Thoracic Wall And Lungs Flashcards
Thoracic Cavity
Superior Boundary: thoracic outlet, root of neck
Rib cage: sternum, ribs, and thoracic vertebrae
Inferior boundary: diaphragm
Diaphragm openings
Caval opening (T8), esophageal hiatus (T10), aortic hiatus (T12)
Thoracic outlet structures
- Esophagus, trachea, superior vena cava
- Phrenic nerve, vagus nerve, sympathetic trunk, thoracic duct
- Right brachiocephalic trunk: R common carotid artery, subclavian artery
- Right brachiocephalic vein: R internal jugular vein, subclavian vein
- Left brachiocephalic vein: L internal jugular vein, subclavian vein
- Left common carotid artery, subclavian artery
Not demifaceted ribs
I, X, XI XII
Ribs w/o tubercle on neck
XI, XII
structure in Costal groove
Neurovascular bundle
Rib 1
One articular facet, broadened superior surface, impressions, and scalene tubercle
Ribs to sternum connection
Costal cartilage
3 parts of sternum
- Manubrium
- Body
- Xiphoid process
Sternum: manubrium parts
- Jugular notch
- Clavicular articulating site
- Rib I articulating site
- Manubriosternal joint w/ Rib II facet (sternal angle)
Right brachiocephalic trunk branches
- Common carotid artery
- Subclavian artery
L/R brachiocephalic vein branches
L/R internal jugular vein
L/R subclavian vein
Sternum: body
- Inferior 1/2 of sternal angle
- Ribs III - VI
- Xiphosternal joint w/ 7th rib facet
Posterior rib joint types
Costovertebral joint: head of rib + facets of vertebral body
Costotransverse joint: neck of rib + transverse facet of vertebrae
Posterior rib ligaments
Superior Costotransverse ligament
Lateral costotransverse
Rib types
True ribs (1-7): connect directly to sternum
False ribs (8-10): connect to rib VII costal cartilage then to sternum
Floating ribs (11-12): not connected to sternum or costal cartilage
Intercostal space
Space between 2 ribs, a total of 11
Motions of thoracic wall (analogies)
Sternum: water pump handle (anterior/posterior)
Ribs: Bucket handle (upward rotation)
Motions of thoracic wall
TVP of sup vertebrae: coronal plane (ribs I-VII)
TVP of inf vertebrae: Sagittal plane (ribs VIII-X)
The axis of the 2 articulations shifted correspondingly
Dermatome landmarks
T4: nipple line
T6: xiphord process
T10: umbilicus
T12: pubic symphesis
Auxiliary artery pneumonic
Screw The Lawyer, Save A Patient
Auxiliary arteries
Superior thoracic artery
Thoracoacromial artery/trunk
Lateral thoracic artery
Subscapular artery
Anterior circumflex humeral artery
Posterior circumflex humeral artery
Pleural cavity and respiration
Expansion: elevation of rib cage, less than -4mmHg
Compression: depression of rib cage, back to -4mmHg
Contents of mediastinum
Heart (pericardial cavity), esophagus, trachea, giant cardiac vessels
Intra-pleural Cavity pressure
Always less than or equal to -4mmHg
Right lung
3 lobes: superior, middle, inferior
Fissures: oblique, horizontal
Hilum: bronchus and bronchus to sup. Lobe, pulmonary artery/vein
Left lung
2 lobes: superior, inferior
Lingual: tongue-like structure, degenerated middle lobe
Fissure: oblique
Hilum: bronchus, pulmonary vein/artery.
Pulmonary artery superior to bronchi
Right lung impressions
Azygos vein
Esophagus
Brachiocephalic trunk
R/L brachiocephalic veins
SVC/IVC
Cardiac
Left lung impressions
Descending/arch aorta
Esophagus
Left common carotid artery
Left subclavian artery
Cardiac impression
