Thorax Flashcards

1
Q

The thorax has two major openings

A

Superior thoracic aperture
Inferior thoracic aperture

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2
Q

Boundaries of the superior thoracic aperture

A

Manubrium of sternum
First pair of ribs
Body of the vertebra T1

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3
Q

Can we palpate the superior thoracic aperture

A

No.due to the clavicle being in the way

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4
Q

Then inferior thoracic aperture is almost completely covered by what muscle

A

Diaphragm 

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5
Q

Borders of the thoracic cage

A

Posteriorly: thoracic vertebral column

Anteriorly: sternum and costal cartilages

Laterally: ribs and intercostal spaces

Superiorly: suprapleural membrane

Inferiorly: diaphragm 

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6
Q

Where does the apex of the lung start 

A

1-2 cm above the clavicle

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7
Q

The thoracic skeleton consist of

A

-12 pairs of ribs and associated costal cartilages

-12 thoracic vertebrae and their intervertebral discs

-The sternum 

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8
Q

What is the sternum and what is its parts

A

Flat bone in the midline of anterior chest wall

  • Manubrium
  • Body of sternum
  • Xiphoid process
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9
Q

The large, visible dip on the manubrium is called

A

Jugular notch or suprasternal notch

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10
Q

What forms the costal margin

A

Bottom edge of the rib cage

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11
Q

The manubrium articulates with the sternum forming what joint

A

Manubriosternal joint

Also called sternal angle or angle of Louis

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12
Q

 Besides the sternum, what else does the manubrium articulate with

A

-Clavicles
-First costal cartilage
-Upper part of second costal cartilage

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13
Q

The manubrium lies opposite to which vertebral levels

A

T3 and T4

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14
Q

The sternal angle is around which vertebral level

A

At the level of the intervertebral disc between T4 to T5

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15
Q

What is the significance of the sternal angle

A

At this level we have:

  • Bifurcation of trachea
  • beginning and end of aortic arch
  • Adjacent to the second rib
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16
Q

Typical thoracic vertebrae are

A

T2 to T8

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17
Q

Atypical thoracic vertebrae are

A

T1
T9
T10
T11
T12

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18
Q

The transverse facet of the vertebrae articulates with what part of the rib

A

Tubercle of the rib

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19
Q

The Demi facets of the vertebrae articulate with which part of the rib

A

Head of the rib

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20
Q

Long curved, flat bones that form most of the thoracic cage

A

Ribs

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21
Q

Characteristic of ribs

A

Head: two facets
Neck
Tubercle
 party: costal groove 

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22
Q

Describe typical rib articulations

A

The head of the typical ribs articulate with TWO vertebrae.

  1. Body of numerically corresponding vertebrae
  2. Body of the vertebrae superior to it
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23
Q

Example: rib 5 articulates with which vertebrae

A

Body of T5 and T4

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24
Q

True or false
The tubercle of a typical rib articulates with numerically corresponding transverse process

A

True

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25
Function of costal cartilages
-Prolong the ribs anteriorly -Contribute to the elasticity of the thoracic wall
26
First 7 costal cartilages articulate ____________ with the sternum
DIRECTLY
27
What is meant by true rib 
Ribs attached directly to the sternum through their own costal cartilages
28
Another word for true rib
Vertebrocostal
29
Which ribs are true ribs
1 to 7
30
Ribs 8, 9 and 10 _____________ articulate with the sternum.
INDIRECTLY
31
What is meant by false ribs
Their cartilages are connected to the cartilage of the rib above them; thus, their connection with the sternum is indirect
32
Another word for false ribs
Vertebrochondral
33
Which ribs are false ribs
8 9 10 (usually)
34
What is meant by floating ribs
Ribs that do not attach to the sternum directly or indirectly
35
Another word for floating ribs
Vertebral , free
36
Which ribs are floating ribs
11 12 (Sometimes 10)
37
The thoracic skeleton consist of 3 major types of joints
1. Costocondral 2. Sternocostal 3. Costovertebral
38
What type of joint is costochondral
Fibrous joints
39
What type of joint is sternocostal
Synovial joint
40
What type of joint is costovertebral
Synovial joint
41
How many intercostal spaces are there
11
42
How many intercostal nerves are there
11
43
Intercostal spaces are occupied by what
Intercostal muscles and membranes Intercostal blood vessels and nerves
44
True or false The space below the 12th rib is an intercostal space
False Subcostal space
45
What is space is below the 12th rib and what does it contain
Subcostal space Subcostal nerve
46
What are the three intercostal muscles
External intercostal Internal intercostals Innermost intercostal
47
Where is the neurovascular arrangement in an intercostal space
Between the internal intercostal and innermost intercostal (VAN)
48
The thoracic wall is covered on the outside by what
Skin and muscles
49
The thoracic wall is lined on the inside by what
Parietal pleura
50
What structures are seen in the thoracic inlet (Contents of thoracic inlet)
Subclavian artery and vein Apex of lung First rib T1 vertebra Common carotid artery Esophagus Trachea Internal jugular vein Manubrium
51
Which cavity is located centrally and bordered by two pleural cavities laterally
Mediastinum
52
The mediastinum consists of what cavities
Superior and inferior mediastinal cavities
53
The inferior mediastinal cavity is further divided into
Anterior, middle, and posterior compartments
54
Compartments of the thoracic cavity
1. Two lateral compartments - lungs and pleura 2. Central compartment (mediastinum) - heart - great vessels - trachea - esophagus - thymus
55
The mediastinum extends from the ___________________ to the __________________.
Superior thoracic aperture Diaphragm 
56
The division between the superior and inferior mediastinum is called
Transthoracic plane
57
Location of transthoracic plane
At level of sternal angle and T4/T5 vertebral column
58
What are the intrinsic muscles of the thorax
External intercostals Internal intercostals Innermost intercostals (Likely includes the transversus thoracic)
59
One particular innermost intercostal that is located on the inside of the thoracic wall
Transversus thoracis
60
The order of neuromuscular structures within the costal groove
VAN Intercostal vein Intercostal artery Intercostal nerve
61
How long is the esophagus
25 cm
62
Where does the esophagus originate at
Inferior border of the cricoid cartilage
63
The Esophagus is continuous superiorly with what structure
Laryngeal part of the pharynx (laryngeopharynx)
64
Order the position of the vertebra esophagus and trachea from anterior to posterior
Trachea Esophagus Vertebra
65
The esophagus enters the abdomen through the diaphragm via what opening
Esophageal hiatus at T10
66
How does the esophagus terminate
By joining the cardiac orifice of the stomach
67
What keeps the airways open
C-shaped cartilage rings
68
What is bronchial tree
Extensively branching respiratory passageways
69
What is the largest bronchi
Primary (main) bronchi 
70
Compare the right main bronchi to the left main bronchi
The right main bronchi is wider and shorter than the left
71
Tough flexible wind pipe that is anterior to the esophagus
Trachea
72
Where does the trachea start and end
Starts: cricoid cartilage C6 Ends: when branching at T5
73
The end of the trachea is known as
Carina
74
What is the hilum of the lung
Where primary bronchus, pulmonary artery and veins enter and exit the lung
75
How many lobes does the right lung have and what are they
3 - superior -middle - inferior
76
How many lobes does the left lung have and what are they
2 -superior -inferior
77
What fissures are found on the right lung
Horizontal fissure Oblique fissure
78
What fissure is found on the left lung
Oblique fissure 
79
What separates the superior lobe from the middle lobe in the right lung
Horizontal fissure
80
What separates the middle lobe from the inferior lobe of the right lung
Oblique fissure
81
What separates the superior lobe and inferior lobe of the left lung
Oblique fissure
82
How many secondary/lobar bronchi are on the right side
3
83
How many secondary/lobar bronchi are on the left side
2
84
Tertiary bronchi are also called
Segmental bronchi because they branch into each lung segment
85
What are bronchioles
Little bronchi, less than 1 mm in diameter
86
Terminal bronchioles
Less than 0.5 mm in diameter
87
What is pleura
Double layered sac surrounding each lung
88
What are the two layers of the pleura
Parietal pleura Visceral pleura 
89
What is the pleural cavity
Potential space between the visceral and parietal pleurae
90
Pleura helps divide the thoracic cavity into
Central mediastinum Two lateral compartments
91
What is atrium
The space at the entrance from the alveolar duct to an alveolar sac
92
Two phases of pulmonary ventilation
Inspiration – inhalation Expiration – exhalation
93
What happens during inhalation
- Diaphragm contracts and pulls downward (flattens) - volume increases - pressure decreases - intercostal muscles contract and raise ribs
94
What happens during expiration
- diaphragm relaxes and moves upward - volume decreases - pressure increases
95
Is inspiration active or passive and why
Active due to contraction of the diaphragm
96
Deep inspiration requires
- Scalenes - Sternocleidomastoid - Pectoralis minor - Erector spinae
97
What does erector spinae do
Extends the back
98
Is expiration passive or active and why
Passive due to relaxation of the muscle
99
Is forced expiration an active or passive process
Active 
100
What muscles are responsible for forced breathing
Oblique and transversus abdominis muscles
101
Where can I locate the apex of the heart
Fifth intercostal space
102
Measurements of the heart
L: 12 cm W: 8 cm Thickness: 6 cm
103
Which circuit takes blood to and from the lungs
Pulmonary circuit
104
Which circuit transports blood to and from body tissues
Systemic circuit
105
Which chambers receive blood from the pulmonary and systemic circuit
Atria
106
What are the pumping chambers of the heart
Ventricles
107
Pericardium layers
- Fibrous pericardium - serous pericardium
108
Which pericardium layer is a strong layer of dense connective tissue
Fibrous Pericardium
109
Which pericardium layer is formed by two layers; parietal and visceral
Serous pericardium
110
Layers of the heart after the pericardium
Epicardium - visceral layer of serous pericardium Myocardium - cardiac muscle Endocardium - internal walls of heart
111
Location of the heart
Superior right: - costal cartilage of 3rd rib - sternum Inferior right: - costal cartilage of 6th rib - lateral to sternum Superior left: - costal cartilage of 2nd rib - lateral to sternum Inferior left : - 5th intercostal space
112
Which ventricle is thicker and why
Left ventricle Because it exerts more pumping force and flattens right ventricle into crescent shape
113
Average heart rate
70-80 beats per min
114
What is meant by systole and diastole
Stage of the heartbeat when ventricles contract and relax Systole - contraction Ventricles - relaxation 
115
Describe tricuspid valve and its purpose
Located between right atrium and right ventricle Has 3 leaflets / cusps Purpose: prevent back flow from right ventricle to right atrium
116
Describe pulmonary valve and purpose
Between right ventricle and pulmonary trunk Has 3 leaflets Purpose: prevents back flow from pulmonary artery to trunk
117
Describe mitral valve and purpose
AKA bicuspid valve Has 2 leaflets Located between left atrium and left ventricle Purpose: prevent back flow from left ventricle to left atrium
118
Describe Aortic valve and purpose
Between left ventricle and aorta Has 3 leaflets Purpose: prevent back flow from aorta to left ventricle
119
What generates the heart’s impulses ?
Sinoatrial node “Pacemaker”
120
True or false Sinoatrial node sets the inherent rate of contraction
True
121
Conducting system of the heart in order
SA node AV node Bundle of His Purjinkie fibers
122
SA node is made up of
Specialized cardiac cells
123
How many intercostal nerves are there
12
124
Intercostal arteries arise from two main arteries
1. Thoracic aorta 2. Internal thoracic arteries (branches of subclavian arteries)
125
Posterior intercostal arteries arise from
Aorta
126
Anterior intercostal arteries arise from
Internal thoracic artery
127
The intercostal veins drain venous blood from the thoracic wall into
1. Azygos system of veins 2. Internal thoracic veins