Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Anatomy Pt. 2 > Thoracic Wall and Lungs > Flashcards

Thoracic Wall and Lungs Flashcards

1
Q

What are the two primary functions of the thorax?

A
  1. Respiration

2. Protect organs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Name the three sections of the central sternum.

A
  1. Manubrium
  2. Body
  3. Xiphoid process
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the superior thoracic aperture?

A

The superior thoracic aperture refers to the opening at the top of the thoracic cavity. It is bounded by the first rib, vertebral column, and manubrium of sternum. It is AKA the thoracic inlet ANATOMICALLY and the thoracic outlet CLINICALLY as in thoracic outlet syndrome (wtf right?)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the inferior thoracic aperture?

A

The opening at the bottom of the thoracic cavity. It is bounded by 12th thoracic vertebra, 12th rib, cartilages of ribs 7-12, and xiphoid process. It is closed by the diaphragm, which separates the thorax from the abdomen.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What runs in the two grooves on the superior surface of the first rib? What separates these two grooves?

A

The subclavian artery and subclavian vein run in the two grooves. The grooves are separated by the scalene tubercle, which serves as the attachment for the scalene anterior muscle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How are the ribs classified?

A

1-7 are vertebrosternal (true ribs)
8-10 are vertebrochondral (false ribs)
11 and 12 are vertebral (floating)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Which part of a rib articulates with the vertebral bodies?

Which part articulates with the transverse processes of the vertebrae? Does this articulation occur with a rib of the same level?

A

The head articulates with the vertebral bodies.

The tubercle of the rib articulates with the transverse processes of the vertebrae at the same level.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Three ribs articulate with only one (instead of two) vertebral bodies. Name them.

A

Ribs 1, 11, 12

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How do the rib levels relate to the vertebral levels that each rib articulates with?

A

Each rib articulates with the vertebrae at the same level + the vertebrae immediately superior.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

At which level (same or superior) does each rib attach to the transverse process of the vertebra? What is this joint called?

A

Same level. The joint is called the costotransverse joint.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the costovertebral articulation?

A

The costovertebral joints are the articulations that connect the heads of the ribs with the bodies of the thoracic vertebrae.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

In diagnosing blood diseases, where is marrow often sampled from?

A

From the sternum, called a sternal puncture.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the jugular (suprasternal) notch?

A

The v-shaped thing on the superior part of the manubrium.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which heart structures are auscultated by placing a stethoscope at the second intercostal space?

A

Aortic and pulmonic heart valves.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

With which ribs does the body of the sternum articulate?

A

Half of the head of rib 2 and the heads of ribs 3-7.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

At what spinal levels do the inferior vena cava, aorta, and esophagus pierce the thoracic outlet, respectively? What nerves innervate the thoracic outlet?

A

IVC: T8
Aorta: T12
Esophagus: T10

Phrenic nerves (C3, 4, 5) innervate the thoracic outlet.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is flail chest?

A

When rib fractures allow a segment of the thoracic wall to move paradoxically during inspiration or expiration. Can cause respiratory failure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What structures are at risk in the case of a fracture of rib 1?

A

Brachial plexus and subclavian vessels.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What complications often arise as a result of middle rib fractures?

A

Pneumothorax, injury to the lungs or spleen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What complication can lower rib fractures cause?

A

Tearing of the diaphragm –> diaphragmatic hernia.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is thoracic outlet syndrome?

A

A syndrome involving compression at the superior thoracic outlet (often due to presence of a cervical rib) resulting in excess pressure placed on the lower brachial plexus (C8 and T1 roots) passing between the anterior scalene and middle scalene muscles attached to a cervical rib. Also at risk of compression is the subclavian artery –> ischemia and ischemic pain in the upper limb.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the two main muscles of the thorax?

A
  1. Intercostals

2. Diaphragm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

How many layers compose the intercostal muscles?

A

3: external, internal, and an incomplete innermost layer.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Which intercostal muscle layer is most active during inspiration?

A

The external intercostal layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which intercostal muscle layer is most active during expiration?

A

The internal intercostal layer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How is the external intercostal muscle layer arranged with respect to the internal layer?

A

Perpendicularly

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the transversus thoracis muscle?

A

An innermost intercostal muscle that arises from the back of the sternum and the xiphoid process and inserts onto the inner surface of the costal cartilages from ribs 3-6.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Can innermost intercostal muscles bridge more than one intercostal?

A

Yeah

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the “bucket-handle” movement?

A

The growth of the thoracic cavity laterally through the lateral movement of ribs 7-10.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is the “pump-handle” movement?

A

The growth of the thoracic cavity anteroposteriorly through the true ribs (1-7) pushing the sternum anteriorly.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

During normal, relaxed breathing, which muscle does most of the work?

A

The diaphragm.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which muscles contract during forced expiration?

A

The anterior abdominal muscles and the costal part of the internal intercostals.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What makes up the neurovascular bundles that lie between the internal intercostals and innermost intercostals?

A

An intercostal vein, artery, and nerve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Are intercostal nerves mixed nerves containing both motor and sensory fibers?

A

Yeah

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What do the dorsal rami of the thoracic spinal nerves do?

A

Innervate the deep back musclesand send out cutaneous branches innervating the overlying skin.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What do the ventral rami of the thoracic spinal nerves do?

A

They become the posterior intercostal nerves that innervate intercostal musculature, periosteum of the ribs and skin of the thorax in a dermatomal fashion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Which nerves provide cutaneous sensation for the abdominal wall?

Which nerves provide cutaneous sensation for the region above the pubis?

A

Abdominal wall: T7-T11 intercostal nerves.

Above pubis: T12 and L1 intercostal nerves.

38
Q

How many thoracic nerve pairs are there? How are they numbered?

A
  1. Each is numbered after the vertebra immediately above the intervertebral foramen through which each nerve passes.
39
Q

What do each spinal nerve divide into?

A

A dorsal primary ramus and a ventral primary ramus.

40
Q

Which nerves supply the dermatomes at the nipple, and umbilicus, respectively?

A

Nipple: T4

Umbilicus: T10

41
Q

What are the three main sources of blood supply for the thoracic wall?

A
  1. Axillary artery
  2. Subclavian artery
  3. Aorta
42
Q

What branches of the axillary artery supply the thoracic wall?

A
  1. Supreme thoracic supplies the first two intercostal spaces from the inside.
  2. The lateral thoracic supplies the first two intercostal spaces from the outside.
43
Q

What branch of the subclavian artery supplies the thoracic wall?

A

The internal thoracic, which gives off anterior intercostal branches.

44
Q

What intercostal arteries arise from the aorta?

A

The posterior intercostal arteries (except for the first two intercostal spaces, which arise from the costocervical trunk from the subclavian artery).

45
Q

Into which larger veins do the posterior intercostal veins drain?

A

The right azygos and left hemiazygos veins. Note that the superior intercostal veins can drain into the brachiocephalic veins.

46
Q

From what do the anterior intercostal arteries and veins arise? Where do they go?

A

From the internal thoracic vessels. These travel laterally and dorsally to anastomose with the posterior vessels in the intercostal spaces around the midclavicular line and also supply the skin over the sternum with perforating branches.

47
Q

What structures are contained within a subcostal groove?

A

An intercostal vein, artery, and nerve (VAN). There are two arteries and veins in each space (one from the posterior and one from the anterior).

48
Q

Define the following terms: hydrothorax, hemothorax, chylothorax, pyothorax. What procedure is performed to treat this and how is it done?

A 
Hydro: fluid in the pleural cavity.
Hemo: blood
Chylo: lymph
Pyo: pus
A thoracocentesis is performed at or posterior to the midaxillary line one or two intercostal spaces below the fluid level but not below the ninth intercostal space. The ideal site is the eighth or ninth intercostal spaces as this site avoids possible accidental puncture of the lung, liver, spleen or diaphragm. A needle should be inserted in the middle of the intercostal space to avoid injury to both the main intercostal neurovascular bundle running under the superior rib or the collateral bundle running above the inferior rib.
49
Q

From what large artery do the internal thoracic arteries arise? Between what two structures do the internal thoracic arteries run?

A

The subclavian artery. They run between the transversus thoracis and the sternum.

50
Q

Which lymph nodes drain the anterior thorax and medial breast?

A

The parasternal lymph nodes.

51
Q

What three things are contained in the thoracic cavity?

A
  1. Pleural cavities
  2. Lungs
  3. The mass of the mediastinum
52
Q

What does the mediastinum contain?

A
  1. Heart.
  2. Pericardium and associated great vessels.
  3. Trachea and structures such as the esophagus, vagus nerves, phrenic nerves, and thoracic duct.
53
Q

What is the difference between visceral and parietal pleura of the lungs?

A

Visceral is in direct contact with the lungs, parietal is not.

54
Q

What are the four subdivisions of the parietal pleura?

A
  1. Mediastinal
  2. Costal
  3. Diaphragmatic
  4. Cervical (cupola)
55
Q

Is the visceral pleura innervated by sensory nerves? What type of epithelium is it made of?

A

Not innervated by sensory nerves. Simple squamous epithelium.

56
Q

Which subdivision of the parietal pleura is vulnerable to puncture, resulting in a pneumothorax?

A

The cupola (cervical) division.

57
Q

Is the parietal pleura innervated by sensory nerves? Which ones?

A

Yes, by free sensory nerve endings of the intercostal and phrenic nerves.

58
Q

Where might pain originating from the diaphragmatic and mediastinal pleura be referred to and why?

A

Pain may be referred to the shoulder because the phrenic nerve (which innervates the diaphram and mediastinal pleura) and the supraclavicular nerves (which supply the shoulder with sensation) have contributions from the same levels - C3 and C4.

59
Q

What is pleurisy?

A

Inflammation of the pleurae with exudation into its cavity, causing the pleural surfaces to be roughened. It produces friction and a pleural rub can be heard with the stethoscope on respiration. The exudate forms dense adhesions vetween the visceral and parietal pleurae forming pleural adhesions. Symptoms are a chill, followed by fever and dry cough and severe pain caused by adhesions of the parietal pleura in the diaphram and cervical regions that is referred to the shoulder.

60
Q

What are the two functions of pleural fluid?

A
  1. Lube

2. Surface adhesion between parietal pleura and visceral pleura

61
Q

What are the three pleural recesses?

A
  1. Costodiaphragmatic recesses.
  2. Sternocostal recesses.
  3. Costomediastinal recesses.
62
Q

Do the lungs follow the same inferior outline as the pleura?

A

No, they are two ribs higher.

63
Q

What is the difference between a primary and secondary pneumothorax?

A

Primary is a pneumothorax that occurs without an apparent cause and in the absence of significant lung disease. A secondary pneunothorax occurs in the presence of existing lung pathology.

64
Q

How many lobes do the right and left lungs have, respectively?

A

The right has three (superior, middle, inferior), the left has two (superior and inferior).

65
Q

Where should you place the stethoscope to examine the superior, and inferior lobes of the right lung, respectively?

A

Superior lobe: put stethoscope on anterior chest wall.

Inferior: put stethoscope posteriorly below the scapula.

66
Q

Where should you place the stethoscope to examine the superior, and inferior lobes of the left lung, respectively?

A

Superior lobe: put stethoscope on the anterior chest wall.

Inferior: put stethoscope posteriorly below the level of rib 6.

67
Q

At what spinal level does the trachea usually bifurcate?

A

T4/T5

68
Q

In which bronchus do aspirated foreign bodies normally get trapped in and why?

A

Foreign bodies usually enter the right bronchus because the angle is steeper and the diameter is larger than the left. Eventually the objects get trapped in the posterior basal segment.

69
Q

What things make up a broncho pulmonary segment?

A

The lung tissue associated with a segmental bronchiole and its own branch of the pulmonary artery and bronchiole artery.

70
Q

The ____________ plexus supplies both parasympathetic and sympathetic nerves to the bronchial and vascular trees.

A

bronchopulmonary

71
Q

What does parasympathetic stimulation do to the lungs? From which nerve does this stimulation occur?

A

Via the vagus nerve (cranial nerve X). Results in smooth muscle contraction and mucus secretion.

72
Q

What does sympathetic stimulation do to the lungs?

A
  1. Smooth muscle relaxation.
  2. Decreases mucus secretion.
  3. Constricts blood vessels.
73
Q

What type of drugs are used to relieve asthma symptoms?

A

B-2 agonists

74
Q

What is the most common etiology of a pulmonary embolism?

A

Venous thrombus

75
Q

What is a cervical rib?

A

An extra rib which usually arises as an extension of the transverse process of the seventh cervical vertebra. Present in only about 1 in 500 (0.2%) of people. They may cause a form of thoracic outlet syndrome due to compression of the lower trunk of the brachial plexus or subclavian artery. These structures are entrapped between the cervical rib and scalenus muscle.

76
Q

The level of the sternal angle at T4/T5 (aka transverse thoracic plane) is important anatomically for various reasons. Name six.

A
  1. The trachea divides here
  2. The pulmonary trunk divides here.
  3. It marks the separation between the superior and inferior mediastinum.
  4. Inferior border of the aortic arch is at this level.
  5. Ligamentum arteriosum is at this level.
  6. Vagus nerve gives off the left recurrent laryngeal nerve here.
77
Q

What are the ligaments called that connect the costal cartilage with the sternum?

A

Sternocostal ligaments

78
Q

What is the difference between a rib separation and rib dislocation?

A

Rib DISLOCATION happens at the sternocostal joint (the costal cartilage from the rib separates from the sternum).

Rib SEPARATION happens at the costo-chondral joint (the cartilage on the rib separates from the rib bone)

79
Q

What is costochondritis and what populations does it tend to affect? What is the symptom?

A

Inflammation of the cartilage of the sternocostal joints - affects children and adolescents. Symptom is chest pain.

80
Q

How can cutaneous sensation of the forearm and hand get messed up as a result of thoracic outlet syndrome?

A

Thoracic outlet syndrome is compression of the lower roots (C8 and T1) which contribute to the ULNAR NERVE, so its dermatome would get screwed up.

81
Q

Which disease usually manifests as a skin rash in a dermatomal pattern on the side of the body? Why?

A

Herpes zoster (shingles). It affects dorsal root ganglia and travels down nerve axons to cause viral infection of the skin in the region of the nerve.

82
Q

What do the intercostal neurovascular bundles do at the angle of each rib?

A

They give off collateral branches that run just above the inferior rib.

83
Q

Describe the divisions of the lungs, including the fissures that divide them.

A

Right lung: Superior lobe is separated from the middle lobe by the horizontal fissure.

The oblique fissure separates the middle lobe from the inferior lobe.

Left lung: The oblique fissure separates the superior and inferior lobes.

84
Q

Can the visceral pleura be removed from the lungs?

A

Nope

85
Q

What is the blood supply to the parietal and visceral pleura of the lungs, respectively?

A

Parietal: Intercostal and musculophrenic arteries.

Visceral: Bronchial arteries

86
Q

Describe the nomenclature of the divisions of the conducting airways.

A

The trachea divides into primary bronchi (aka main stem), which then divide into lobar bronchi, which then divide into segmental divisions.

primary (main stem) –> lobar –> segmental divisions

87
Q

Pulmonary ________ are a common cause of spontaneous pneumothorax in young children and adults. These are weakened out-pouchings in the lung, which can rupture, causing a pneumothorax.

A

blebs

88
Q

What is the difference between a tension and a spontaneous pneumothorax?

A

Tension pneumothorax is caused by trauma to the lung pleura, creating a one-way valve that lets air in during inspiration without a mechanism to get the air out. The lung collapses as more air invades the pleural space.

Spontaneous pneumothorax is not caused by trauma. They are often caused by blebs that pop and let some air into the pleural space.

89
Q

Which muscles are recruited during forced expiration?

A

Anterior abdominal wall muscles to push viscera up under the diaphragm.

90
Q

What is the “bare area?”

A

The area left of the sternum in the 5th intercostal space where a pericardiocentesis can be performed.

91
Q

Pulmonary arteries run _______ lung segments, while pulmonary veins run _______ lung segments.

A

Pulmonary arteries run within lung segments, while pulmonary veins run between lung segments.

92
Q

How do you determine which structures are which (especially bronchi and pulmonary arteries) when looking at a cut section of the root of the lungs?

A

The bronchi are always posterior. On the right lung, the pulmonary artery will be anterior to the bronchi. On the left lung, the pulmonary artery will be superior to the bronchi (and a little anterior, too)

Anatomy Pt. 2 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions