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SPOM > Thoracic Outlet > Flashcards

Thoracic Outlet Flashcards

1
Q

Boundaries of thoracic outlet?

A
  • Manubrium
  • First rib
  • First thoracic vertebrae
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2
Q

Prevertebral muscles?

A

Lateral:

  • Scalenes (anterior, middle, posterior)
  • Splenius Capitus
  • Levator Scapulae
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3
Q

Anterior and Middle scalenes attachments?

A
  • Transverse process

- 1st rib

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4
Q

Posterior scalene attachments?

A
  • Transverse process

- 2nd rib

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5
Q

Scalenes innervation?

A

ventral rami

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6
Q

Scalenes function?

A
  • flex neck laterally
  • flex head
  • raise ribs
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7
Q

Branches of Aortic arch?

A
  1. Brachiocephalic trunk off right side
    - Right Common Carotid
    - Right Subclavian
  2. Left Common Carotid
  3. Left Subclavian
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8
Q

Branches of Subclavian Artery?

A
  1. Vertebral Artery (1st branch)
  2. Internal Thoracic
  3. Thyrocervical Trunk
    - Inferior Thyroid
    - Transverse Cervical (Trapezius)
    - Suprascapular (level of clavicle)
  4. Costocervical Trunk
    - Superior Intercostal
    - Deep Cervical
  5. Dorsal Scapular
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9
Q

Clinical significance of Internal Thoracic Artery?

A

-used for bypass surgery to maintain blood flow to ventricles

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10
Q

Where does Dorsal Scapular Artery run?

A
  • runs in between trunks of brachial plexus

- supplies Rhomboids

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11
Q

Where does Subclavian Vein run?

A
  • anterior to anterior scalene

- not compromised by scalene interval syndrome

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12
Q

What drains into the Subclavian vein?

A
  • External jugular vein runs superficial to sternocleidomastoid muscle
  • Subclavian combines with Internal Jugular
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13
Q

What drains into the Brachiocephalic vein?

A

-Internal Jugular and Subclavian form it

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14
Q

Where does the brachiocephalic vein drain?

A
  • 2 brachiocephalic veins join to form the Superior Vena Cava
  • Left vein crosses the midline
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15
Q

T/F

Thymus is always active.

A

T

-does regress in size but stays active

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16
Q

Path of Vagus nerve?

A
  • starts as Cranial Nerve 10 off of the brainstem
  • goes down the neck along with Internal Carotid Artery and Internal Jugular Vein
  • Left side sends a branch that loops under the Aortic arch at the Ligamentum Arteriosum called the Left Recurrent Laryngeal Nerve
  • Right Side sends the Right Recurrent Laryngeal Nerve back up and loops under Right Subclavian Artery
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17
Q

Phrenic Nerve?

A
  • C3, 4, 5
  • innervates diaphragm
  • anterior to anterior scalene
18
Q

Ligamentum Arteriosum?

A
  • ligament that is remnant of ductus arteriosum

- connects Aorta to Pulmonary Artery

19
Q

Sympathetic trunk path?

A
  • starts anterior then lateral to vertebral bodies
  • ganglia along chain (1 per level)
  • Cervical ganglion
  • stellate ganglion
  • ganglion impar
  • ends anterior to sacrum
20
Q

Where do superficial lymph nodes drain?

A
  • external jugular vein

- anterior jugular veins

21
Q

Where do deep cervical lymph nodes drain?

A

-internal jugular vein

22
Q

Lymphatics in neck?

A
  • Superficial cervical
  • deep cervical
  • pharyngeal
  • pretracheal
  • paratracheal
  • retropharyngeal
23
Q

What does the Thoracic duct drain?

A
  • lymph from everything below diaphragm

- everything except right side of head and neck, right upper limb and right side of thorax (right lymphatic duct)

24
Q

Where does the Thoracic duct drain into?

A

junction between left Internal Jugular Vein and Subclavian Vein

25
Q

Cervical viscera?

A
  1. Respiratory layer
    - larynx
    - trachea
  2. Alimentary layer
    - pharynx
    - esophagus
26
Q

Cartilage in larynx?

A
  • thyroid
  • cricoid (inferior C6)
  • arytenoids
27
Q

Where does the trachea begin?

A
  • after cricoid cartilage

- this marks the end of larynx

28
Q

What is the trachea?

A
  • conduit from larynx to main bronchi

- 16-20 C shaped rings of cartilage

29
Q

Location of C shaped rings in trachea?

A
  • anterior side

- posterior side is smooth muscle to allow movement of bolus down esophagus without pain sensation

30
Q

Where is the pharynx and esophagus located?

A

-posterior to larynx and trachea

31
Q

Divisions of the pharynx?

A
  • Nasopharynx
  • Oropharynx
  • Laryngopharynx
32
Q

Muscles of the pharynx?

A

Pharyngeal Constrictors:

  • superior
  • middle
  • inferior
33
Q

Where is the landmark for the end of the pharynx and larynx?

A
  • Cricoid cartilage

- beginning of esophagus and trachea

34
Q

What is the esophagus?

A
  • continuation of pharynx inferior to cricoid cartilage (C6 vertebral level)
  • conduit from pharynx to stomach
35
Q

Where do the brachial plexus and Axillary Artery run in relation to scalene muscles?

A

-in between anterior and middle scalenes

36
Q

Where does the Axillary vein run in relation to Scalene muscles?

A

-anterior to anterior scalene

37
Q

Prefixed brachial plexus?

A

-C4-C8

38
Q

Postfixed brachial plexus?

A
  • C6-T2
  • lower syndrome
  • ulnar nerve problems
39
Q

Cervical rib?

A
  • bilateral or unilateral
  • fuses with 1st rib
  • restricts space of Subclavian Artery
40
Q

Thoracic Outlet syndrome?

A

Injury to structures between anterior and middle scalene:

  1. Brachial Plexus and Subclavian Artery
  2. Scalenus Anticus Syndrome
  3. Cervical Rib syndrome
  4. Costoclavicular syndrome
    - surgery as intervention, maybe OMM
41
Q

Superior Brachial Plexus Injury?

A
  • C5-C6
  • limb hangs by side
  • medial rotation
  • Erb-Duchenne Palsy (waiters tip)
  • could be from trauma or pulling baby out
42
Q

Inferior Brachial Plexus injury?

A
  • C8-T1
  • see more often in thoracic outlet syndrome
  • hyperflexion
  • claw hand
  • could be from pulling on baby’s arm at birth, climbing

SPOM (17 decks)

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