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
2
Q
identify: trachea
A
Cartilaginous ring
Anterior to esophagus
Rostral to bronchioles
C6-T5
3
Q
identify: lobes of lungs
A
4
Q
identify: fissures of lungs
A
Oblique and horizontal fissure (right lung only between superior and middle lobe)
5
Q
identify: hilum of lungs, base, and apex
A
Hilum pulmonary veins and primary bronchi enter and exit lung
Apex : top
Base : bottom
6
Q
identify: surfaces of the lungs
A
costal, mediastinal, diaphragmatic
7
Q
identify: borders of the lungs
A
anterior, inferior, posterior
8
Q
identify: cardiac notch
A
visible on left lung
don’t confuse with cardiac impression
9
Q
identify: bronchi
A
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
11
Q
identify: aortic arch
A
Posterior to superior be a cava, anterior to trachea but descending aorta curves behind trachea
12
Q
identify: brachiocephalic artery
A
13
Q
identify: left common carotid artery
A
Arises from aortic arch
14
Q
identify: subclavian artery (left and right)
A
15
Q
identify: right common carotid artery
A
branch off brachiocephaic trunk
16
Q
identify: thoracic aorta
A
In the inferior mediastinum. Continuation of aortic arch. T4-T12
17
Q
identify: superior and inferior vena cava
A
18
Q
identify: right and left brachiocephalic veins
A
Receives blood from subclavian and internal jugular veins
Unite to form superior vena cava
19
Q
identify: right and left internal jugular veins
A
drain into brachiocephalic veins then into superior vena cava
20
Q
identify: right and left subclavian veins
A
drain into brachiocephalic veins and then into superior vena cava
21
Q
identify: esophagus
A
Posterior to trachea
Extends from pharynx to stomach
22
Q
identify: diaphragm
A
Origin: Xiphoid process, internal surfaces of 7-12 ribs and costal cartilages, L1-L3 vertebrae.
Insertion: Central tendon.
23
Q
identify: esophageal hiatus
A
t10
central
24
Q
identify: aortic hiatus
A
T12
posterior to other hiatuses
25
identify: hiatus of the inferior vena cava
T8
anterior to esophageal and aortic hiatuses
26
identify: left and right atria and ventricles
27
identify: left and right atrial appendages
28
Where is a major site of thrombus formation in patients with non-valvar atrial fibrillation?
left atrial appendage
29
Define: interventricular septum and interatrial septum
interventricular septum: left and right ventricles (visible on the outside of heart)
interatrial septum: left and right atria
30
identify: pulmonary trunk
carries deoxygenated blood from right ventricle --> pulmonary arteries --> lungs
31
identify: ascending aorta
Left ventricle --> ascending aorta --> aortic arch --> descending aorta
32
identify: great cardiac vein
drains into coronary sinus
33
identify: middle cardiac vein
drains into coronary sinus
34
identify: coronary sinus
lies in coronary sulcus
great cardiac vein and middle cardiac vein drain into coronary sinus
35
What muscles are responsible for resting inspiration and forced inspiration
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
What muscles are responsible for forced expiration
bony portion of the internal intercostals
37
Describe at what vertebral levels can you find the hiatus for the inferior vena cava, esophagus, and aorta
I: T8
E: T10
A: T12
I ate ten eggs in the afternoon
38
Each intercostal space is named for the rib ____ (above/below)
above
39
Describe the contents of each intercostal space
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
Where do intercostal veins drain into?
superior vena cava via azygos veins
41
where do intercostal nerves arise from?
ventral ramus of the spinal nerve
42
Describe the 3 compartments of the thoracic cavity
bilateral pulmonary cavities and mediastinum
43
Define:
- visceral pleura
- parietal pleura
- pleural cavities
- function
- 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
Describe the borders of the thoracic cavity
caudally diaphragm, anteriorly sternum and ribs, posteriorly thoracic vertebrae and ribs
45
If one phrenic nerve is injured, describe the movement of the diaphragm
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
define: pneumothorax and treatment
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
define: atelectasis
at-uh-lec-tah-sis
Atelectasis: collapsed lung
48
define: hemothorax
Hemothorax: blood in the pleural cavity
49
define: hydrothorax
Hydrothorax: fluid in the pleural cavity
50
define: costodiaphragmatic recesses
space between lungs and parietal pleura which contain pleural fluid
Decreases with forceful breathing
51
define: thoracentesis
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
Percussion on the thoracic cavity produces what kind of sound based on the underlying anatomy?
- Solid tissue (scapula/thick muscle): flat
- Dense or fluid filled: dull
- Air: resonant sound
53
Describe the divisions of the tracheobronchial tree
draw it out
arises from bifurcation of trachea at the carina. Gives rise to primary bronchi, lobar bronchi, segmental bronchi, subsegmental and conducting bronchioles
54
Define: conducting zone
path of inhaled gas; nose to terminal bronchioles (airway generation 0-16)
55
Define: respiratory zone
where gas exchange takes place; respiratory bronchioles, alveolar ducts, alveolar sacs (airway generation 17-23)
56
Define: cartilaginous airways
trachea, main bronchi, lobar bronchi, segmental bronchi, subsegmental bronchi (airway generation 0-11)
57
Define: non-cartilaginous airway
bronchioles, terminal bronchioles (airway generation 12-16)
58
Define: lobar bronchi
generation 2. Between main bronchi and segmental
59
Define: bronchoscopy
passage of a camera into the proximal tracheobronchial tree. Also to remove things like legos
60
Define: carina
ridge of cartilage at the base of the trachea separating the openings of the left and right main bronchi
61
How many lobes does the left lung and right lung have?
left 2 right 3
62
What enters/exit the hilum of the lung?
pulmonary arteries, pulmonary veins and primary bronchi enter and exit lung
63
List the contents of the mediastinum
Describe the different divisions
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
List the contents of the superior mediastinum
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
Describe and give the function of the thymus
Give its position compared to everything else in the superior mediastinum
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
In the superior mediastinum, the veins are ____ (anterior/posterior) to the superior mediastnium
anterior
67
List the contents of the inferior mediastinum
heart and pericardium
68
Define: pericardium
connective tissue sac that encompasses heart and proximal portion of the great vessels. Protects heart
69
Describe the layers of the pericardium
outer to inner
fibrous pericardium (continuous of central tendon)
serous pericardium (parietal and visceral)
70
Define: pericarditis
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
How does the aortic arch change when supine vs standing?
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
Describe the vagus nerve in reference to the phrenic nerve
medial to the phrenic nerve
73
Define: atrial appendages
Small pouch that projects anteromedially from each atria
74
Define: trabeculae carnae
meaty ridges inside the ventricles
75
Define: pectinate muscles
look like the teeth of a comb. Parallel ridges of cardiac muscle in the atria
76
list the atrioventricular valves
Tricuspid valve: right atria and right ventricle
Bicuspid valve: left atria and left ventricle
77
Define: chordae tendinae
fibrous connective tissue that tethers AV valves to ventricular wall at the papillary muscles
78
Define: papillary muscles
contraction causes what?
act on AV leaflets; contraction closes the AV valves to prevent prolapse and blood regurgitation
79
list the semilunar valves
Aortic valve (left semilunar): separate left ventricle and aorta
Pulmonary valve (right semilunar): separate right ventricle and pulmonary artery
80
Discuss the branching off the aorta
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
What do the coronary arteries supply?
supply epicardium and myocardium
82
What innervates the heart? where are they derived from
cardiac plexus
Sympathetic cardiac nerves are derived from T1-T5
Parasympathetic innervation comes from vagus nerve originating in medulla
83
List the great vessels
originate and terminate in the heart
superior and inferior vena cava, pulmonary artery, pulmonary veins, aorta
84
Draw the branches of the aortic arch
Proximal to distal: brachiocephalic trunk (branches into right common carotid and subclavian arteries), left common carotid artery, left subclavian artery
85
Summarize coronary circulation
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
