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326 > Thoracic Cavity > Flashcards

Thoracic Cavity Flashcards

1
Q

identify: larynx

A

area of the throat containing the vocal cords and used for breathing, swallowing, and talking. Also called voice box.

Above trachea

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2
Q

identify: trachea

A

Cartilaginous ring

Anterior to esophagus

Rostral to bronchioles

C6-T5

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3
Q

identify: lobes of lungs

A
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4
Q

identify: fissures of lungs

A

Oblique and horizontal fissure (right lung only between superior and middle lobe)

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5
Q

identify: hilum of lungs, base, and apex

A

Hilum pulmonary veins and primary bronchi enter and exit lung

Apex : top

Base : bottom

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6
Q

identify: surfaces of the lungs

A

costal, mediastinal, diaphragmatic

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7
Q

identify: borders of the lungs

A

anterior, inferior, posterior

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8
Q

identify: cardiac notch

A

visible on left lung
don’t confuse with cardiac impression

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9
Q

identify: bronchi

A
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10
Q

identify: pulmonary arteries and veins

A

In the hilum, pulmonary arteries are rostral to the pulmonary veins.

Remember there are 2 sets of pulmonary veins (tot 4) and 1 set of pulmonary arteries (tot 2)

Pulmonary arteries originate from right ventricle base

Pulmonary veins supply the left atria

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11
Q

identify: aortic arch

A

Posterior to superior be a cava, anterior to trachea but descending aorta curves behind trachea

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12
Q

identify: brachiocephalic artery

A
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13
Q

identify: left common carotid artery

A

Arises from aortic arch

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14
Q

identify: subclavian artery (left and right)

A
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15
Q

identify: right common carotid artery

A

branch off brachiocephaic trunk

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16
Q

identify: thoracic aorta

A

In the inferior mediastinum. Continuation of aortic arch. T4-T12

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17
Q

identify: superior and inferior vena cava

A
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18
Q

identify: right and left brachiocephalic veins

A

Receives blood from subclavian and internal jugular veins

Unite to form superior vena cava

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19
Q

identify: right and left internal jugular veins

A

drain into brachiocephalic veins then into superior vena cava

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20
Q

identify: right and left subclavian veins

A

drain into brachiocephalic veins and then into superior vena cava

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21
Q

identify: esophagus

A

Posterior to trachea

Extends from pharynx to stomach

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22
Q

identify: diaphragm

A

Origin: Xiphoid process, internal surfaces of 7-12 ribs and costal cartilages, L1-L3 vertebrae.

Insertion: Central tendon.

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23
Q

identify: esophageal hiatus

A

t10
central

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24
Q

identify: aortic hiatus

A

T12
posterior to other hiatuses

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25
Q

identify: hiatus of the inferior vena cava

A

T8
anterior to esophageal and aortic hiatuses

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26
Q

identify: left and right atria and ventricles

A
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27
Q

identify: left and right atrial appendages

A
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28
Q

Where is a major site of thrombus formation in patients with non-valvar atrial fibrillation?

A

left atrial appendage

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29
Q

Define: interventricular septum and interatrial septum

A

interventricular septum: left and right ventricles (visible on the outside of heart)

interatrial septum: left and right atria

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30
Q

identify: pulmonary trunk

A

carries deoxygenated blood from right ventricle –> pulmonary arteries –> lungs

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31
Q

identify: ascending aorta

A

Left ventricle –> ascending aorta –> aortic arch –> descending aorta

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32
Q

identify: great cardiac vein

A

drains into coronary sinus

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33
Q

identify: middle cardiac vein

A

drains into coronary sinus

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34
Q

identify: coronary sinus

A

lies in coronary sulcus

great cardiac vein and middle cardiac vein drain into coronary sinus

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35
Q

What muscles are responsible for resting inspiration and forced inspiration

A

diaphragm is prime mover

external intercostals

intercartilaginous portions of internal intercostals

serratus posterior superior elevates ribs for inhalation

forced or deep inhalation: scalenes, sternocleidomastoid, pectoralis minor, trapezius

36
Q

What muscles are responsible for forced expiration

A

bony portion of the internal intercostals

37
Q

Describe at what vertebral levels can you find the hiatus for the inferior vena cava, esophagus, and aorta

A

I: T8
E: T10
A: T12

I ate ten eggs in the afternoon

38
Q

Each intercostal space is named for the rib ____ (above/below)

A

above

39
Q

Describe the contents of each intercostal space

A

Each intercostal space has a vein, artery, and nerve (in that order rostral caudal) branching from the aorta

Nerves are nestled against costal groove and between the internal intercostals and innermost intercostals

40
Q

Where do intercostal veins drain into?

A

superior vena cava via azygos veins

41
Q

where do intercostal nerves arise from?

A

ventral ramus of the spinal nerve

42
Q

Describe the 3 compartments of the thoracic cavity

A

bilateral pulmonary cavities and mediastinum

43
Q

Define:
- visceral pleura
- parietal pleura
- pleural cavities
- function

A
  • Visceral pleura: adheres to lung
  • Parietal pleura: adheres to the thoracic wall
  • Pleural cavities: Space between the visceral and parietal pleura. Contains a small volume of lubricating fluid

Function: allows layer of pleura to glide over one another during ventilation and maintains negative pressure continuity between the lungs and thoracic wall. This is required for inhalation and prevents the lungs from collapsing

44
Q

Describe the borders of the thoracic cavity

A

caudally diaphragm, anteriorly sternum and ribs, posteriorly thoracic vertebrae and ribs

45
Q

If one phrenic nerve is injured, describe the movement of the diaphragm

A

If one phrenic nerve is injured, the corresponding hemidiaphragm will move with pressure in breathing (i.e., paradoxical movement)

Ex: if the right hemidiaphragm is paralyzed, it will move up when inspiring
With decreasing thoracic pressure and increasing thoracic volume

46
Q

define: pneumothorax and treatment

A

collapsed lung causing accumulation of air in the pleural space.

Pressure in the pleural cavity exceeds pressure in the lung causing it to collapse.

Loss of continuity between the visceral pleura and the parietal pleura is lost

Treatment: Air in the pleural space must be evacuated to re-inflate the lung.

47
Q

define: atelectasis

A

at-uh-lec-tah-sis
Atelectasis: collapsed lung

48
Q

define: hemothorax

A

Hemothorax: blood in the pleural cavity

49
Q

define: hydrothorax

A

Hydrothorax: fluid in the pleural cavity

50
Q

define: costodiaphragmatic recesses

A

space between lungs and parietal pleura which contain pleural fluid

Decreases with forceful breathing

51
Q

define: thoracentesis

A

insertion of a chest tube to remove significant volumes of air, pus, blood, fluid from the intrapleural space.

Syringe pierces intercostal muscles to remove fluid in pleural cavity

52
Q

Percussion on the thoracic cavity produces what kind of sound based on the underlying anatomy?

A
  • Solid tissue (scapula/thick muscle): flat
  • Dense or fluid filled: dull
  • Air: resonant sound
53
Q

Describe the divisions of the tracheobronchial tree

draw it out

A

arises from bifurcation of trachea at the carina. Gives rise to primary bronchi, lobar bronchi, segmental bronchi, subsegmental and conducting bronchioles

54
Q

Define: conducting zone

A

path of inhaled gas; nose to terminal bronchioles (airway generation 0-16)

55
Q

Define: respiratory zone

A

where gas exchange takes place; respiratory bronchioles, alveolar ducts, alveolar sacs (airway generation 17-23)

56
Q

Define: cartilaginous airways

A

trachea, main bronchi, lobar bronchi, segmental bronchi, subsegmental bronchi (airway generation 0-11)

57
Q

Define: non-cartilaginous airway

A

bronchioles, terminal bronchioles (airway generation 12-16)

58
Q

Define: lobar bronchi

A

generation 2. Between main bronchi and segmental

59
Q

Define: bronchoscopy

A

passage of a camera into the proximal tracheobronchial tree. Also to remove things like legos

60
Q

Define: carina

A

ridge of cartilage at the base of the trachea separating the openings of the left and right main bronchi

61
Q

How many lobes does the left lung and right lung have?

A

left 2 right 3

62
Q

What enters/exit the hilum of the lung?

A

pulmonary arteries, pulmonary veins and primary bronchi enter and exit lung

63
Q

List the contents of the mediastinum

Describe the different divisions

A

heart, trachea, esophagus, great vessels

superior and inferior segments separated at the sternal angle/transverse thoracic plane (division of manubrium and body of the sternum)

64
Q

List the contents of the superior mediastinum

A

thymus, portions of the great vessels, nerves, trachea, esophagus

Nerves: vagus nerve (CN X), phrenic nerve (C3-5), intercostal nerves, subcostal nerve, recurrent laryngeal nerve, cardiac plexus, pulmonary plexus, esophageal plexus

65
Q

Describe and give the function of the thymus

Give its position compared to everything else in the superior mediastinum

A

small, irregular-shaped gland that produces or releases substances (such as hormones, saliva, digestive juices, sweat, tears or milk). Important for immune function as it is where T cells mature

Most anterior to everything else in the superior mediastinum

66
Q

In the superior mediastinum, the veins are ____ (anterior/posterior) to the superior mediastnium

A

anterior

67
Q

List the contents of the inferior mediastinum

A

heart and pericardium

68
Q

Define: pericardium

A

connective tissue sac that encompasses heart and proximal portion of the great vessels. Protects heart

69
Q

Describe the layers of the pericardium

A

outer to inner

fibrous pericardium (continuous of central tendon)

serous pericardium (parietal and visceral)

70
Q

Define: pericarditis

A

inflammation of the serous pericardium which reduces its capacity to permit smooth heart movement, causing the layers of serous pericardium to rub against one another and the heart

71
Q

How does the aortic arch change when supine vs standing?

A

Supine: aortic arch lies superior to the transverse thoracic plane

Standing: aortic arch is transected by the transverse thoracic plane because the heart flops down to touch the diaphragm

72
Q

Describe the vagus nerve in reference to the phrenic nerve

A

medial to the phrenic nerve

73
Q

Define: atrial appendages

A

Small pouch that projects anteromedially from each atria

74
Q

Define: trabeculae carnae

A

meaty ridges inside the ventricles

75
Q

Define: pectinate muscles

A

look like the teeth of a comb. Parallel ridges of cardiac muscle in the atria

76
Q

list the atrioventricular valves

A

Tricuspid valve: right atria and right ventricle

Bicuspid valve: left atria and left ventricle

77
Q

Define: chordae tendinae

A

fibrous connective tissue that tethers AV valves to ventricular wall at the papillary muscles

78
Q

Define: papillary muscles
contraction causes what?

A

act on AV leaflets; contraction closes the AV valves to prevent prolapse and blood regurgitation

79
Q

list the semilunar valves

A

Aortic valve (left semilunar): separate left ventricle and aorta

Pulmonary valve (right semilunar): separate right ventricle and pulmonary artery

80
Q

Discuss the branching off the aorta

A

Aorta → coronary arteries (right and left)

Right coronary artery → right marginal artery and posterior descending artery

right coronary artery: supplies right heart

Left coronary artery → left circumflex artery and anterior interventricular artery (or left anterior descending artery or LAD)

left coronary artery: supplies left heart, part of right ventricle, most of the conducting system of heart

Left circumflex → left marginal artery

LAD → anterior interventricular groove

81
Q

What do the coronary arteries supply?

A

supply epicardium and myocardium

82
Q

What innervates the heart? where are they derived from

A

cardiac plexus

Sympathetic cardiac nerves are derived from T1-T5

Parasympathetic innervation comes from vagus nerve originating in medulla

83
Q

List the great vessels

A

originate and terminate in the heart

superior and inferior vena cava, pulmonary artery, pulmonary veins, aorta

84
Q

Draw the branches of the aortic arch

A

Proximal to distal: brachiocephalic trunk (branches into right common carotid and subclavian arteries), left common carotid artery, left subclavian artery

85
Q

Summarize coronary circulation

A

the two coronary arteries arises arise from the ascending aorta

left coronary artery becomes circumflex artery and anterior interventricular artery

circumflex artery lies in coronary (AV) sulcus and anterior interventricular artery lies in anterior interventricular groove

right coronary artery becomes the posterior interventricular artery and marginal artery

posterior interventricular artery lies in posterior interventricular groove

great cardiac vein ascends in the anterior interventricular groove (lies alongside the anterior ventricular atery)

middle cardiac vein ascends in the posterior interventricular groove along the posterior interventricular artery

both great cardiac vein and middle cardiac will drain into the coronary sinus which lies on the coronary (AV) sulcus on the posterior surface of the heart

326 (32 decks)

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