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Human Anatomy MSc Sheffield - trunk and limb > Thorax > Flashcards

Thorax Flashcards

1
Q

Which structure separates the subclavian artery and vein?

A

Scalenus anterior muscle

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2
Q

Where is the mitral valve best auscultated?

A

Over the cardiac apex

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3
Q

What is the blood supply to the superior 1/3rd of the oesophagus?

A

Inferior thyroid artery

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4
Q

What is the blood supply to the middle 2/3rds of the oesophagus?

A

Direct branches from the thoracic aorta

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5
Q

What is the blood supply to the lower 1/3 of the oesophagus?

A

Oesophageal branches off the left gastric artery

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6
Q

What is the level of the sternal angle? (angle of louis)

A

T4, or in line with rib 2

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7
Q

Which ribs are your false ribs?

A

8-12

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8
Q

Which ribs are your floating ribs?

A

11 and 12

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9
Q

Which ribs are your true ribs?

A

1-7

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10
Q

What are the three parts of the sternum?

A

Manubrium, body, xiphoid process

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11
Q

How far above the clavicle does the cervical pleura project?

A

3cm

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12
Q

How low down does the pleura extend to?

A

Mid-clavicular line: rib 8
Mid axillary line: rib 10
Scapular line: rib 12

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13
Q

What are the four parts of the pleura?

A

Diaphragmatic, costal, mediastinal, cervical

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14
Q

What is the costodiaphragmatic recess?

A

The potential space between the lung and the pleura at the most inferior part of the lung

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15
Q

What are the costomediastinal recesses?

A

Potential spaces around the mediastinum

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16
Q

Where is the apex of the heart?

A

5th intercostal space, left mid-clavicular line

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17
Q

Where is the inferior border of the heart?

A

Upper border of the 6th costal cartilage, 1cm laterally from the edge of the sternum to the apex

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18
Q

How many intercostal nerves are there?

A

11

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19
Q

What is the 12th thoracic nerve called?

A

Subcostal nerve

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20
Q

What are the two branches of the intercostal nerves?

A

Lateral and anterior cutaneous branches

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21
Q

What is the action of pectoralis major?

A

Adduction, flexion, extension and internal rotation

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22
Q

What is the innervation to Pectoralis major?

A

Lateral and medial pectoral nerves (C5-T1)

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23
Q

What is the insertion of pec major?

A

Crest of the greater tubercle of the humerus - lateral lip of the intertubercular sulcus

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24
Q

What are the origins of pec major?

A
  • medial half of the clavicle
  • anterior surface of the sternum
  • Costal cartilages of ribs 1-6
  • Anterior layer of the rectus sheath
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25
Q

What are the two heads of pectoralis major?

A

Sternocostal head and clavicular head

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26
Q

What are the borders of the deltopectoral triangle?

A

Clavicle superiorly, lateral border of pec major medically, and medial border of deltoid laterally

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27
Q

What is the clinical significance of the deltopectoral triangle?

A

It contains the cephalic vein, and the deltoid branch of the thoracoacromial artery

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28
Q

What lies within the deltopectoral groove?

A

The cephalic vein

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29
Q

What does the cephalic vein empty into?

A

The axillary vein

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30
Q

Which part of the upper limb does the cephalic vein drain?

A

The radial aspect of the arm, forearm and hand

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31
Q

Which of the pectoral nerves is deeper?

A

The medial pectoral nerve is deeper than the lateral

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32
Q

Where do the medial and lateral pectoral nerves come from?

A

Brachial plexus, they emerge from under the clavicle

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33
Q

What are the attachments of pectoralis minor?

A

Insertion: Coracoid process of the scapula
Origin: ribs 3-5

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34
Q

What is the innervation to pec minor?

A

Medial pectoral nerve

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35
Q

What is the function of pectoralis minor?

A

Protraction of the scapula, stabilization of the scapula

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36
Q

What are the attachments of the subclavius muscle?

A

O: Costal cartilage and sternal end of rib 1
I: Anteroinferior surface of middle 1/3rd of the clavicle

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37
Q

What is the action of the external intercostals?

A

Elevate the ribs during forced inspiration

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38
Q

What is the blood supply the intercostal muscles?

A

Intercostal artery (vein drains and intercostal nerve innervates)

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39
Q

What is the action of the internal and innermost intercostals?

A

Depress ribs during forced expiration

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40
Q

Between which layers of intercostal muscles do the neurovascular bundles lie?

A

Between the internal and innermost intercostals

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41
Q

What are the attachments of serratus anterior?

A

Origin: Ribs 1-9/10
Insertion: Anterior surface of the scapula

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42
Q

What are the attachments of transversus thoracis?

A

O: Inferior surface of the sternum and xiphoid process
I: Internal surface of ribs 2-6

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43
Q

What is the action of transversus thoracis?

A

Depresses ribs during expiration

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44
Q

What is the innervation to transversus thoracis?

A

Intercostal nerves

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45
Q

What is the innervation to serratus anterior?

A

SALT (Serratus anterior, Long thoracic nerve) (C5,6,7 raise your arms to heaven)

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46
Q

What is the action of serratus anterior?

A

Protraction of the scapula

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47
Q

Which artery does the internal thoracic (internal mammary) artery come off?

A

The subclavian artery

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48
Q

Which artery does the superior epigastric artery come off?

A

The internal thoracic artery

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49
Q

Where does the internal thoracic artery run?

A

Deep and lateral to the sternum

50
Q

What do the internal thoracic (internal mammary) veins drain into?

A

The brachiocephalic veins

51
Q

Where does the subclavian artery lie in relation to the brachiocephalic vein?

A

Superior and more deep

52
Q

Where are the parasternal lymph nodes?

A

Either side of the body of the sternum, deep to the intercostal muscles

53
Q

What are the nerve roots of the phrenic nerve?

A

C3,4,5 - Keeps the diaphragm alive

54
Q

Where do the intercostal VAN lie?

A

In the subcostal groove, VAN from superior to inferior.

55
Q

What is the path of the phrenic nerves to the diaphragm?

A

Runs anterior to subclavian artery, anterior to hilum of lung, passes over fibrous pericardium

56
Q

Where do the phrenic nerves pass through the diaphragm?

A

Left: straight through at apex of heart
Right: Through the caval hiatus

57
Q

Which vascular structures run alongside the phrenic nerve?

A

The pericardiophrenic artery and vein

58
Q

What is the pulmonary ligament?

A

A triangular fold of pleura that extends from the hilum of the lung to the mediastinum. A double fold of mediastinal pleura.

59
Q

What is the function of the pulmonary ligament?

A

It allows vascular enlargement of the hilar vessels in times of increased cardiac output

60
Q

How many lobes do the lungs have?

A

Left: 2
Right: 3

61
Q

Where does the oblique fissure lie in relation to the ribs?

A

From rib 5 posteriorly to rib 6 anteriorly

62
Q

Where does the horizonal fissure lie in relation to the ribs?

A

Along the intercostal space below rib 4

63
Q

What is the pathway of the right vagus nerve?

A

Passes between the brachiocephalic vein and brachiocephalic trunk, descends alongside trachea, to oesphagus

64
Q

What branches does the right vagus nerve give off in the thorax?

A

Branches to the cardiac and pulmonary plexus

65
Q

What branch does the left vagus nerve give off in the thorax?

A

Left recurrent laryngeal nerve

66
Q

What is the path of the left recurrent laryngeal nerve?

A

Branches off the vagus at the aortic arch, runs posteriorly under the arch and back up towards the larynx

67
Q

What is the path of the right recurrent laryngeal nerve?

A

It branches off the right vagus at the subclavian artery, loops posteriorly under the subclavian and ascends medially towards the larynx

68
Q

What is the path of the left vagus nerve?

A

Passes between left common carotid and brachiocephalic vein, passes over the aorta giving off the L recurrent laryngeal nerve

69
Q

What impressions are found on the left lung?

A

Cardiac impression, groove for arch of aorta, groove for subclavian artery, oesophagus

70
Q

What impressions are found on the right lung?

A

Groove for azygous vein, groove for SVC, groove for oesophagus, cardiac impression

71
Q

Where do the arteries and veins of the hilum of the lung lie in relation to each other?

A

Veins are usually inferior

72
Q

What are the branches of the bronchial tree?

A

Trachea - lobar bronchi - segmental bronchi - subsegmental bronchi - conducting bronchioles - terminal bronchioles - respiratory bronchioles

73
Q

Which arteries supply the lung tissue with oxygen?

A

The bronchial arteries

74
Q

How many costal facets do the ribs have?

A

One except ribs 2 and 7 which have 2 demi-facets

75
Q

Where is the aortic valve best heard?

A

2nd intercostal space, 1cm R of sternum

76
Q

Where is the pulmonary valve best heard?

A

2nd intercostal space, 1cm L of sternum

77
Q

Where is the Tricuspid valve best heard?

A

5th intercostal space, 1cm L of sternum

78
Q

Where is the mitral valve best heard?

A

5th intercostal space, mid-clavicular line

79
Q

What is the mnemonic to remember the valve placement?

A

All Prostitutes Take Money

80
Q

What does the superior articular process of the vertebrae articulate with?

A

The inferior articular process of the vertebra above

81
Q

What are the parts of the intervertebral disc called?

A

Annulus fibrosus, nucleus pulposus

82
Q

What are the distinguishing characteristics of a cervical vertebra?

A

Small, kidney-bean-shaped body, no costal facets, transverse foramina, bifid spinous process (except C1 and maybe C7)

83
Q

What runs through the transverse foramina?

A

The vertebral arteries

84
Q

Which cervical vertebra has no spinous process?

A

C1 - atlas

85
Q

Which vertebra has an odontoid peg?

A

C2 - axis

86
Q

What are the distinguishing characteristics of a thoracic vertebra?

A

Demi-facets (costal facets) for rib articulation, long posteriorly facing spinous processes, circular vertebral foramen

87
Q

What are the distinguishing characteristics of the lumbar vertebrae?

A

Large, triangular vertebral foramen, short stumpy spinous process

88
Q

How many vertebrae are in the sacrum?

A

5

89
Q

How many vertebrae are in the coccyx?

A

4

90
Q

Where do the bronchial arteries come from?

A

Direct branches from the thoracic aorta

91
Q

What are the branches that come off the internal thoracic artery?

A

Pericardiophrenic, anterior intercostals, superior epigastric, musculophrenic, phrenic

92
Q

What are the four main groups of branches that come off the thoracic aorta?

A

Pericardial, eosophageal, bronchial, posterior intercostal

93
Q

At what vertebral level is the carina?

A

T4

94
Q

Which bronchus is more vertically disposed?

A

The right

95
Q

Where does the azygous vein drain into?

A

SVC, around T4

96
Q

Where do the oesophagus, and trachea lie in relation to each other?

A

Oesophagus is most posterior and to the left, the trachea lies anteriorly to the oesophagus

97
Q

Where do the para-sternal lymph-nodes drain into?

A

The thoracic duct

98
Q

What is the cisterna chyli?

A

A dilated sac at the lower end of the thoracic duct that collects lymph from the abdomen and lower limbs

99
Q

Where does the thoracic duct lie?

A

To the left of the oesophagus

100
Q

Where do the azygous and hemi-azygous veins run?

A

Azygous runs along the right of the vertebral body, the hemi-azygous runs along the left

101
Q

What is the accessory hemi-azygous vein?

A

A vein that runs superior to the hemi-azygous vein and drains into the azygous vein

102
Q

What goes through the three main diaphragmatic hiati?

A

T8: Vena Cava + phrenic
T10: Oesophagus + vagus + gastric arteries
T12: Aorta + thoracic duct + azygous vein

103
Q

The sympathetic trunk comes from which spinal levels?

A

T1-L2

104
Q

Which ganglia contribute to the greater splanchnic nerve?

A

5-9

105
Q

Which ganglia contribute to the lesser splanchnic nerve?

A

10-11

106
Q

Which ganglia contribute to the least splanchnic nerve?

A

12

107
Q

What does the greater splanchnic nerve innervate?

A

Foregut

108
Q

What does the lesser splanchnic nerve innervate?

A

Midgut

109
Q

What does the least splanchnic nerve innervate?

A

Kidneys

110
Q

Which muscles are involved in forced expiration?

A

Transversus thoracis, internal + innermost intercostals, serratus posterior inferior, diaphragm, external obliques, rectus abdominis, transversus abdominis

111
Q

Which muscles are involved in forced inspiration?

A

Sternocleidomastoid, scalenes, serratus posterior superior, pec minor, erector spinae, external intercostals

112
Q

What is the epithelium of the trachea?

A

Psuedostratified ciliated columnar

113
Q

How many bronchial arteries are there?

A

3 per lung, directly from thoracic aorta

114
Q

Which nerve innervates sternocleidomastoid?

A

Accessory nerve

115
Q

Which nerves roots form the pulmonary plexus?

A

T2-T5

116
Q

What are the boundaries of the visceral pleura on rib levels?

A

Midclavicular line = 6th rib
Midaxillary line =8th rib
Scapular line = 10th rib

117
Q

Where are the positions of the pulmonary arteries in relation to the bronchii?

A

RALS
Right artery is anterior to bronchus
Left artery is superior to bronchus

118
Q

What is the function of the papillary muscles?

A

To prevent prolapse of the atrioventricular valves. They open and close passively due to changes in pressure

119
Q

Where do the posterior intercostal arteries come from?

A

Direct branches of thoracic aorta and subclavian artery (for some of the superior intercostal arteries)

120
Q

What structures empty into the SVC?

A

Left and right brachiocephalic veins and azygous vein

121
Q

Lymph from the right upper quadrant of the body drains into venous circulation via what?

A

The right lymphatic duct

122
Q

What structure is found posterior to the right main bronchus?

A

The azygous vein

Human Anatomy MSc Sheffield - trunk and limb (13 decks)

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