Thoracic Wall, Lungs, and Mid Mediastinum Flashcards
what subdivides the MS between T4-5
sternal angle
anterior closure of thor cavity via diaphragm
rib 6-7
post closure of thor cavity via diaphragm
rib 12
sternum
- manubrium has clavicular notch for sternoclavicular jt
- body joins manu. at sternal angle
- xiphoid process is lowest part
ribs
- 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
breasts
- 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
what is the attachment btwn UL and ant chest
pectoral region
pec major: clavicular and sternocostal heads
pec minor: in clavipectoral fascia
ant thor wall
-int thor vessels (brs of subclavian)
-ant IC vessels and nn (br from int thor)
3 sets of intercostal mm
what does post IC vessels arise from
aorta
IC mm
- external
- internal
- inner most (deep surface)
*transversus thoracis: fan shaped coming from sternum
IC v, a, n
v=sup, a=mid, n=inf
in costal groove along inf border of rib
collateral n, a, v
n=sup, a=mid, v=inf
pleura
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
pleural cavities
- 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
lungs
R: 3 lobes (upper, middle, lower)
L: 2 lobes (upper, lower)
oblique fissure (R and L), horiz fissure (R only)
root of lungs
- connects lungs to MS
- covered in sleeve of pleura-inferiorly=pulmonary ligament
- bronchi and pulm vessels
Bronchi
- 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
symp tr
paravert, contribute to ant and post pulm plexuses, dilates bronchioles
vagus n
post to root of lung, contribute to ant and post pulm plexuses, constrict bronchioles
R lung neurovasc
- phrenic n
- vagus n
- pericardiacophrenic vess: run w/ phrenic n, brs of int thor aa and brachiocephalic vv
L lung neurovasc
- vagus n
- phrenic n: close to pericardial sac
- pericardiacophrenic vess
bronchial aa
nutrients to bronchi and lungs
lymph vessels and nodes
drain lymph from lungs via tracheobronchial nodes and R/L bronchomediastinal trs
middle MS
- pericardium and heart
- phrenic n applied to pericardium
- pericardiacophrenic vess
- roots of great vess to and from heart
pericardium
- tough fibrous sac lined with serious mem
- encloses heart and pierced by roots of 8 vess (SCV, IVC, aorta, pulm tr, 4 pulm vv)
pericardial sac
complete inner pericardial mem (parietal and visceral)
pericardial cavity
inside sac, potential space, contains small amt of serous fluid
pericardial effusion
- accumulation of excess fluid in cavity
- compresses heart
- in conjunction with CHF
- hemopericardium: blood in cavity, after trauma or MI, causes cardiac tamponade
