The Thorax Flashcards
Where is the tricispid valve heard best ?
left of the lower part of the sternum near the 5th intercostal space
Where is the mitral valve heard best?
heard over the apex of the heart in the left 5th intercostal space at the mid clavicular line
Where is the pulmonary valve heard best ?
medial end of the left second intercostal space
The aortic valve is heard best ?
medial end of the right second intercostal space
Where is the aortic valve in the body
left part of mid sternum
Where is the tricuspid valve in the body
right lower/mid sternum
Where is the mitral valve in the body
right above the left 4th rib
Where is the pulmonary valve in the body
right on the 3rd rib left side
arterial supply of the SA/AV nodes
Right coronary artery
arterial supply of the AV bundle
usually left coronary artery
vascular supply to esophagus is
esophageal arteryes off the arota
esophagus drains to what veins
azygous system
What is the dermatome of the nipple
T4
What is the deratome of the xiphoid process
T6
Umbilicus is what dermatome
T10
three major functions of the thorax
conduit, breathing and protection of vital organs
boundaries of the superior thoracic aperature
body of T1, medial margin of Rib 1, and the manubrium
boundaries of inferior thoracic aperature
body of T12, rib 12 and rib 11, cartilagenous ends of rib 7-10 and xiphoid process (bounded by diaphgram
the inferior vena cava pierces the central tendon of the diaphragm to enter the abdomen at what vertebral level
T8
Significance of T4/T5 level ?
sternal angle
rib 2
seperates superior and inferior mediastinum
arch of aorta begins and ends
where superior vena cava penetrates pericardium, trachea bifurcation, limit of pulmonary trunk
arterial supply to the breast
axillary artery, internal thoracic, and 2-4 intercostal arteries
venous drainage of the breast
drains to axillary, internal thoracic and intercostal veins
innervation of the breast
anterior and lateral cutaneous branches of the 2nd-6th intercostal nerves
ligaments associated with the ribs
costotransverse ligament-neck of the rib to transverse process
lateral costotransverse ligament- tubercle to transverse process
superior costotransverse ligament-superior surface of neck to transverse process of vertebra above
manubrium and the xiphisternal joints are what type
symphyses
what ribs are true ribs
1-7
what ribs are false ribs ?
8-10
what ribs are floating ribs
11-12
demifacets are located where?
body of the vertebrae
internal thoracic artery bifurcates where ?
7th intercostal space
when the internal thoracic artery bifurcates what are the two terminal branches
musculophrenic and superior epigastric arteries
which muscles function in expiration
internal intercostals along with tranversus thoracis, innermost intercostals and subcostales
which muscles function in inspiration
external intercostales
posterior intercostal circulation
supreme intercostal (first 2 off the costocervical trunk) and the rest come off the thoracic aorta
the internal thoracic artery and vein are a branch off the
brachiocephalic vein and artery
ribs 2-4 are drained by
right superior intercostal vein to azygous and the left superior intercostal vein to brachiocephalic
azygous vein
drains the posterior intercostal veins which drain into the superior vena cava
accessory hemiazygous
drains upper ribs on left
hemiazygous
drains lower ribs on left
intercostal muscles are innervated by
anterior rami of spinal nerves T1-T11
lymphatic drainage of thoracic wall
patasternal, intercostal and diaphgramatic nodes
the parasternal lymph nodes drain into
bronchomediastinal trunks
the intercostal nodes drain into
thoracic duct
Things that pass through near or around the diaphragm
IVC at T8
esophagus and vagus at T10
aorta and thoracic duct at T12 (azygous and hemiazygous)
arterial supply of diaphragm
pericardiophrenic, muscuophrenic and superior phrenic and inferior phrenic arteries
venous drainange of diaphragm
azygous system, brachiocephalic and abdominal veins
the visceral pleura is innervated by…
visceral afferent fibers from pulmonary plexus, no Pain
lateral diaphragmatic pleura and mediastinal is innervated by
phrenic nerve
blood supply to the lungs
right bronchial artery from 3rd intercostal
superior left and inferior left off aorta
what supplies the bronchopulmonary segments
segmental bronchi
four areas of constriction for esophagus
pharynyx
arch of aorta
left main bronchus
esophageal hiatus at diaphragm
lymphatic drainage of the pericardium
lateral percardiophrenic, and superior phrenic to brachiocephalic lymph nodes
