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AA Radiographic Anatomy > The Thorax 3 > Flashcards

The Thorax 3 Flashcards

1
Q

What is the oesophagus?

Where?

Length?

A

Muscular collapsible tube

Posterior to the trachea

25cm long

Inferior end of the laryngopharynx, thro’ mediastinum anterior to the vertebral column, pierces the diaphragm (opening called oesophageal hiatus) to stomach.

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2
Q

Label this image of the oesophagus?

A
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3
Q

Describe the 4 coats of the oesophagus?

A
  1. Outer areolar layer which contains elastic fibres (adventitia) – attaches the oesophagus to the surrounding structures.
  2. A muscular coat – outer longitudinal and inner transverse smooth muscle fibres, the upper oesophagus contains skeletal muscle that enables voluntary swallowing
  3. A submucous coat (lamina propria) – loose areolar tissue containing vessels and nerves and mucous glands.
  4. An inner mucous coat (mucosa)– lined with stratified squamous epithelium, lies in a series of longitudinal folds (rugae) when the oesophagus is empty.
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4
Q

Label this oesophagus

A
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5
Q

At what 3 points does the oesophagus narrow?

A
  1. Commencement
  2. Level of the left main bronchus
  3. Passes through diaphragm (the cardia)
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6
Q

Label on this image:

Lymph node

Fold of skin

Glandular tissue

Blood vessels

Fatty tissue

Subcutaneous tissue

A
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7
Q

Label this image

A
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8
Q

What does the lymphatic system do?

A

Lymphatic system – drains interstitial fluid, transports dietary lipids and protects against invasion – tissues carries out immune response.

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9
Q

What are a couple of causes of lymphoedema?

A

Sometimes happens if cancer blocks the drainage of fluid through the lymphatic system.

It can also occur when part of the lymphatic drainage system has been removed by surgery or damaged by cancer treatments such as radiotherapy.

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10
Q

What are the causes of axillary lymph node calcification?

A
  1. Axillary lymph node calcification may be seen in association with benign or malignant processes.

●

  1. Of the malignant causes, metastatic breast carcinoma is the most common, with axillary lymph node calcification identified radiographically in up to 3% of patients with breast cancer
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11
Q

What is shown in this image?

A

Lymphoedema

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12
Q

What is lymphoedema?

A

A condition of localized fluid retention and tissue swelling caused by a compromised lymphatic system, which normally returns interstitial fluid to the thoracic duct, then the bloodstream.

The condition can be inherited or can be caused by a birth defect, though it is frequently caused by cancer treatments and by parasitic infections. Though incurable and progressive, a number of treatments can ameliorate symptoms.

Tissues with lymphedema are at high risk of infection.

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13
Q

What is the thoracic duct?

What does it carry?

Size?

Where is it?

What lymph fluid does it not collect?

A

The largest lymphatic vessel of the lymphatic system. It is also known as the left lymphatic duct. It carries chyle, a liquid containing both lymph and emulsified fats, rather than pure lymph. Thus when it ruptures, the resulting flood of liquid into the pleural cavity is known as chylothorax.

In adults, the thoracic duct is typically 38–45 cm in length and has an average diameter of about 5 mm. The vessel usually starts from the level of (T12) and extends to the root of the neck. It drains into the systemic (blood) circulation at the angle of the left subclavian and internal jugular veins as a single trunk, at the commencement of the brachiocephalic vein.

It also collects most of the lymph in the body other than from the right thorax, arm, head, and neck which are drained by the right lymphatic duct.

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14
Q

How big is the right lymphatic duct?

Where is it?

What lymph fluid does it drain?

A

About 1.25 cm. in length, courses along the medial border of the Scalenus anterior at the root of the neck. The right lymphatic duct forms various combinations with the right subclavian vein and right internal jugular vein. A right lymphatic duct that enters directly into the junction of the internal jugular and subclavian veins is uncommon.

The right duct drains lymph fluid from:

  1. The upper right section of the trunk, (right thoracic cavity, via the right bronchomediastinal trunk),
  2. The right arm (via the right subclavian trunk),
  3. The right side of the head and neck (via the right jugular trunk),
  4. In some individuals, the lower lobe of the left lung.
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15
Q

What is the cisterna chyli?

A

A dilated sac at the lower end of the thoracic duct into which lymph from the intestinal trunk and two lumbar lymphatic trunks flow.

It receives fatty chyle from the intestines and thus acts as a conduit for the lipid products of digestion. It is the most common drainage trunk of most of the body’s lymphatics.

The cisterna chyli is a retro-peritoneal structure, located posterior to the abdominal aorta on the anterior aspect of the bodies of the first and second lumbar vertebrae (L1 and L2).

There it forms the beginning of the primary lymph vessel, the thoracic duct, which transports lymphand chyle from the abdomen via the aortic opening of the diaphragm up to the junction of left subclavian vein and internal jugular veins.

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16
Q

What does the thymus gland control?

Where does it lie?

Size change?

A
  • Controls T-lymphocytes (carry out immune response)
  • Lies in the antero-superior mediastinum
  • Is retrosternal (behind sternum)
  • Grows in size from birth until puberty and then reduces in size again
  • Cellular reduction actually starts at age 5
  • The thymus plays an important role in the proper development of the lymphatic system
17
Q

Label the thymus gland on this image

A
18
Q

Label this thoracic spine

A
19
Q

Label this right lateral T spine

A
20
Q

Where does the spinal cord run from and to?

Where is it found?

Length- in utero?

Level of conus medullaris aged 20?

Shape?

A
  1. Runs from level of foramen magnum to conus medullaris
  2. Runs in vertebral foramina with ligaments, meninges, and CSF
  3. In-utero the spinal cord and the vertebral column are the same length
  4. By age 20 the conus medullaris is at the level of L1/2
  5. Roughly cylindrical but slightly flattened in AP
21
Q

What is the conus medullaris?

A

The tapered, lower end of the spinal cord. It occurs near lumbar vertebral levels 1 (L1) and 2 (L2), occasionally lower.

22
Q

What is the cauda equina?

A

A bundle of spinal nerves and spinal nerve roots, consisting of the second through fifth lumbar nerve pairs, the first through fifth sacral nerve pairs, and the coccygeal nerve, all of which arise from the lumbar enlargement and the conus medullaris of the spinal cord.

The nerves that compose the cauda equina innervate the pelvic organs and lower limbs to include motor innervation of the hips, knees, ankles, feet, internal anal sphincter and external anal sphincter. In addition, the cauda equina extends to sensory innervation of the perineum and, partially, parasympathetic innervation of the bladder.

23
Q

Label this image

Modality?

A

Axial MRI

24
Q

What are spinal nerves?

A

Spinal nerves – paths of communication between the spinal cord and most of the body – separate points of attachment (roots) that connect each part of the spinal nerve to a segment of the cord.

25
Q

What is the brachial plexus?

Where is it?

What nerves make it?

A

Brachial plexus (c5-t1) –

Formed by anterior rami of last 4 cervical nerves & 1st thoracic nerve, provides entire nerve supply of shoulder and upper limb.

The musculocutaneous

The median nerve

The ulnar nerve

The axillary nerve

The radial nerve

Remaining thoracic nerves (12 pairs) – directly innervate the structures they supply in the intercostal spaces.

•Do not form plexi (network of nerves – provide a direct supply)

26
Q

What does the musculocutaneous nerve innervate?

A

The musculocutaneous nerve innervates all the muscles of the anterior compartment of the arm.

27
Q

What does the median nerve innervate?

A

The median nerve innervates all the muscles of the anterior compartment of the forearm except flexor carpi ulnaris and the ulnar part of the flexor digitorum profundus. It also innervates the three thenar muscles and the first and second lumbricals.

28
Q

What does the ulnar nerve innervate?

A

The ulnar nerve innervates the muscles of the forearm and hand not innervated by the median nerve.

  1. Flexor carpi ulnaris
  2. Ulnar part of the flexor digitorum profundus.
  3. The three thenar muscles
  4. First and second lumbricals.
29
Q

What does the axillary nerve innervate?

A

The axillary nerve innervates the deltoid and teres minor.

30
Q

What does the radial nerve innervate?

A

The radial nerve innervates the posterior muscles of the arm and forearm

31
Q

What do T3-T6 of the thoracic nerves innervate?

A

•T3-t6 pass in the costal grooves of the ribs and then to the intercostal muscles of the ant. and lateral chest wall.

32
Q

What do the nerves T7-T12 innervate?

A

Nerves t7-t12, intercostal muscles & skin of posterior & anterior abdominal wall. ( 1 – 11 intercostal nerves & 12 subcostal nerve)

33
Q

Label image

A

A- SVC

B - Right pulmonary artery

C- Right atrial border

D - Inferior vena cava

E- Right ventricle

F- Arch of aorta

G- Left pulmonary artery

34
Q

What does the mediastinum contain?

A

The mediastinum contains the heart and its vessels, the oesophagus, trachea, phrenic and cardiac nerves, the thoracic duct, thymus and lymph nodes of the central chest.

35
Q

Label image

A

A-Transverse process

B- Spinous process

C-Transverse process

D-Pedicle

E- Rib

36
Q

Label image

A

A-Arch of aorta

B-Right ventricle

C-Right main

pulmonary artery

D-Left atrium

E- Inferior vena cava

37
Q

Label image

A

A-Pulmonary veins

B-Left atrium

C-Right atrium

D-Aortic Valve

E-Right ventricle

F-Aorta

AA Radiographic Anatomy (10 decks)

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