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Human Anatomy 2 > Thoracic Contents > Flashcards

Thoracic Contents Flashcards

1
Q

Superior thoracic aperture

A
  • T1
  • 1st ribs and costal cartilages
  • superior manubrium
  • borders
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2
Q

Inferior thoracic aperture

A
  • T12
  • ribs 11 and 12
  • costal cartilages 7-10
  • Xiphisternal joint
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3
Q

Pleural sac

A
  • Visceral: around the organ
  • parietal: around the cavity
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4
Q

Lobes of the lung

and what seperates them

A
  • right lung as 3 lobes while left has 2
  • horizontal fissue: seperates middle lobe and superior lobe on the right
  • Oblique fissue: seperates the middle and inferior on the right and the superior and inferior on the left
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5
Q

bony landmarks

Right lung

A
  • upper lobe: adjacent to ribs 1-4 anteriorly
  • middle lobe: extends inferiorly and laterally between ribs 4-6
  • lower lobe: largest, posteriorly extends from T4-T10
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6
Q

bony landmarks

left lung

A
  • Upper lobes: sits within ribs 1-6
  • lingual lobe: area corresonding to the middle lobe
  • lower lobe: same as right lower lobe
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7
Q

Mediastinum

A
  • area between the lungs containing the following structures
  • heart
  • roots of great vessels (ascending aorta, pulmonary trunk, superior and inferior vena cava)
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8
Q

Structure of the heart

A
  • 4 chambers
  • AV vales: mitral and bicuspid
  • semilunar vales: aortic and pulmonic
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9
Q

blood flow through the heart

A
  • superior vena cava/inferior vena cava
  • right artium
  • tricuspid valve
  • right ventricle
  • pulmonary valve
  • pulmonary arteries
  • pulmonary veins
  • left atrium
  • mitral valve
  • left ventricle
  • aortic valve
  • aorta
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10
Q

Heart auscultations

A
  • aortic valve: right 2nd intercostal space next to sternum
  • pulmonic valve: left 2nd intercostal space next to sternum
  • tricuspid: left 5th intercostal space close to sternum
  • mitral: left 5th intercostal space at midclavicular line
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11
Q

RIb fracture

causes:

A
  • direct trauma to the area
  • repetitive motions such as golf swing, or rowing
  • coughing hard or long periods of time
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12
Q

rib fracture

clinical presentation

A
  • pain with any of the following: deep breathing, bending/twisting, palpation on the injured area
  • if there are double fractures to 3+ ribs can present with flail chest
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13
Q

rib fracture

complications:

A
  • tear of aorta: usually from a break in one of the 1st 3 ribs
  • tear in the lungs: punctured lung causing it to cave in
  • ripped spleen, liver, kidneys: caused from a break in on eof the lower ribs
  • TOS - usually with 1st rib
  • excessive use of acessory muscles can also cause TOS
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14
Q

rib fracture

Diagnostic tools

A
  • good history
  • physical exam
  • imaging is not needed unless multple rib fractures are suspected with underlying organ damage
  • if imaging is used CT is gold standard for rib fx
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15
Q

Pancaust tumor

A
  • apical region of the lung
  • can cause entrpament and disruption of structures in this area
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16
Q

rib fx

PT treatment

A
  • pain control is super important with these patients
  • this will allow early respiratory care to prevent pulmonary complications
  • examples: effective coughing, diaphragmatic breathing, intercostal nerve blockss, muscle relaxants
17
Q

Costochondritis

A
  • inflammation of the cartilage that connexts the ribs to the sternum
  • has no clear cause but can be connected to trauma, illess or severe strain
18
Q

Costochondritis

symptoms

A
  • pain that is sharp or aching like
  • affects more than one rib
  • pain that can radiate to shoulders and arms
  • symptoms will worsen with coughing, sneezing, or taking a deep breath
  • can be exacerbated during pregnancy due to diaphragm being unable to descending causing ribs to move more
19
Q

Costochondritis

diagnostic tools

A
  • tests are used to rule out other possible diagnosis
  • lab tests: cardiac enzymes and troponin levels, sed rate, C-reactive test (CRP)
  • imaging: X-ray to check for pneumonia
  • diagnostic procedure: ECG
20
Q

Costochondritis

Treatment

A
  • medications: cortisone injection/lidocain patch, asprin, non-steroidal, anti-inflammatory, analgescis
  • cryotherapy
  • taping to support ribs of costal cartailges
21
Q

Heart referral patterns

A
  • chest
  • left shoulder
  • left neck and jaw
  • left back
  • can be right just unusual
22
Q

Lungs referred pain

A
  • neck
  • back
  • both shoulders
  • ribs
23
Q

Intercostal nerves

A
  • 11 intercostal nerves
  • innervate intercostal muscles
  • provide sensory information from overlying skin and outer wall of the pleura
24
Q

Pathway of intercostal nerves

A
  • from the anterior rami of that thoracic nerves T-T11
  • enter between the posterior intercostal membrane and outer wall of pleura
  • goes into the subcostal groove of its repective rib
  • lies posteriorly to the rib
  • first 6 nerves have branches and end in their intercostal space
  • the 7-11th nerves leave the space and go into the abdominal wall
25
Q

Intercostal neuralgia

presentation

A
  • pain and symptoms within the distribution of the intercostal nerves
  • burning, sharp and or stabbing pain
  • numbness and tinglinging within the distribtuion
  • pain may be constant of intermittent
  • severe cases may affect the intercostal muscles
26
Q

Intercostal neuralgia

causes

A
  • damage from thoracotomy
  • shinges
  • trauma
  • iatrogenic
  • pregnancy
  • inflammatory infections
  • neoplasms
  • aberrant or no motion of thoracic vertebrae
27
Q

Intercostal neuralgia

Treatment

A
  • intercostal nerve blocks
  • meds: NSAIDs, anticonulsants, topical meds
  • chroninc conditions = SSRIs, SNRIs, tricyclic antidepressants can be used
  • antiviral
  • thoracic joint mobs if caused by lack of movement
  • surgery: neurectomy, dorsal rhizotomy or sensory ganglionectomy
28
Q

The vagus nerve

functions

A
  • parasympathetic control of heart rate and respiratory rate
  • digestion
  • immune response
  • involved in swallowing and coughing
  • innervates muscles of the soft palate, pharynx,larynx
29
Q

The vagus nerve

simplified pathway

A
  • begins in the medulla
  • exist skull through jugular foramen
  • travels through the carotid sheath into thoracic cavity
  • continues as pharyngeal, laryngeal, bronchia, esophageal and gastric branches and superior cardiac nerve
30
Q

The vagus nerve

injury: causes

A
  • upper cervical instability: AA-C1-C3
  • post-concussion syndrome
  • whiplash
  • cervical spine laminectomy
  • injury to the chest
  • poor posture
  • injury to the ascending pharyngeal artery
  • infection
31
Q

The vagus nerve

injury: signs and symptoms

A
  • abdominal pain
  • acid reflux
  • change in HR or BP
  • dysphagia
  • dizziness or fainting
  • hoarse voice
  • nausea and vomiting
  • uvular deviation to contralateral side

Human Anatomy 2 (14 decks)

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