Thorax Flashcards
Diaphragm attachments
Anterior to xiphisternum opposite T8/9, then deep surface of ribs and costal cartilage of 7-12
What passes through the diaphragm at T8
IVC and R. phrenic nerve
What passes through the diaphragm at T10
Oesophagus, with both vagus nerves and L. gastric vessels
What passes through the diaphragm at T12
Aorta (behind) with thoracic duct and azygos vein
Where does the lung root lie
T5 - T8
What passes through the thoracic inlet (4)
Oesophagus
Trachea
Vagus and phrenic nerves
Brachiocephalic veins
Branches of the arch of the aorta
Anterior to posterior, structures that pass into the UL from the thoracic inlet
Subclavian vein
Scalenus anteror
Subclavian artery
Inferior trunk of the brachial plexus
What lies more medial, vagus or phrenic nerve
Vagus
What does the superior mediastinum lie between?
What does the inferior mediastinum lie between?
Thoracic inlet and the plane between sternal angle & T4/5
What does the inferior mediastinum lie between?
The plane between sternal angle & T4/5 and the outlet
What lies in the anterior mediastinum?
Thymus
What lies in the middle mediastinum
Contents of the pericardium
What lies in the posterior mediastinum (4)
Aorta, thoracic duct, oesophagus and azygos vein
What provides sensory innervatin to the pericardium?
Phrenic nerves
Anterior heart surface mainly formed by?
R. ventricle and some L. ventricule
Inferior heart surface mainly formed by?
L. > R. ventricules
What forms the R. border of the heart
Right atrium
What forms the L. border of the heart
L. ventricle and L. auricleW
what frms the base of the heart?
L. atrium
4 corners of the heart sufarce anatomy
3rd R. CC
2nd L. CC
6th R. CC
Left 5th interspace mid-clavicular line
Which coronary artery usually supplies the SA & AV nodes?
RCA branches
Where listen to the aortic valve?
2nd right ICS
Where to listen for the pulmonary valve?
2nd left intercostal space
Where to listen for the tricuspid valve?
4th or 5th IS, left edge of the sternum
Where to listen for the mitral valve?
Apex
At what level does the oesophagus start at?
End at?
C6
T11 (pierces diaphragm at T10)
At what level does the trachea start at?
End at?
C6
T4/5
Oesophagus in relation to the aorta at the diaphragm?
Anterior
Where is the oesophagus compressed (4 locations?)
Junction with pharynx
Arch of aorta (sup. mediastinum)
L.main bronchus in the posterior mediastinum
Oesophageal hiatus in the diaphragm (posterior mediastinum)
Oesophageal innervation arises from?
Vagus nerve and sympathetic trunks
Where is the needle inserted in a pericardial aspiration?
1-2CM, on the left, inferior to the xiphochondral junction (between xiphisternum and L. costal margin)
At what angle is the needle inserted in a pericardial aspiration?
45 degrees aiming towards the tip of the scapula
Which bronchus does the aorta arch over?
L. main bronchus
What arches over the R. main bronchus?
Azygos vein
Hila located at what level
Ant.
Post.
3rd-4th CC
T5-T7 vertebrae
Oblique fissure posteriorly, surface landmarks
Below and lateral to spine of T4
Anterior surface marking of horizontal fissure (R)
Ribs 4/5
Lung root contents
Pulmonary artery
2 x pulmonary veins
Main bronchus
Bronchial vesseks
Nerves
Lymphatics
Sensory supply to the parietal pleura is from
Branches of the phrenic and IC nerves (think referred pain)
Pleural surface markings
Mid axillary
Axilla
Back
Ribs 8 -> 10 -> 12
Lungs surface markings
Mid axillary
Axilla
Back
6 -> 8 -> 10
Which ribs are….
True
False
Floating
1-7
8-10
11 & 12
Lung root spinal levels
T 5- 8
Where does the horizontal fissure meet the oblique fissure?
At the mid axillary line
Atypical ribs are
Rib 1, 2, 10 , 11 & 12
What does the typical rib articular with posteriorly
Transverse process of the corresponding vertebrae (neck)
Superior costal facet on the body of the corresponding vertebra and the inferior costal facet on the body of the vertebra above (head)
Name of the two joints between typical ribs and vertebra
Costovertebral joint
Costotransverse joint
