Thorax Flashcards
The left and right Branchiocepalic vein joins to form_____ in the _____ of the aortic arch
Superior vena cava
Front
The superior vena cava drains blood from____ ____ ____
Upper limb
Head
Neck
The azygous vein joins the ____ part of the ____ before entering the pericardium @____
Posterior
Superior vena cava
T4
The azygous vein drains
____
____
____
____
____
____
____
Pst Intercostal space
Pst abdominal wall
Pericardium
Diaphragm
Bronchii
Oesophagus
The main azygous vein originates from?
Right Subcostal vein
Right asending lumber vein
Or renal vein
Hemi azygous is found at the ___ side of the pst mediastinum
Left
Hemi azygous vein is formed by ___ and ___
Left asending lumber vein
Left subcostal vein
Hemi azygous asends through ___ of the diaphragm
Left crus
The Hemi azygous joins the azygous vein @
T8
Superior Hemi azygous or asending Hemi azygous is formed by the Union of ____ to ____ Intercostal vein
5 to 8
The interior vena cava pieces the _____ of the diaphragm @ ____ vertebrae
Central tendon
T8 vertebrae
The asending aorta lies within____
Fibrous pericardium
The ascending aorta possess ____ bulges forming
3
The sinuses of the aorta
The asending aorta has____ branches namely
2
Left and right coronary artery
What are the branches of the aortic arch
Branchiocepalic artery
Left common carotid artery
Left Subclavian artery
The defending aorta begins at ____ vertebrae
T4
The defending aorta pierces the diaphragm through
Aortic opening
There are ____ branches of the Defending aorta namely
5
Subcostal
Intercostal
Pericardial
Oesophangial
Branchial
The right side of the head, neck, right upper limb and right thorax are drained by____
Right Lymphatic duct
The left side of the next, head, left upper limb, left thorax, abdomen, pelvic region and lower limb are drained by _____(lymph)
Thoracic duct
The thoracic duct passes the diaphragm through______
Aortic opening
The thoracic duct runs along the median line and crosses to the left @_____ vertebrae
Sternal angle
T4
The thoracic duct begins below the abdomen as______
Cisterma chyli
The L&R vegus nerve supplies____ and ____
Lungs and oesophagus
The Left vegus nerve gives off ____
Cardiac nerve
The Right vegus nerve gives off ____
Left Recurrent Laryngeal nerve
The phrenic nerve arises from _____ and supplies _____
Anterior rami of C3 to C5
Diaphragm
____ thoracic nerve has both afferent and efferent fibre
Phrenic nerve
The muscle fibers of the diaphragm is grouped into
Sternal part
Costal part
Lumber part
The Lt&R Crus is from ____ part of the diaphragm
Lumber part of lumber origin
The aortic opening lies at ____ vertebrae
And allows ___, ____, ____ to pass through
T12
Aorta
Thoracic duct
Azygous vein
What are the opening of the diaphragm
Oesophagial opening
Aortic opening
Vena caval opening
The oesophagial opening lies at ____ vertebrae
T10
What are the structures that passes through the oesophagial opening
Oesophagus
Vagus nerve
Vena caval opening in the diaphragm lies at ____ vertebrae
And allows ____ and ____ structures through
T8
Inferior vena cava
Branches of right phrenic nerve
The diaphragm is supplied by ____ nerve
Phrenic
The lungs visceral pleura receives inervation from_____
Pulmonary plexus
The parietal pleura is sensitive to____, _____, ______, ______
While the visceral pleura is sensitive to ________
Pain, temperature, touch, pressure
Stretch only
The lungs is supplied by _____ nerve
Pulmonary plexus
The pulmonary plexus is formed from branches of (I) _____&(II) ______.
(II). fibres are from ___ nerve
Sympathetic and parasympathetic nerve
parasympathetic nerve are from vagus nerve
The pericardium is posterior to the ____ to ____ costal cartilage (rib)
And anterior to the ______ to______ thoracic vertebrae
2nd to 6th
5th to 8th
The pericardium is made of _____ and ______ layers
Fibrous and serous pericardium
The serious pericardium consists of ____ and _____ layers
Parietal and visceral layers
The slit-like space between the parietal and visceral layer is______
Pericardial cavity
How can obstruction to the SVC be solved?
Blood can be shunted through the Azygous vein
The clinical sign of aortic coarctation is?
Deminished or no femoral pulse
The greater part of the liver lies under___ part of the diaphragm?
Right dome
The stomach and spleen lies under ____ part of the diaphragm?
Left dome
The kidney at the posterior thorax lies at ____
T11- T12
The supra spinal notch is at ____ line with thoraxic vertebrae in female
And in males @____ line
T3
T2
The true ribs
False ribs
And floating ribs are
T1 - T7
T8 - T12
T11 & T12
Sternal angle is @ ____ vertebrae
And ____ ribs?
T4
2nd rib
The body of the sternum articulate on each side with?
2nd to 7th costocartilage
Are there ribs or costal cartillage attached to the xiphod process?
No
The xiphisternal joint lies opposite the _____ thoracic vertebrae
T9
A Typical ribs has____
Head, neck, tubercle, shaft, angle, 2 articulating faccet
Typical ribs are from___ to ____
3 to 9
The Atypical ribs are?
1,2,10,11,12
What group of muscle of the thorax helps increase the volume of the thorax during restoration?
Intrinsic muscle and they connect only to the thorax
The deepest layer of muscle in the intrecostal space is called?
Transverse thoracis group
Transverse thoracis group of muscle includes
Subcostal muscle Pst
Innermost intrecostal muscle Lat
Transversus thoracic/ sternovostalis Ant
The structures of the intrecostal space are supplied by______
Large Pst intrecostal Artery
Small Ant intrecostal Artery
The posterior veins of the thorax drains into______
And anterior vein drain into____
Azygous or Hemi azygous vein
Internal thoacic or musculophrenic vein
The intrecostal space is Innervated by ___ to ____ nerve
T1–T11
The imterchondral ribs connects _____
Costal cartillage of ribs 7-10
What are the contents of the superior mediastinum
Traceha
Oesophagus
Thymus
Thoracic duct
Superior half of superior vana cava
Muscle-sternohyoid and Sterno thyroid, Longus colli
Nerve of the superior mediatinum are?
L and R phrenic nerve
L and R vagus N
Cardaic N
Left recurrent laryngeal nerve
Deep cardiac plexus
What makes the 2nd rib atypical?
Its broad and short
Rough superior Tuberosity
Example of intrinsic thoracic muscle are?
External, internal, innermost intercostal muscle
Subcostal muscle
Transversus thoracic muscle
Levatores costarum
Seratus posterior (superior and inferior muscle)
What’s the difference between the intrinsic and extrinsic thoracic muscle?
Intrinsic connects only to the thoracx
Extrinsic connect to the thorax and other places.
Example of extrinsic thoracic muscles are?
Pectoralis major and minor
Seratus anterior
Subclavius muscle
Blood vessels in the thorax runs between
Internal and innermost intercostal muscle
What muscle are present in the superior mediastinum
Sternohyoid, sternothyroid
Lower longus coli
The lymph nodes of the superior mediastinum are
Branchiocephalic
Paratracheal
Tracheobronchial
Organs
Arteries
Vein
of the superior mediastinum
Trachea, oesophagus, thymus, thoracic duct
Arch of the aorta–brachiocephalic A, L common carotid and Let subclavian
Upper half of superior vena cava, left and right brachiocephalic vein
The nerve of the superior mediastinum
L vagus N
R vagus N
L Phrenic N
R Phrenic N
Cardiac N
Left recurrent Laryngeal N
Deep cardiac plexus
Boundaries of ant. Mediastinum
Ant. Sternum
Pst. Pericardium
Sup. Transverse thoracic plane
Inf. Superior surface of diaphragm
Lat. Mediastinal pleura
Contents of the ant. Mediastinum
Sterno pericardial Lig.
Lymph node with lymphocyte
Fat
Lowest part of the thymus
Aorta tissue internal thoracic artery
Contents of the middle. Mediastinum
Heart, pericardium, trachea, R&L primal bronchi
Lymph nodes: Tracheobranchial LN
Phrenic and pericardiaphrenic vessels
Boundaries of the middle mediastinum
Sup. Transverse thoracic plane
Inf. Diaphragm
Lat. Mediastinal pleura
Ant. Sterno pericardial Lig.
Pst. Oesophagus, defending Aorta, Azygous vein
Arteries, veins and nerves of the middle mediastinum
Ascending A, pulmonary trunk, L&R pulmonary arteries
Lower half of superior vena cava, termination of azygous vein, L&R pulmonary vein( 2 each)
Right Phrenic, L Phrenic, Deep cardiac N
Boundaries of the pst mediastinum
Ant. Pericardium
Pst. T5 to T12
Lat. Mediastinal pleura
Sup. Transverse thoracic plane
Inf. Diaphragm
Contents of the pst. Mediastinum
O, A, V
Oesophagus
Decending aorta and branches of defending aorta
Azygous V, Hemi azygous V, accessory Hemi azygous V
Contents of the pst. Mediastinum
N, LN,
Vagus N, splanchnic N(greater, lesser, least)
Pst. Mediastinal Lymph, thoracic duct
The splanchnic N arises from?
5th- 8th thoracic ganglia of sympathetic chain
In supine position, the aortic arch lies
Superior to the transverse thoracic plane
When standing the central tendon falls to the level of
T8-T9
The muscle fibers of the central part of the diaphragm is direci
Directed upwards and inwards
Muscle fibers of the diaphragm is divided into ____ parts namely?
Sternal, costal and lumber end(vertebral)
The sternal part of the diaphragm arises from
Two fleshy slips from the pst. Xyphoid process
The costal end of the diaphragm originates from?
Lower six ribs and their costal cartilage interdiginating with transversus abdomnis
The lumber origin of the diaphragm originates from?
Medially and laterally L1
Right crus arises from anterolateral surface of _____ vertebrae
Left crus arises from anterolateral surface of _____ vertebrae
L1-L3
L1-L2
The central part of the diaphragm has 3 leaflet looking tendon
Middle is _____ shaped and directed_____
L&R are ____ shaped and which is narrower?
Triangular and apex is directed towards the xiphoid precess
Tongue shaped (L is narrower than R)
The Oesophagial opening is ____ shaped
Allows what structures through?
Contraction of the diaphragm causes ____ to the opening
Elliptical
Oesophagus, vagus N, phreno Oesophagial Lig. Lymphatic of the liver
Constriction of the opening
Vena caval opening is ____ shaped?
Allows_____ through
Contraction of the diaphragm causes_____ to the opening?
Quadrilateral
Right Phrenic N, inferior vena cava, lymph vessel of the liver
Causes dialation of the vena caval opening
Each crus is pierced by?
Left crus is pierced separately by?
Greater and lesser splanchnic N
Left is pierced by Hemi azygous V
_______ pierces the diaphragm @ 9th costal cartilage?
Musculophrenic N
The nerve supply to the diaphragm is?
Phrenic nerve from (ventral rami C3, C4, C5
The sensory innovation of the diaphragm
Central part– phrenic N
Peripheral– lower six thoracic N
_____ forms the central tendon?
______ forms the dorsal paired portion?
The circumferential portion of the diaphragm
Dorsal unparir part?
Septum transversum
Pleuriperitoneal membrane
Lateral thoracic wall
Dorsal mesentery of the oesophagus
The 2 most common types of diaphragmatic hernia are:
All continental
Retrosternal– through the foramen of space of Larry
Posterolateral hernia– thought the foramen of Bochdalek
Hiatal henia can be congenital for kids and acquired for old men due to
Persistent of embryonic peritoneal process in pst. Mediastinum
Aq. Backflow of gastric acid to the oesophagus
How are hiccups produced?
Hiccups are caused byinvoluntary contractions of your diaphragm— the muscle that separates your chest from your abdomen and plays an important role in breathing. This involuntary contraction causes your vocal cords to close very briefly, which produces the characteristic sound of a hiccup.24 May 2017
The reflection of the parietal pleura occurs @
Hilium of the lungs in the mediastinal pleura
During inspiration the lungs lower Margin decends into
Costodiaphragmatic recess
During inspiration and expiration the anterior border of the lungs slides into
Costomediatinal recess
The parietal pleura is sensitive to?
Pain, temp, touch, pressure
The costal
Mediastinal
Diaphragmatic pleura are innervated by?
Intercostal N
Phrenic N
Phrenic and 6-12 intercostal N
The visceral pleura is sensitive only to?
And is innervated by?
Stretch
Pulmonary plexus
Difference between the costal and medial surfaces of the lungs
Costal– smooth, convex
Medial– pst. Mediastinal part–conave, ant. Vertebral part
The features of each lung
Apex
Base
3 border–ant. Pst. Inf.
2 surface
What are the impressions in the Right lung
Cardiac
Superior and inferior vena cava
Azygous vein
Oesophagial
Trachea
Vagus N
What are the impressions in the Left lung
Cardiac
Pulmonary trunk
Aortic arch and decending aorta
Left subclavian Artery
Thoracic duct
Oesophagus
The pulmonary roots lies @ the level of ____ vertebrae
T5-T7
The pathway of the bronchus(BRANCHOPULMONARY SEGMENT)
Bronchus— lobar bronchus— segmental bronchus(tertiary)—- bronchiole— terminal bronchioles— Respiratory bronchiole— alveolar sacs
Difference between the right and left lung branchopulmonary segments
The R Lung has midle lobe & L doesn’t
L Lungs has Superior and inferior lingular(@ superior lobe) & R Lung doesn’t
The branchi, viseral pleura and connective tissue of the lungs receive blood supply from?
Bronchial artery from decending aorta
Branchial vein drains into?
Azygous and Hemi azygous V
All lymph from the lungs drains into?
4rm sup. &deep plexus
To
Trachobronchial node and then to broncho mediastinal lymph trunk
The sympathetic efferent fibre of the pulmonary plexus causes
Broncho dialation and vaso constriction
The parasympathetic efferent fibre of the pulmonary plexus causes
Broncho constriction
Vaso dialation
Increased glandular secretion
This left coronary artery branches into
Anterior inter ventricular and
Circumference Artery
The anterior inter ventricular artery of the L coronary artery runs along
Inter ventricular groove
And the left conos artery the anastomosise with right conos artery
The Left coronary artery arises from
Left pst. Aortic opening,
It’s larger BT shorter than right coronary artery
What are the branches of the right coronary artery?
Sinu Arterial branch
Conus branch
Large marginal branch
Ps. Inter ventricular branch
The inferior border of the heart and sometimes apex is supplied by?
Large Lateral marginal, Right coronary artery
The large lateral margin of the right coronary artery originates from?
Right coronary artery along the inferior margin of the heart
What’s the area of distribution of the left coronary artery?
Left Atrium
Greater part of the left ventricle( except pst. Interventricular groove)
Lesser part of the right ventricle
Anterior part of inter ventricular Septum
Area of distribution of the Right coronary artery
Right atrium
Greater part of the right ventricle (except anterior inter ventricular groove)
Lesser part of the left ventricle
Pst. Part of inter ventricular septum
The anterior surface of the left ventricle is drained by?
Grater cardiac vein
The ant. Surface of the left ventricle is drained by?
Greater cardiac vein
