Thoracic wall, lungs & middle mediastinum Flashcards

1
Q

what encloses the thoracic cavity

A

Thoracic wall and diaphram

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2
Q

compartments of the thoracic cavity

A

Left and Right Pleural cavities

Mediastinum

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3
Q

what bounds the inferior thoracic apperature

A

xiphoid process
costal cartilage
T12
12th ribds

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4
Q

what bounds the thoracic inlet

A

Manubrium of the sternum
Rib 1
T1

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5
Q

where is the sternal angle

A

At the articulation point of the manubrium of the sternum and the body of the sternum

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6
Q

vertebral level of sternal angle

A

T4-T5

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7
Q

land marks of the sternal angle

A

Bifurcation of the trachea
arch of the aorta
articulation of rib 2

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8
Q

Posterior thoracic wall

A

Thoracic vertebrae

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9
Q

Lateral thoracic wall

A

Ribs and Intercostal mm

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10
Q

Anterior thoracic wall

A

Sternum (manubrium, body, xiphoid process)

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11
Q

part of the manubrium for the sternoclavicular joint

A

Clavicular notch

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12
Q

where does the body of the sternum meet the manubrium

A

Sternal angle

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13
Q

the lowest point of the sternum

A

Xiphoid process

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14
Q

WHat does the head of the rib articulate with

A

2 vertebral bodies and 1 disc

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15
Q

what does the Tubercle of the rib articulate with

A

the transverse process

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16
Q

what large portionof the rib

A

The body

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17
Q

The region of greatest curve on the body of a rib

A

Angle

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18
Q

What forms the costal groove

A

Formed by intercostal V, A, and N

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19
Q

where is the pectoral region

A

External to anterior thoracic wall

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20
Q

roll of the pectoral region

A

anchors upper limb to the trunk

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21
Q

what is the superficial compartment of the pectoral region contain

A

Skin, supericial fascia and boob

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22
Q

what does the deep comparment of the pectoral region contain

A

Muscles and associated strucutres

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23
Q

Development of boobs in men in women

A

Well developed in women

Rudimentary in men

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24
Q

what does the breast consist of

A

Secretory glands in fatty matrix

Overlying skin and superficial fascia

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25
Q

What supplies blood too the lateral breast

A

Vessels from axillary A (superior thoracic, thoracoacromial, lateral thoracic, subscapular)

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26
Q

what supplies blood to the medial breast

A

Branches from internal thoracic A

Branches from 2-4th intercostal aa

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27
Q

Lymphatics of breast drain to

A

Parasternal nodes

Axillary nodes

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28
Q

what does Curaneous innervates the breast

A

Lateral and anterior branches of 2nd to 6th intercostal nn

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29
Q

Muscles of the pectoral region

A

Pec major and minor

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30
Q

what are the heads of the pec major

A

Clavicular and sternocostal heads

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31
Q

What envelops the pec minor

A

Clavipectoral fascia

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32
Q

what are the intercostal

(span 1 rib) muscles

A

External
Internal
Innermost

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33
Q

what muscles span 2 ribs

A

Subcostal

transversus thoracis

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34
Q

direction of external intercostals

A

Run down and towards the midline

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35
Q

direction of internal intercostals

A

Run down and to the lateral

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36
Q

direction of innermost intercostals

A

Run down and to the lateral

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37
Q

how do artiers, vein and nerves arange themselves in the intercostal

A

Below the rib going down: V, A, N

Above the rib going up: V, A, N

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38
Q

where are intercostal V,A,N

A

Between the internal and innermost intercostal muscles

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39
Q

where do anterior intercostal arteries come of

A

Internal thoracic artery (run on the side of the sternal

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40
Q

where do posterior intercostal arteries come off

A

The thoracic aorta

top two arties come off the supreme intercostal artery

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41
Q

anterior intercostal veins drain to

A

Anterior thoracic Vein

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42
Q

posterior intercostal veins drain to

A

azygos vein

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43
Q

LEft superior intercostal vein drains into

A

Left brachiocephalic vein

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44
Q

Right superior intercostal vein drains into

A

azygous veins

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45
Q

where do the intercostal V, A, N day

A

Lie in the costal groove

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46
Q

where is the costal groove

A

Inferior margin of the rib

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47
Q

Collaterial intervostal a, v, and , run what direction superior to inferior

A

N, A, V

48
Q

what do Colateral n, a, v arise from

A

Intercostal n and vessels

49
Q

where are collateral nerve artery and vein

A

SUperior margin of the below rib

50
Q

where are the plueral cavities

A

On either side of the medisitunum

51
Q

what is found between the visceral and serous pleura

A

Potential space

52
Q

does the pleura cavity contain the lungs

A

NO

53
Q

what is the pleura

A

A serous secreting membrane to reduce friction

54
Q

what does the parietal pleura cover

A

The thoracic walls

55
Q

sensitivity of the parietal pleual

A

Very sensitive to pain

56
Q

innervation of the parietal pleura

A

Intercostal and phrenic nn

57
Q

what does the Visceral pleura conver

A

The lungs

58
Q

Sensitivity of the visceral pleura

A

Not sensitive (no sensory nerves)

59
Q

where are the parietal and visceral pleura continous

A

At the root of the lung

60
Q

Pathological accumulation of excess fluid within the pleural space

A

Pleural effusion

61
Q

What does A pleural effusion do

A

May compress lungs

Difficulty in breathing

62
Q

where can you see a pleural effusion

A

Visible on chest films that can obscure the lung

63
Q

An accumulation of air in the pleural cavity

A

Pneumothorax

64
Q

what does Pneumothorax lead to

A

Collapse of the lung due to its own elasticity

65
Q

Accumulation of blood in the pleural cavity

A

Hemothorax

66
Q

what can hemothorax do if blood is not removed

A

Adhesion and infection if not removed

67
Q

Inflammation of the pleura

A

Pleurisy

68
Q

what does Pleurisy lead to

A

Formation of adhesion between parietal and visceral pleura

Exquisite pain relative to pareital pleura

69
Q

aspiration of fluids from the pleural space

A

Pleural tap (thoracentesis)

70
Q

where is the pleural tap done

A

Midaxxillary line or slightly posterior

Between Intercostal space 6 or 7

71
Q

why not insert needle between 8 or 9 Intercostal space for pleural tap

A

Can pierce the diaphram, liver or spleen

72
Q

how is the needle for the pleural tap

A

Avoiding intercostal n and vessels

73
Q

Lobes of the right lung

A

Upper (superior)
Middle
Lower (inferior)

74
Q

Lobes of the left lung

A

Upper (superior)

Lower (inferior)

75
Q

what are the fissures of the lungs

A

Oblique (major) fissue on both lungs

Horizontal (minor )fissure on the right lung

76
Q

Impressions on the Right lung

A

Esophagus
Superior and inferior vena cava
azygus vein above the hilum

77
Q

Impressions of the left lung

A

Heart
thoracic aorta
Arch of aorta over hilum

78
Q

Grooves on the lungs

A

Costal grooves

Verteberal grooves

79
Q

What is the short tubular collection of structures that connect the lung to the mediastinum

A

The root of the lung

80
Q

what does the root of the lung consist of

A

Bronchi and Pulmonary vessels

81
Q

what covers the root of the lung

A

Sleeve of the pleura

82
Q

what does the root of the lung plura extend down as

A

The pulmonary ligament

83
Q

The inferior fold of pleura

A

Pulmonary ligament

84
Q

what is in the pulmonary ligament

A

Mostly empty and collapsed with a few lymph vessels

85
Q

what are the strucutres going in and out of the lung

A

Bronchi- thick walls (white and shiny)
Pulmonary artery on top (thicker walls)
Pulmonary vein on the bottom (thinner walls)

86
Q

Remeber the pulmonary artery to the bronchi

A

RA LS
R-Right (pulmonary A) A- anterior to bronchi
L- Left (pulmonary A) S-superior to bronchi

87
Q

what does the trachea split into

A

2 primary (main) bronchi

88
Q

what does the primary (main bronchi split into

A

Secondary (lobar) bronchi

89
Q

number of Secondary (lobar) bronchi

A

3 in the right

2 in the left

90
Q

what do Secondary (lobar) bronchi split into

A

Ttertiary (segmental) bronchi

91
Q

Number of Tertiary (segmental) bronchi

A

8-10

92
Q

area of the lung supplied by a segment of bronchus and a single brnach of pulmonary artery

A

Bronchopulmonary segment

93
Q

what is the smallest functionally independent region of the lung

A

Bronchopulmonary segment

94
Q

where are the sympathetic trunks

A

Paravertebral

95
Q

what do the sympathetic trunks contribute to at the root of the lung

A

Anterior and posterior pulmonary plexuses

96
Q

Roll of the sympathetic trunks on the airways

A

Dilates bronchioles

97
Q

where does the vagus n travel

A

Posterior to the roots of lungs and closelt applied to the trachea, esophagus, and aorta

98
Q

what does the vagus nn contibute to near the lungs

A

ANterior and posterior pulmonary plexues

99
Q

Roll of the vagus nn on the bronchioles

A

Constricts

100
Q

what nerve passes posterior to the root of the lung

A

The Vagus

101
Q

What nerve passes anterior to the roots of the lungs

A

Phrenic nn

102
Q

what does the Phrenic nn adhere closely to

A

Pericardial sac

103
Q

what do pericardiocophren vessels run with

A

phrenic nn

104
Q

what do pericardiacophrenic vessels branch off of

A

Internal thoracic aa, and brachiocephalic vv

105
Q

what arteries supplies nutrients to bronchi and lungs

A

Bronchial aa

106
Q

what does the bronchial aa brnach from

A

Thoracic aorta or associated branch

107
Q

how is lymph drainsed from the lungs

A

TRacheobronchial node to r/l bronchomediastinal trunks

108
Q

regions of the mediastinum

A
superior (above sternal angle)
inferior (below sternal angle)
 -anterior
 -middle
 -posterior
109
Q

where does mediastinum run from

A

Thoracic inlet to the diaphram

from sternum to bondies of thoracic vertebrae (down to T12)

110
Q

what does the middle mediastinum contain

A

Pericardium and heart
Phrenic nn applied to pericardium
Pericardiacophrenic vessel
Roots of great vessels to and from heart

111
Q

what is the pericardium

A

Tough fibrous sac lined with serous membrane

112
Q

what is the fibroud portion of the pericardium

A

Tough connective tissue outer layer

113
Q

Where does the fibrous portion of the pericardium attach inferiorly

A

Diaphram

114
Q

layers of the serous portion of he pericardium

A

Parietal

Visceral layers

115
Q

What does the Pericardium enclose

A
Heart
SCV
IVC
Aorta 
Pulmonary trunk
4 pulmonary v