Thoracic Cavity Flashcards
Attachements of spinous process
trapezius, rhomboids, latissimus dorsi, erector spinae, transversospinalis, interspinous and supraspinous lig.
Transverse process attach:
erector spinae, psoas, levator scapulae, transversalis fascia
Pulmonary Arteries
originate in pulmonary trunk and carry deoxy blood from right ventricle of heart to lungs
where does the esophagus enter the diaphragm
esophageal hiatus
collateral branch
T1-6 arise near angles of the ribs and descend along superior margin of the lower rib, to supply intercostal and parietal pleura
path of right side of heart
SVC or IVC with low O2 blood into right atrium, through tricusupid valve to right ventricle, then delivers blood to pulmonary trunk through pulmonary valve.
phrenic n. passes _____ to the root of the lung
anterior
bronchopulmonary nodes
drain pulmonary nodes and bronchi along main bronchi
Pulmonary veins run ______ to the pulmonary arteries
Inferior
Sympathetic fibers of lung
bronchodilater vasoconstrictor, inhibits alveolar glands
Respiration movements
Superior-Anterior movement due to anterior ribs being inferior to posterior (sternum up and forward) Lateral: due to middle shaft being inferior to ends
path of left side of heart
pulmonary veins deliver O2 rich blood from lungs into left atrium. passes through bicuspid value into left ventricle, then passes through aortic valve into the ascending aorta to rest of the body.
what is on the body of the sternum
sternal angle costal notches (articulates with 2-7)
Path of trachea
Trachea –> R and L bronchi –> lobal Bronchi (l2, R3) –> Segmental Bronchi –> (Bronchioles) broncho-pulmonary segment
visceral pericardium
forms the epicardium, outermost of three layers of heart walls gives rise to the transverse pericardial sinus and the oblique pericardial sinus
costomedialstinal recess
occurs in area where costal pleura is opposed to mediastinal pleura region overlying the heart.
paratracheal nodes
drain trachiobronchial nodes located solely on trachia
costotransverse
synovial plane articulate surface on tubercle of rib to transverse process or costotubular facet
posterior mediastinal lymph nodes
esophagus and thoracic aorta, posterior pericardium and diaphragm, middle posterior intercostal spaces.
subcostal n.
T12 S, Post G Sym skin overlying lateral and anterior, parietal peritoneum, and muscles of anterior ab wall, LMN muscles of anterior ab wall
Divisions of the thorax
2 pleural cavities and mediastinum
Thoracic dorsal rami - lateral
S, Post G symp back muscles and skin LMN of back
pulmonary nodes
drain the lung located in lung on lobar bronchi
The oblique pericardial sinus is bounded posteriorly by
the pericardium overlying the anterior aspect of the esophagus
interventricular sulci
separates the right and left ventricles. anterior and posterior
What is the conus arteriosus?
The tapering into an atrial cone, which leads to the pulmonary trunk. It is the smooth cardiac muscle leading to the pulmonary trunk.
lactiferous ducts
ducts of the breast. give rise to buds that develop into 15-20 lobes of the mammary gland to accumulate milk during nursing.
what is the supraventricular crest?
in the right ventricle ridge that changes the flow of the blood from a downward direction more upwards, towards the pulmonary trunk.
tracheobronchial
drain brochpulmonary and posterior mediastinal nodes, trachea and heart located along division of trachea into bronchi
oblique pericardial sinus
a wide pocket like recess in pericardial cavity posterior to base of heart formed by left atrium.
thymus
primary lymphoid organ in superior and anterior mediastinum after puberty, undergoes gradual involution and is replaced by fat. Rich aterial supply from anterior intercotstal a.
What is the septum?
remnant of the fossa ovalis or Formen ovale from the fetus oval or thumb size depression located in the right atrium
Costal Facet of vertebral body
ariculates with head of rib
endothoracic fascia
lines the thorax between intercostal muscles and the pleura; equivalent to transversalis fascia in abdomen
Name of fascia in thorax
endothoracic fascia
the r pulmonary a passes _____ to the aorta, SVC, and superior pulmonary vein
posterior
oblique fissure
separates inferior lobe and superior lobe and middle lobe of right lung
Apical Nodes
drains superior breast and other axillary nodes located on subclavian v.
Lobes left vs right
Left has 2 lobes, right and 3
Right side of heart recieves
low O2 blood from SVC and IVC in right atrium
Costodiaphragmatic recess
between costal pleura and diaphragmatic pleura. region between inferior margin of lung and inferior margin of pleura cavity.
Manubrium att.
pectoralis major
What are the identifying features of the Right ventricle?
Tricuspid valve conus arteriosus Atrioventricular orifice pulmonary trunk orifice. Pulmonary valve Trabeculae carnae and steomarginal trabecula on wall of ventricle
sternocostal
synovial plane between costal cartilage and sternum for 1-7
tubercle of rib
articular facet that articulates with transverse process
The SVC is ________ and _______ to the trachea.
anterior and lateral
What is the innervation of the pericardium?
phrenic n., vagus n.
What is the pulmonary valve?
the valve between the right ventricle and the pulmonary trunk. semilunar cusps
esophagus
extends from pharynx to stomach enters Sup. mediastinum between trachea and vertebral column (anterior to T1-T4. enters Post Mediastinum posterior and to the right of the arch of the aorta before movign left and passing through esophageal haitus into diphragm.
Thoracic Dorsal Rami - Medial
S, Post G symp back muscles and skin LMN of back
Superior Vena Cava
returns blood from structures superior to diaphragm, excep lungs and heart. Enters right atrium On right side of posterior mediastinum
What are the orifices of the right atrium?
Atrioventricular (R atrium to right ventricle) coronary Sinus (receives cardiac veins) Inferior Vena Cava Superior Vena Cava
Operations of the semilunar cusps
Regulate directional blood flow based on pressure. When pressure is high, cusps collapse and left blood flow through. when pressure is low, cusps are closed like umbrellas. Looking superiorly on the cusp is like looking downward at three umbrellas (UU)
Anterior mediastinum
Thymus, lymph nodes, sternopericardial ligmanet
Internal and innermost intercostal m
from rib to rib oriented superior-medial to inferior lateral depression of ribs intercostal n. ant and post intercostal a.
The transverse pericardial sinus runs ______ to the SVC and ______ to the atria.
anterior, superior
Base of lung
sits on diaphragm
coronary arteries
right and left arise from corresponding aortic sinuses at the proximal part of the ascending aorta and pass around opposite sides of pulmonary trunk.
Parietal Nodes of Thoracic area
Parasternal intercostal diaphragmatic posterior mediastinal
what is characteristic of the left ventricle?
Aortic valve Aortic and atrioventricular orifices bicuspid valve (mitral) interventricular septum trabeculae carnae that is finer and more numberous thicker walls than right ventricle
nerves of lung
pulmonary plexus vagus nerve CN X Cell bodies are pre-ganglionic and are in the sympathetic trunk.
Posterior mediastinum
esophagus, trachea, thoracic aorta, azygous,v., thoracic duct, sympathetic trunks, thoracic nodes
Trachea
descends anterior to the esophagus and enters superior mediastinum ends at sternal angle and divides into the right and left bonchi
Attachments to angle of rib
erector spinae
Brachiocephalic veins
formed posterior to sternoclavicular joints by union of internal jugular and subclavian veins. United to for SVC at border of 1st rigth costal cartilage
where are the auricles located?
Right auricle on right atrium left auricle on left atrium
What are the orifices of the right ventricle?
Atrioventricular pulmonary trunk
The thoracic duct
largest lymph channel in body lies left of the esophagus in the SM Are to the right of the descending thoracic aorta in the posterior mediastinum, along the anterior aspect of the vertebrae. passes through the
bronchial arteries
supply blood for nutrition to the root of the lungs, supporting tissue and visceral pleura. either arise from the thoracic aorta or from upper posterior intercostal arteries.
Intercostal n. T1-6
S, Post G sym intercostal muscles and parietal pleura LMN of intercostal muscles Lateral cutaneous anterior cutaneous collateral branch intercostobrachial n.
Left pulmonary Artery
shorter than right
the oblique pericardial sinus is bounded ________ by the pericardial reflections surrounding the pulmonary veins and IVC.
laterally
What are the contents of the mediastinum?
thymus pericardiac sac, heart trachea, major arteries and veins
coronary sulcus
separates atria from ventricles
superior articular facet
articulates with adjacent inferior articular facet
Xiphoid process att
diaphragm and rectus abdominus
Joints of thoracic cage
costovertebral costotransverse sternocostal
Middle mediastinum
Heart, pericardium, origin fo great vessles, nerves, small vessles
the SVC is _______and ______ to the ascending aorta
posterior and lateral
Pulmonary Ligament
thin blade-like fold of pleura that projects inferirly from root of lung to mediastinum. stabilize and accommodate up and down translocation.
Left side of heart recieves
Rich O2 blood from pulmonary veins
pericardinal cavity
potential space between opposing serious pericardium
Base of heart
heart’s posterior aspect formed mainly by left atrium faces to vertebral bodies receives pulmonary veins, SVC and IVC
what are the orifices of the left ventricle?
antrioventricular Aortic (to arch of the aorta)
Characteristics of a valve?
Cusps attach to fibrous ring around orifice. Cordae Tendinae attach to edges and ventricular surface of cusps Cordae tendinae are attached to papillary muscles in ventricular wall. When papillary muscles contract, it draws the cusps together like an umbrella to prevent back-flow of the blood.
Right coronary artery
from right coronary sinus along coronary sulcus. near origin, give off sinuatrial nodal branch to supply SA node. gives off right marginal branch to supply right border as it turns towards apex of heart. goes around the heart towards the crux of the heart to give off antrioventricular nodal branch to supply AV node. typically the right gives off the posterior interventricular branch.
attachments to shaft of rib
pectoarlis minor, serratus anterior, external, internal, and innermost innercostal, diaphragm, quadratus lumborum
Visceral lymph nodes
pulmonary borcnhopulmonary tracheobronchial paratracheal
scalene tubercle
located on 1st rib anteiror scalene muscle to 1st rib
What are Crista terminalis
located in right atrium is the terminal crest, or vertical ridge, that separates the smooth cardiac muscle from rough pectinate muscle
Coronary Sinus
Merging of all the veins of the heart to feed into the right atrium.
Anterior cutaneous branch
T1-6 S, Post G sym of skin overly anterior intercostal space
Circumflex branch
continuation of the left coronary a. travels around coronary sulcus and gives off left marginal a. and terminates on the posterior aspect of the heart.
Pulmonary veins
Super and inferior carry oxygenated blood from lungs back to left atrium; middle lobe vein is a tributary of the right superior pulmonary vein. run independently of bronchi and arteries in the lung.
mitral valve
bicuspid valve separating left and right ventricles anterior and posterior cusps More developed papillary muscles
The right phrenic nerve passes _____ to the right brachiocephalic vein, SVC and pericardium.
on the right
transversus thoracis
from posterior sternum to costal cartilage depression of ribs intercostal n. internal thoracic and anterior intercostal a.
what drains the pleura
parasternal (anterior) diaphragmatic posterior mediastinal
Tricuspid valve
valve between right atrium and left atrium three cusps - anterior, posterior, and septal Chordae tendinae - attach to free edges and ventricular surfaces of the three cusps Anterior (from anterior wall with CT to A and P), posterior (from inferior wall with CT to P and S), and septal papillary muscles (from interventricular septum to A and S)
Parasternal nodes:
medial breast, upper ab. wall, anterior pleura and part of liver located between costal cartilage on lateral sides of sternum
costal groove of rib
houses intercostal v, a, and n.
in the right lung the ______ to R. bronchi
anteriorly
the L pulmonary A. runs __________ to the L bronchus
superiorly
Diaphragmatic nodes
drain liver, pleura, and diphragm located psoteior to xiphoid process and sit where phrenic n. penetrates diaphragm and where diaphragm attaches to vertebral column
Visceral pleura
continuous with parietal and hilum of lungs innervated by visceral afferent nerves that accompany bronchial vessels
How does the thoracic aorta enter the diaphragm?
aortic hiatus
Azygos vein
forms collateral pathway between SVC and IVC and drains blood from thorax and abdomen. Passes close to the right sides of the vertebral bodies and arches over the root of the right lung to join SVC. Also communicates with vertebral venous plexus.
What is pleura? what types are there?
single layer of mesothelium Parietal: post to chest wall and diaphragm visceral: against lungs
Intercostobrachial n.
T2 only S, Post G sym of skin overly proximal and medial aspect of arm and armpit Important for referred pain. Pain can originate at the heart, due to location of T2, but you will feel it in the armpit.
the R pulmonary a. passes _______ to the tracheal bification and ______ to the right bronchus
anterior/inferior anteriorly
Right lung
3 lobes 2 fissures (oblique and horizontal)
the left bronchus runs ______ to the L pulmonary a.
inferiorly
diaphragmatic part of pleura
covers diaphragm innervated by phrenic n.
where are the groove for suclavian a and v located
1st rib
posterior interventricular branch
splits off the right coronary a in the posterior aspect of the heart and goes down the posterior IV groove towards apex.
Foramen ovale
is found in the left atrium is a semilunar depression from fetal development.
horizontal fissure
separates superior lobe from middle lobe
mediastinal part of pleura
covers mediastinal innervated by phrenic n.
what is on the transverse process and articulate with rib?
cosotubercular facet
SA node
sinuatrial node located antero-laterally to epicardium at the junction of the SVC and right atrium
bronchopulmonary segment
area provided by segmented bronchi and accompanied pulmonary artery. pulmonary veins pass intersegmentally smallest functionally independent lung region, can be isolated without affecting adjacent regions
what is on the manubrium
jugular notch clavicular notch and facet costal notch and facet for 1st rib
Inspiration vs. expiration
inspiration is active; expiration is usually passive
Apex
projects above the 1st rib and into root of neck
costotubercular facet
located on transverse process articulates with rib
Phrenic N.
C3-5 S, Post G symp to pericardium and central tendon (and adacent pleura and peritoneum) LMN and post G sym of diaphgram
What are distinctive features of the right atrium?
Crista terminalis Pectinate muscles Septum or Fossa Ovalis
Apex of heart
infero-lateral aspect of left ventricle posterior to 5th intercostal space remains motionless
what is the purpose of the cordae tendinae?
Prevent valve from ballooning into the atrium in the opposite direction.
What is the blood supply and drainage of the pericardium?
percardiocophrenic a. and v.
hemiazygos vein
arises on the left side by the junction of the left subcostal and ascending lumbar. ascends on left side of vertebral column posterior to throacic aorta up until T9, where it crosses to the right, posterior to the aorta, thoracic duct, and esophagus and joins the azygous vein.
what is notable about the trabeculae carne in the right vs. left ventricle?
in the left it is much finer and more prominent than in the right
suspensory ligaments of the breast
attaches the mammary gland to the dermis of the overlying skin.
Bronchial veins
only drain part of blood supplied to lungs, the remainder is trained by pulmonary veins.
what does serous fluid in pleura do?
helps lubricate for sliding of lungs creates surface tension to both both pleura and the lungs alongside in breathing
The Transverse pericardial sinus runs ______ to the pulmonary trunk and ________ to the ascending aorta.
Posterior and posterior
costovertebral
synovial plane articualte head of Rib to vertebral body
mediastinum
mass of tissue between pulmonary cavities - central part of thoracic cavity. from superior thoracic aperture to the diaphragm and from costal cangle to anterior to thoracic vertebral bodies loose connective tissue enable for those attached to it to move during respiration, passage of heart Acts as conduit for esophagus, throacic ducts, and nerves
Ventral Rami of Thoracic spinal n.
intercostal n. T1-6 Intercostal n T7-11 subcostal n. t12
Pneumothorax
air in pleura cases decreased surface tension and leads to collapsed lung
the azygous vein runs ______ to they hilum of the right lung
superior and posterior
Ascending aorta
arrises from aortic oriface. only branches are coronary arteries. middle medistinum
L pulmonary a. passes ______ to the descending aorta and ______ ti the superior pulmonary vein
anterior posterior
costal part of pleura
articulates to ribs and intercostal spaces innervated by intercostal n.
Intercostal T7-T11
S, Post G sym: intercostal muscles, anterior ab muscles, peripheral diaphragm, parietal pleaura, parietal peritoneum LMN: intercostal m., anterior ab wall m. lateral cutaneous branch anterior cutaneous branch collateral branch
What is the septomarginal trabecula?
also know as moderator band in the right ventricle a curved muscle that traverse the right ventricular chamber from inferior part of Intraventricular septum to anterior papillary muscle. *carried part of the AV node*
Explain the conduction of the heart:
the Cardiac plexus sends axon potentials to the SA node (sinuatrial doe) to initiate and regulate heart beat. SA node myogenically sends signal to both atria This activates the AV node in the Setomarginal trabeculae, which transmits signal through AV bundle. AV bundles divide into right and left around interventricular septum and then active purkinje fibers which extend to wall of respective vencricles.
aortic valve
semilunar valve separating right ventricle from ascending aorta has posterior, right and left cusps
transverse pericardial sinus
formed by visceral pericardium transversely running passage between Aorta and Pulmonary heart and where SVC and IVC and pulmonary vein enter the heart. runs posterior to pulmonary trunk and ascending aorta and anterior to SVC, and superior to atria of the heart
Inguinal Nodes
located near inguinal canal may drain inferior breast
What is trabeculae carnae?
in the right ventricle the irregular muscle, leads to the supraventricular crest.
Parasternal nodes
located laterally to sternum in between costal cartilage drains medial breast
Inner layer pericardium
serous layer
cervical pleura
lines the cervical extension of pleura cavity
orifices of the left atrium?
atrioventricular pulmonary veins (4 total R sup, R In, L sup, L inf)
Inferior mediastinum
Anterior, Middle and posterior From t4 to the diaphgram
Calm inspiration
Volume change due to contraction of diaphragm and intercostal muscles
The phrenic nerve passes ______ to the root of the lung .
anterior
what lymph nodes drain the breast?
parasternal inguinal infraclavicular axillary apical axillary
Left lung
2 lobes oblique fissure lingula of left lung (projects over heart bulge)
Expiration
passive; relaxation of diaphragm, recoiling of lungs
Hilum of lung
where pumlonary a., 2 pulmonary vs., a main bronchi, two bronchial vessels, nerves, and lymphatics enter and leave the lung
Lateral cutaneous branch
T1-6 S, Post G symp of skin overlying lateral intercostal space
Infraclavicular nodes:
located inferior to clavical may drain superior breast
External intercostal
from rib to rib oriented from superior-lateral to inferior medial elevation of ribs intercostal n. ant and post intercostal a.
what covers the mediastinum
mediastinal cavotu
AV node
atrioventricular node, smaller nodal tissue. located in posteroinferior region of interatrial septum near opening of coronary sinus.
Attachments to verebral body
psoas, diaphragm (crura) .m, ant and post longitudina lig.
superior mediastinum
superior thoracic aperture to horizontal plane
What are pectinate muscles?
located in the right atrium the rough, muscular anterior wall
head of rib
has articular facet that articulates with body of vertebrae
What are the notable features of the left atrium?
forms base of the heart Foramen ovale orifice: atrioventricular and pulmonary veins thicker walls than the right atrium
Outer layer of pericardium
fibrous layer, continuous with central tendon of diaphragm.
Forced inspiration
recuirt sternocleidomastoid, pectoral, and scalene muscles to help expand cavity.
Left coronary artery
from left aortic sinus and passes between left auricle and left side of pulmonary trunk to run along coronary sulcus. divides into two branches, the anterior IV branch and the circumflex branch.
forced expiration
utilizing internal intercostal and abdominal muscles
Root of lung
short tubular collection of strugures that attach the lung to mediastinum
Pericardium
fibrouserous material that covers heard and beginning of great vessels. Composed of two layers, a rough external language and thin serous membrane.
Vagus n. passes _______ to the root of the lung
posterior
axillary nodes
predominate drainage of breast located on axillary v., subscapular v.,, and pectoral v.
Body of sternum att.
pectoralis major transversis thoracis
Superior division of mediastinum
from superior thoracic aperature to T4 Thymus, thrachea, esophagus, thoracic duct, aortic artch, brachiocephalic trunk, SVC, vagus n., left recurrent vegus
auricles of heart
conical muscular pouch that project from the chapers as add-ons to increase the chambers capacity.
intercostal nodes
drain lateral and posterior thoracic wall head/neck of ribs (posterior)
