Thoracic Wall, Lungs, and Mid Mediastinum

Question 1

what subdivides the MS between T4-5

Answer 1

sternal angle

Question 2

anterior closure of thor cavity via diaphragm

Answer 2

rib 6-7

Question 3

post closure of thor cavity via diaphragm

Answer 3

rib 12

Question 4

sternum

Answer 4

• manubrium has clavicular notch for sternoclavicular jt
• body joins manu. at sternal angle
• xiphoid process is lowest part

Question 5

ribs

Answer 5

• head articulates with 2 vert bodies and 1 disc
• tubercle art w/ transvese process of 1 vert
• costal roove formed by IC v, a, n

Question 6

breasts

Answer 6

• superficial (uniloclar adipose)
• secretory glands and superficial fascia
• int thor a and v (2-4 IC space)
• lymphatics drain to parasternal and axillary nodes
• lat and ant nn of 4th-6th IC nn carry cutaneous inn

Question 7

what is the attachment btwn UL and ant chest

Answer 7

pectoral region
pec major: clavicular and sternocostal heads
pec minor: in clavipectoral fascia

Question 8

ant thor wall

Answer 8

-int thor vessels (brs of subclavian)
-ant IC vessels and nn (br from int thor)
3 sets of intercostal mm

Question 9

what does post IC vessels arise from

Answer 9

aorta

Question 10

IC mm

Answer 10

1. external
2. internal
3. inner most (deep surface)

*transversus thoracis: fan shaped coming from sternum

Question 11

IC v, a, n

Answer 11

v=sup, a=mid, n=inf

in costal groove along inf border of rib

Question 12

collateral n, a, v

Answer 12

n=sup, a=mid, v=inf

Question 13

pleura

Answer 13

portion of thor cavity containing lungs

• serous secreting mem that reduce friction
• parietal layer: covers thor walls, very sensitie
• visceral layer: covers lungs, not sensitive

*both layers continuous at root of lung

Question 14

pleural cavities

Answer 14

• potential space btwn pleural layers, can become actual
• effusion: filled with fluid, can compress lung
• pneumothorax: accumulation of air, lung collapse
• hemothorax: accumulation of blood, can cause adhesion/inf
• pleurisy: inflam pf pleura, leads to adhesions, much pain
• thoracentesis: pleural tap to aspirate fluid, IC space 6 or 7

Question 15

lungs

Answer 15

R: 3 lobes (upper, middle, lower)
L: 2 lobes (upper, lower)
oblique fissure (R and L), horiz fissure (R only)

Question 16

root of lungs

Answer 16

• connects lungs to MS
• covered in sleeve of pleura-inferiorly=pulmonary ligament
• bronchi and pulm vessels

Question 17

Bronchi

Answer 17

• tracheal splits into primary bronchi
• primary bronchi: splits into 2/3 secondary bronchi
• secondary bronchi: splits into 8/10 tertiary bronchi, supplied by single br of pulm a, smallest functionally independent region

Question 18

symp tr

Answer 18

paravert, contribute to ant and post pulm plexuses, dilates bronchioles

Question 19

vagus n

Answer 19

post to root of lung, contribute to ant and post pulm plexuses, constrict bronchioles

Question 20

R lung neurovasc

Answer 20

• phrenic n
• vagus n
• pericardiacophrenic vess: run w/ phrenic n, brs of int thor aa and brachiocephalic vv

Question 21

L lung neurovasc

Answer 21

• vagus n
• phrenic n: close to pericardial sac
• pericardiacophrenic vess

Question 22

bronchial aa

Answer 22

nutrients to bronchi and lungs

Question 23

lymph vessels and nodes

Answer 23

drain lymph from lungs via tracheobronchial nodes and R/L bronchomediastinal trs

Question 24

middle MS

Answer 24

• pericardium and heart
• phrenic n applied to pericardium
• pericardiacophrenic vess
• roots of great vess to and from heart

Question 25

pericardium

Answer 25

• tough fibrous sac lined with serious mem

- encloses heart and pierced by roots of 8 vess (SCV, IVC, aorta, pulm tr, 4 pulm vv)

Question 26

pericardial sac

Answer 26

complete inner pericardial mem (parietal and visceral)

Question 27

pericardial cavity

Answer 27

inside sac, potential space, contains small amt of serous fluid

Question 28

pericardial effusion

Answer 28

• accumulation of excess fluid in cavity
• compresses heart
• in conjunction with CHF
• hemopericardium: blood in cavity, after trauma or MI, causes cardiac tamponade