks

A

each trunk is situated on each side of the vertebral column

315
Q

What type of nerves originate from the sympathetic trunks

A

greater, lesser, and least splanchnic nerves

316
Q

The greater, lesser, and least splanchnic nerves supply the input to:

A

the celiac, superior, and renal ganglia

317
Q

The azygos and hemi-azygos veins drain into the:

A

superior vena cava via the arch of the azygos vein

318
Q

The azygos vein drains into:

A

the right intercostal veins as it rises

319
Q

What level does inferior vena cava penetrate the diaphragm

A

T8

320
Q

What level does esophagus penetrate the diaphragm

A

T10

321
Q

What level does descending aorta penetrate the diaphragm

A

T12

322
Q

What is the first branch of aorta

A

coronary arteries

323
Q
A

Apex

324
Q
A

Superior lobe

325
Q
A

Oblique fissure

326
Q
A

Pulmonary arteries

327
Q
A

Bronchi

328
Q
A

Pulmonary veins

329
Q
A

Inferior lobe

330
Q
A

Diaphragmatic surface

331
Q
A

Cardiac impression

332
Q
A

Lingula

333
Q
A

Horizontal fissure

334
Q
A

Middle lobe

335
Q
A

Diaphragmatic surface

336
Q
A

Inferior lobe

337
Q
A

Pulmonary veins

338
Q
A

Bronchi

339
Q
A

Pulmonary arteries

340
Q
A

Oblique fissure

341
Q
A

Superior lobe

342
Q
A

Apex

343
Q
A

Right internal jugular vein

344
Q
A

Right subclavian vein

345
Q
A

Right brachiocephalic vein

346
Q
A

Superior vena cava

347
Q
A

Inferior vena cava

348
Q
A

Left brachiocephalic vein

349
Q
A

Left subclavian vein

350
Q
A

Entry of the thoracic duct

351
Q
A

Left internal jugular vein

352
Q
A

Pulmonary trunk

353
Q
A

Descending aorta

354
Q
A

Left pulmonary artery

355
Q
A

Ligamentum arteriosum

356
Q
A

Left subclavian artery

357
Q
A

Left common carotid artery

358
Q
A

Brachiocephalic artery

359
Q
A

Arch of aorta

360
Q
A

Ascending aorta

361
Q
A

Sinoatrial node

362
Q
A

Atrioventricular node

363
Q
A

Right bundle branches

364
Q
A

Left bundle branches

365
Q
A

Atrioventricular bundle of His

366
Q
A

Esophagus

367
Q
A

Carina

368
Q
A

Trachea

369
Q
A

Arch of the aorta

370
Q
A

Left subclavian artery

371
Q
A

Left common carotid artery

372
Q
A

Right common carotid artery

373
Q
A

Brachiocephalic artery

374
Q
A

Esophagus

375
Q
A

Ligamentum arteriosum

376
Q
A

Aorta

377
Q
A

Left recurrent nerve

378
Q
A

Left vagus nerve

379
Q
A

Right vagus nerve

380
Q
A

Right recurrent nerve

381
Q
A

Right subclavian artery

382
Q
A

Pulmonary artery

383
Q
A

Superior vena cava

384
Q
A

Jugular veins

385
Q
A

Thoracic duct

386
Q
A

Arch of aorta

387
Q
A

Left branchiocephalic vein

388
Q
A

Thoracic duct

389
Q
A

Diaphragm

390
Q
A

Cisterna chyli

391
Q
A

Brachiocephalic veins

392
Q
A

Superior vena cava

393
Q
A

Jugular veins

394
Q
A

Left subclavian vein

395
Q
A

Intercostal veins

396
Q
A

Hemi-azygos veins

397
Q
A

Left renal vein

398
Q
A

Lower vena cava

399
Q
A

Azygos vein

400
Q
A

Arch of the azygos

401
Q
A

Intercostal veins

402
Q
A

Azygos vein

403
Q
A

Inferior vena cava

404
Q
A

Superior vena cava

405
Q
A

Subclavian veins

406
Q
A

Internal jugular veins