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Anatomy > Thorax > Flashcards

Thorax Flashcards

1
Q

Label the different parts of the chest wall

A
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2
Q

Label the different planes of the chest wall

A
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3
Q

Label the ICM, the pleura and the neurovascular bundle ; where is the neurovascular bundle found?

A

Visceral pleura covers the lungs
Parietal pleura lines the pulmonary cavities ; neurovascular bundle is found between the internal and innermost ICM

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4
Q

What is the superior thoracic aperture

A

Opening of thorax to allo structures to enter and leave the thorax

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5
Q

What is the inferior thoracic aperture

A

Opening at lower part of thoracic cavity (closed by diaphragm)

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6
Q

What is thoracic outlet syndrome ?

A

When important arteries and nerves that are found in the thoracic outlet (space between collarbone and first rib) are compressed e.g by tumours, due to car crash

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7
Q

Ribs 8,9 and 10 and known as

A

False ribs because they do not articulate with the sternum they attach to the 7th ribs cartilage

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8
Q

The first 7 ribs are known as

A

True ribs as they attach separately to the sternum

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9
Q

Describe and label the first rib

A

Shorter and wider
Only 1 facet on head (as there is no thoracic vertebrae above)
Superior surface has 2 grooves which make way for the subclavian vessels
Scalene tubercule permits attachment of the anterior scalene muscle (accessory muscles of respiration)

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10
Q

Describe the structure of the 8th rib

A

8th rib is a typical rib
Head has 2 facets ; one articulates with corresponding vertebrae, the other articulates with the one above
Near head is a tubercule which also articulates with corresponding vertebrae
Body has a groove for the neurovascular bundle
The other end of the rib terminates in bony cartilage that connects to the sternum

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11
Q

Describe the attachmnets, actions and nerve supple of the pectoralis major

A

Attachments =
clavicular head attaches from medial half of clavicle ;
sternocostal head attaches from the sternum and upper 6 costal cartilages ;
All fibres converge on the interubercular groove of humerus

Actions:
Allow adduction and medial rotation of arm at shoulder joint

Nerve supply :
Medial and lateral pectoral nerves ( C5-8, T1)

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12
Q

Describe the attachmnets, actions and nerve supple of the pectoralis minor

A

Attachments:
Coracoid process of scapula; ribs 3-5 near their cartilages

Actions:
Stabilises the scapula by drawing it anteroinferiorly against the thoracic wall. Nerve supply : medial pectoral nerve (C8-T1)

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13
Q

What is the mediastinum
What are the boundaries of the mediastinum

A

It is the central part of the thoracic cavity that lies between the pleural cavities
Anteriorly the sternum
Posteriorly the thoracic vertebral column
Superiorly the superior thoracic aperture
Inferiorly the diaphragm

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14
Q

Describe how inspiration/expiration occurs

A

Diaphragm contracts and flattens = increases thoracic vol = lower intrathoracic pressure = air moves in

Diaphragm relaxes = lungs recoil = lower thoracic vol = increased intrathoracic pressure = air moves out

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15
Q

Describe the attachments, actions and nerve supply of the Diaphragm

A

Attachments - cc7-10, lumbar vertebrae, xiphoid process

Nerve supply = Innervated by phrenic nerve

Actions : inspiration and expiration

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16
Q

Where is the phrenic nerve located and what is its role

A

The primary motor supply to the diaphragm, the major respiratory muscle
Originates from C3-5 and passes down through the chest and the heart/lungs to reach the diaphragm

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17
Q

Describe the arrangement of the ICM

A

Assists in respiration
Obliquely angled
External ICM arranged this way : \
Internal ICM arranged this way : /

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18
Q

Describe the movement of the ribs and sternum during respiration

A

Ribs rotate around the vertebrae
Sternum moves up and down like a pump handle

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19
Q

Describe the differences between breathing in adults and children

A

Newborn ribs more horizontal and weak ICM
Abdominal breathing used ; reliance on diaphragm so higher risk of respiratory failure

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20
Q

What is a main sign of respiratory distress

A

Use of accessory muscles while at rest

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21
Q

Symptoms of respiratory distress

A

Blue coloured lips
Rapid and shallow breathing
Rapid HR

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22
Q

What is NRDS

A

Neonatal respiratory distress syndrome
Can affect premature babies typically

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23
Q

What is pneumothorax

A

Non-tension = hole in parietal pleura but no flap ; air enters pleural cavity = lung collapse
Tensions =Hole in parietal pleura, flap formed ; surface tension lost = air continuously enters lungs with every breath = lung compresses heart and the other lung

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24
Q

Describe emphysema

A

Over-inflated alveoli - lungs less able to recoil
Prolonged deep breaths lead to rounded back

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25
Q

The neurovascular bundle is found in the

A

Intercostal groove

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26
Q

Desribe the function and label the mammary gland

A

The breast is a modified sebaceous gland with lobes that comprise of glands and adipose tissue separated by suspensory ligaments

It is separated from the deeper pectoral muscle by a retromammary space

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27
Q

Label the structure of a thoracic vertebrae

A

1=transverse process (where tubercule attaches)
2=vertebral body
3=Vertebral foramen
4=Spinous process
5=Lamina
6=Pedicel
7=Superior articular facet (articulation of head of rib)

28
Q

How do you calculate the pulmonary ventilation rotate

A

Respiration rate (per min) x TV

29
Q

Describe the 3 different pericardia

A

The outer layers of the heart :

Fibrous pericardium is tough and not stretchy ; holds the heart in place and protects it ; attached to diaphragm by pericardiophrenic ligaments ; also attaches to sternum and vertebral columnl; overlaps with the adventitia of the biggest vessels

Serous pericardium ; made up of the visceral layer (called epicardium) and parietal layer (lining the fibrous pericardium) ; visceral layer has fat for shock absorption and contains the coronary arteries

the pericardial cavity is found between these two layers ; it contains pericardial fluid and allows expansion of the heart

30
Q

What are the borders of the heart markings

A

Remeber 2,3,5,6

Superior border from Left costal cartilage 2 to right costal cartilage 3

Right from R cc3 to R cc6

Inferior from R cc6 to left intercostal space 5

Left from L ics5 to L cc2

31
Q

Where are the valve auscultation sites

A

Auscultation sites : downstream of valve positions
P : L ics2 near sternal edge
A : R ics2 near sternal edge
M : L ics5 at midclavicular line
t : l ics5/6 neat lower sternal edge

32
Q

What are the locations of the outline of the lungs (surface anatomy of visceral pleura)

A

2- lungs closest to each other at cc 2
4 - left lung indents due to cardiac notch here
6 - right lung continues parasternally from rib 2 to rib 6 ; both lungs cross the 6th rib at midclavicular line
8 - visceral pleura then cross rib 8 at mid axillary line
10 - cross rib 10 at scapular line

33
Q

Surface anatomy of parietal pleura

A

2- left and right parts close together at rib 2
4 - parallel down to rib 4 the left indents
6 - right continues to cc 6
8 - crosses at midclavicular line of rib 8
10 - crosses at mid axillary line of rib 10
12 - crosses rib 12 at lateral border of erector spinae muscle

34
Q

Where are the 3 lobes of the right lung found

A

Superior , middle and inferior
Oblique fissure from T2 to rib 6
Horizontal tissue from rib 4 to oblique fissure

35
Q

Where are the lobes of the left lung found

A

2 lobes superior and inferrior
Oblique fissure from T2 to rib 6

36
Q

Function/structure of larynx and pharynx

A

Pharynx

  • ring-like muscular tube
  • located behind the nose and mouth and connects the oral cavity and nose to the trachea and oesophagus

Larynx

  • structure that covers the trachea
  • involved in speech, cough reflex and protecting the lower respiratory tract (via the epiglottis)
  • Consists of a cartilaginous skeleton, which is held together by ligaments and membranes 9 cartilages
  • 3 unpaired (epiglottis, thyroid and cricoid)
  • 3 paired (Arytenoid, Corniculate And Cuneiform )
37
Q

label where the 4 paranasal air sinuses are found

A
38
Q

State where each sinus drains into

A
39
Q

What is the adventitia

A

the outermost layer of a blood vessel and contains connective tissue, nerves, and the smaller vessels that supply the vessel wall with oxygen and nutrients

40
Q

State the 4 surface of the heart

A

Anterior/sternocostal : mostly of the right (with a bit of the left) ventricle

Inferior or diaphragmatic ; mostly the the left (with a bit of the right ventricle )

Posterior or base (mostly left atrium no pulmonary vein)

41
Q

Describe the 4 surfaces of the lungs

A

Mediastinal : flat contains the hilum and pulmonary ligament

Diaphragmantic : concave and faces domes of diaphragm

Costal is convex and faces the ribs

Cervical extend into the neck ; includes apex of lung

42
Q

State the function of the parietal and visceral pleura
State how each of them are supplied

A

They are both serous membranes ; this means the two layers are separated by a serous liquid which ensures they stick together via surface tension

Parietal line the thoracic cavity ; supplied by intercostal and phrenic nerves (so pain sensitive )

Visceral pleura covers the lungs and follow the fissures ; supplied by autonomic nerves

The two layers join at the hilum of each lung

43
Q

The right bronchus is wider and more vertical ; state the implications of this

A

Higher incidence of foreign body inhalation in right bronchus

44
Q

What are the 2 pleural recesses
Explain their clinical importance

A

There are places in the pleural cavity that are not filled by the lungs ; these are called the recesses ; opposing surfaces of the parietal pleura touch here

Costodiaphragmatic

Costomediastinal

These recesses are of clinical importance as fluid can collect here e.g. during pleural effusion

45
Q

Label the upper respiratory tract

A
46
Q

How are structures arranged at the hilum of the lung?

A

Bronchi – posterior/ central

Pulmonary artery – superior

Pulmonary veins – inferior/anterior

47
Q

What is a bronchopulmonary segment?

why are they clinically relevant?

A

Each segment functions independently and is supplied by its own tertiary bronchus (or segmental bronchus) artery, lymph vessels, and autonomic nerves

if one segment is infected or damaged, others in the same lobe may not be affected

48
Q

clinical use of cricoid cartilage

A

only complete circle of cartilage in the larynx or trachea.

during emergency intubation – pressure applied to the cricoid to obstruct the oesophagus, and prevent vomiting

(known as cricoid pressure or Sellick’s manoeuvre).

49
Q

lymphatic drainage of lungs

A

2 networks

subpleural network collects lymph from peripheral lung tissue and drains into hilum

deeper lymphatic system within bronchioles ; R lymphatic duct collects lymph from R thorax and drains into the R subclavian vein; Thoracic duct collects lymph from the L thorax and drains into the L subclavian vein

50
Q

Lung auscultation sites

A
51
Q

What do the azygous veins supply ?

A

transports deoxygenated blood from the posterior walls of the thorax and abdomen into the superior vena cava vein

52
Q

What do the thoracid splanchnic nerves do ?

A

thoracic splanchnic nerves are a set of sympathetic nerves that contribute to autonomic supply to the abdomen and pelvis.

53
Q

Function of thoracic duct?

A

the main lymphatic vessel for the return of lymph to the systemic venous system

It drains lymph from both lower limbs, abdomen, left side of thorax, left upper limb and left side of face and neck.

54
Q

what are the right and left venous angles ?

A

is the junction where the internal jugular and subclavian veins at each side of the neck merge to form the corresponding brachiocephalic vein.

The left venous angle receives lymph from the thoracic duct

The right venous angle receives lymph from the right lymphatic trunk

55
Q

where is the right lymphatic duct located?

A

The right lymphatic duct drains the right thorax, upper limb, head and neck

found near the base of the neck

56
Q

Openings of the diaphragm ; what vertebral level do the aorta, oesophagus and superior vena cava pass through the diaphragm?

A

aorta at T12 with the azygous vein

oesophagus - T10

superior vena cava - T8

57
Q

what does the head of the 7th rib articulate with ? a) The inferior articular demifacet of T6 and superior articular demifacet of T7

b) The inferior articular demifacet of T7 and superior articular demifacet of T8
c) The inferior articular demifacet of T7 and superior articular demifacet of T6
d) The superior and inferior demifacets of T7

A

a

58
Q

origin of internal thoracic artery ?

A

subclavian artery

59
Q

which 3 bones for the roof of the nasal cavity?

A

ethmoid, frontal and sphenoid

60
Q

At what level does the trachea bifurcate?

A

T4/6

61
Q

which 3 structures are often observed leaving impressions on a fixed cadaveric right lung?

A

arch of azygous vein, oesophagus, SVC

62
Q

the vagus nerve is also referred to as which cranial nerve? also which structures does it supply?

A

CN X ; the vagus nerve supplies the oesophagus, heart, lungs, bronchi and aorta only in the thorax

63
Q

A thoracic vertebra:

A)Always has one or more facets for the articulation of ribs on its body.

B)Has a vertebral canal which is bounded posteriorly in part by the pedicles.

C)Articulates with its neighbours by both synovial and secondary cartilaginous joints.

D)Will have the 8th cervical nerve as a superior relation if it is the 1st thoracic vertebra.

E)Has a neural arch lined on its internal surface by dura mater.

answer true or false for each statement

A

A thoracic vertebra:

T Always has one or more facets for the articulation of ribs on its body. The easiest way to initially identify vertebrae is to use qualitative features. Thus if a rib facet is present on the body it is thoracic; if it has a foramen transversarium it is cervical; if it has neither of these it is either lumbar or sacral - and the sacrum is obvious! Use quantitative features, such as the angle of the spine or shape of the body, as a backup. They are difficult to judge in junctional regions.

F Has a vertebral canal which is bounded posteriorly in part by the pedicles. Substitute ‘laminae’ for ‘pedicles’! The neural arch, which sits on the vertebral body, is divided into pedicles and laminae by the attachments of the transverse and spinous processes. The pedicles (L ‘little feet’) are those parts of the arch between the body and the transverse processes; the laminae lie posteriorly, between the transverse and spinous processes.

T Articulates with its neighbours by both synovial and secondary cartilaginous joints. The intervertebral disc is a secondary cartilaginous joint and the facetal joints are synovial. The mechanisms of movement are quite different. Synovial joints rely on sliding surfaces and so can ‘wear away’ - osteoarthritis; intervertebral discs are deformed by movement and so can ‘fatigue’ and rupture - a ‘slipped disc’.

T Will have the 8th cervical nerve as a superior relation if it is the 1st thoracic vertebra. That’s right. Yes, I agree, it is pretty basic. The ‘problem’ is that there are 8 cervical nerves but only 7 cervical vertebrae. Thus cervical nerves 1 to 7 emerge superior to the vertebrae of the same number; C8 emerges between the 7th cervical and 1st thoracic vertebrae; all other spinal nerves emerge inferior to the vertebra of the same number.

F Has a neural arch lined on its internal surface by dura mater. The internal surface of the neural arch is lined with periosteum. There is then an interval - the epidural (extradural) space - between this periosteum and the dura. The space contains fat, blood vessels and the spinal nerve roots passing to the intervertebral foramina and is of the highest importance clinically, especially to anaethetists.

64
Q

answer True or False to these statements:

Concerning the pleura :

A) In the costodiaphragmatic recess visceral pleura lies against parietal pleura.

B) The parietal pleura has a sensory supply in part from the vagus nerve.

C) The pulmonary ligament is formed from mesothelium.

D) The fibrous pericardium is lined with parietal pleura.

E) The diaphragmatic and mediastinal pleura are discontinuous on the right.

A
65
Q

Bifurcation of the trachea occurs at which vertebrae?

A

T4/5

66
Q

what type of joint in the sternoclavicular joint?

A

Synovial joint

67
Q

Vessels of the thorax

A

Anatomy (8 decks)

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