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Anatomy > Thorax 1 + 2 > Flashcards

Thorax 1 + 2 Flashcards

1
Q

Thorax (3)

A
  • superior thoracic aperature -> diaphragm
  • 3 cavities in thorax = R/L pleural + central pericardial cavity
  • heart (perfusion) + lungs (gas exchange)
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2
Q

Thorax Functions (3)

A
  • conduit = structures from head/neck - ab cavity
  • protection (bony structure)
  • respiration (gas exchange)
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3
Q

looking down body (5)

A
  • trachea
  • rib 1
  • VB
  • clavicles
  • manubrium
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4
Q

Inferior Thorax Boundary (3)

A
  • diaphragm -> ribs 11 + 12
  • Anteriorly: xiphoid process of sternum
  • cavity = slanted structure
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5
Q

Superior Thoracic Aperature

A
  • over rib 1, manubrium, T1

- subclavian vein and artery over rib 1

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6
Q

Pectoral region

A
  • Superficial cmpt – mamillary glands

- Deep cmpt – muscles over bony cage

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7
Q

Breast

A
  • sweat gland, w/structural/support suspensory ligaments of cooper (cont w/dermis)
  • axillary process on side - imp for breast exam
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8
Q

Breast perfusion

A
  • axillary art, thoracocaromial process, lateral thoracic artery, internal thoracic artery (TAIL)
  • veins parallel these
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9
Q

Lymph Drainage/Tumor spread

A
  • lateral tumor -> axillary nodes
  • medial tumor -> parasternal node
  • inferior tumor -> subdiapraghmatic nodes
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10
Q

Breast Cancer

A
  • mass puts tension on ligs of cooper = skin pitting/dimpling = Peau d’range
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11
Q

Pectoralis Major

A
  • innervation = medial/lateral pectoral nerves

- function = adduction, medial rotation, flexion of humerus shoulder

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12
Q

Subclavius

A
  • innervation = nerve to subclavius

- fn = Pulls clavicle medially to stabilize sternoclavicular joint

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13
Q

Pectoralis Minor

A
  • innervation = Medial pectoral nerves

- Depresses tip of shoulder; protracts scapula

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14
Q

breastbone

A
  • costacondral junction (expansion to breathe) for ribs + sternum
  • manubrium - articulation for clavicle, rib 1 + 2
  • xiphoid process on bottom
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15
Q

Ribs

A
  • rib 8-12 = false ribs = connect to other costochondral junctions, not sternum
  • 11-12 = floating ribs
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16
Q

Special TV

A 
T1 = small VB, complete face for rib 1 
T10 = single complete facet for rib 10
T11 = no articulation pt on TP due to floating rib
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17
Q

Rib structure

A
  • Int surface = art, vein, nerve (protective mech)
  • rib 1 = short flat rib, 2 circular pits for subclavian art/vein, scalene muscles attach
  • rib 11/12 = bony finger
  • other ribs similar (rib 7 biggest, most curved)
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18
Q

Rib joint to VB

A
  • Joint capsules btwn facets of ribs + VBs
  • Superior costotransverse lig = from TP, supports capsule
  • costotransverse lig + lateral costotransverse lig
  • Ribs held by 3 lig connections
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19
Q

Rib joints

A
  • Rib 6-10 ribs = interchondral + synovial joints in cartilaginous connections
    Rib 1 = fibrocartilaginous joint
    upper 7 ribs = sternocostal synovial joint
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20
Q

External intercostal

A
  • plane (hands in pocket) btwn ribs
  • innervation = intercostal nerves, T1-T11
  • fn = inspiration, moves ribs superiorly
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21
Q

Internal + innermost intercostal

A
  • opposite plane btwn ribs – provides strength
  • innervation = intercostal nerves, T1-T11
  • fn = expiration, moves ribs inferiorly
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22
Q

Subcostals

A
  • span rib/2, connect rib to rib
  • innervation = related intercostal nerves
  • fn = depress ribs
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23
Q

Transversis thoracis

A
  • radiate out from breast bone
  • innvervation = related intercostal nerves
  • fn = depress costal cartilages, exhaling
24
Q

thoracic arterial system

A
  • Aorta = brachiocephalic trunk, common int. carotid, subclavian + anterior/posterior intercostal
25
Q

Subclavian

A

off subclavian = 2 lateral internal thoracic arteries -> bifurcate at rib 7 to terminal musculophrenic and superior epigastric art

26
Q

Anterior + posterior intercostal

A
  • anterior intercostal arts branch off internal thoracic arteries at each rib.
  • Posterior intercostal off aorta -> costal groove -> form anastamotic connection (still bleed when cut) at midaxillary line
27
Q

Azygos Vein

A
  • right side = Ant + post intercostal vein -> azygos vein -> brachiocephalic vein
  • left side = accessory hemiazygos (ribs 1-9) + hemiazygos (ribs 10-12) -> azygos system
  • draining R/L thoracic cages
28
Q

Thorax Lymphatics

A
  • post thorax lymph -> intercostal nodes (in back - infections in back go to these nodes)
  • Anterior -> parasternal nodes
  • all return to braciocephalic nodes -> thoracic duct -> venous system
29
Q

Thorax Wall Inntervation

A

all autonomic
Nipple level = T4
Xiphoid Process = T6
Umbilical/ belly button = T10

30
Q

Intercostal nerve/space

A
  • ventral rami, wrap around
  • over sternum w/ant cutaneous branch
  • space = vein, artery, nerve (VAN)
  • chest tube - decompress pressure, can cause damage
31
Q

Manubriotsternal + xiphisternal joints

A

symphysis

32
Q

Pleural Cavities

A
  • R/L pleural cavity, pericardial cavity

- pericardial in mediastinum

33
Q

Diff Parts of Pleura

A

Costa (ribs) + mediastinal (heart) +

diaphragmatic + cervical pleura = where lungs sit

34
Q

Pleural recess

A
  • space for lung to expand

- space for infection/fluid buildup

35
Q

costodiaphragmatic recess

A
  • space for lungs to go down on inhalation – # 1 location for fluid accumulation
36
Q

Lungs

A
  • Right lung = 3 lobes; left lung = 2 lobes
  • mediastinal to lungs = pul art superior to pul veins
  • Pleural mem – hilum – surrounds lung roof
37
Q

Left Lung

A
  • superior + inferior lobes separated by oblique fissure (rib 6)
  • Cardiac notch = space for heart
  • Lingula – tongue like projection
  • depressions on mediastinal surface
38
Q

Left Lung Vasculature

A
  • aorta + aortic arch

- left subclavian art + braciocephalic vein at lung apex (above superior thoracic aperature, tumor site)

39
Q

Right Lung

A
  • 3 lobes = superior, middle and inferior
  • horizontal fissure (superior from middle at 4th intercostal)
  • oblique (middle from inferior at 5th intercostal space, rib 6)
40
Q

Right Lung Vasculature

A
  • inferior + superior vena cava
  • Azygos system
  • esophagus
  • subclavian art + vein
41
Q

Trachea

A
  • CV 6 -> TV 4, bifurcates to R/L bronchus
42
Q

Bronchi

A
  • R bronchus = more vertical, gets more foreign bodies (least resistance)
  • L bronchus - shallow, longer, for heart
  • main bronchus -> lobar/secondary bronchi (supplies lobes -> segmental/tertiary bronchi (supplies bronchopulmonary segments)
43
Q

Bronchoscopy

A
  • stick scope down pt’s windpipe
  • Carina = bifurcation of trachea
  • 3/2 secondary -> keep branching off and get smaller
44
Q

Bronchopulmonary Segments

A
  • Segmental bronchus
  • Pul art branch
  • Pul venous drainage – pass intersegmentally btwn/around margins of segments
45
Q

Pulmonary Arteries

A
  • Originate from pul trunk (right ventricle)
  • Trunk bifurcates ~ T4-T5 (anterior/inferior to bronchus)
  • Deoxygenated blood
46
Q

Right Pulmonary Artery

A
  • longer than left
  • posterior to ascending aorta, superior vena cava and upper right pulmonary vein
  • anterior to right main bronchus
47
Q

Left Pulmonary Artery

A
  • shorter than right
  • anterior to descending aorta and left main bronchus
  • posterior to superiorpulmonary vein
48
Q

Pulmonary Veins

A
  • each side contain two pulmonary veins
  • Superior + Inferior pulmonary vein
  • Carry oxygenated blood to left atrium
49
Q

Pulmonary Vasculature

A
  • Bronchi + pulmonary arteries pair/branch in unison.

- Pulmonary veins from pul caps, drain toward and course in septa btwn adjacent segments.

50
Q

Bronchial Arteries + Veins

A
  • thoracic aorta -> post surface of bronchus

- Veins drain to pul veins/left atrium + azygos system

51
Q

R/L bronchial artery

A
  • R Bronchial art - from 3rd posterior intercostal artery

- L Bronchial art - from aorta

52
Q

Pulmonary Innervation

A
  • GVA/GVE via anterior and (mainly) post pul plexus
  • Vagus nerve = parasymp – constrict bronchioles
  • Symp (T4) chain = symp – dilate bronchioles
  • pul plexus accompany bronchi + arts in lung.
53
Q

Lymph Drainage

A
  • Lungs drain to tracheobronchial nodes -> bronchomediastinal trunks
  • Right lung + L inferior lung lymph to inferior tracheo-bronchial (carinal nodes), ascend up right side
  • L superior of left lung – goes bronchopulmonary (hilar nodes) and goes up left side
54
Q

Lymph nodes

A
  • Pulmonary = lobar bronchi
  • Bronchopul = hilum of lung (drain from superficial lymphatic plexus)
  • Inf. Tracheobronchial (Carinal nodes)
  • Superior tracheobronchial
  • Tracheal
55
Q

Lung Sounds

A
  • Apex of lung – above clavicle
  • Superior lobe – 3rd intercostal space on either side
  • Right side – middle lobe – 5th intercostal space, close to sternum
  • Inferior lobe – more axillary, 7th intercostal space
56
Q

things you don’t want in pleural space

A
  • Pneumo (air) – from penetrative trauma, pneumothorax
  • Hydro (water) – due to infection
  • Hemo (blood) – infection, intenral trama
57
Q

Thoracocentesis

A
  • withdraw fluid – syringe on superior border of lower rib, needle at upward angle
  • aim for middle 7th intercostal space mid axillary (make sure in thoracic cavity, also go as low as possible because of gravity + fluid.

Anatomy (10 decks)

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