Thorax Flashcards
How many pairs of external intercostal muscles are there
11 pairs
Which blood vessel is the Sa and AV node supplied by
Right coronary
What is the main arterial blood supply of the diaphragm?
Inferior phrenic artery
Surfaces and borders of the heart
Anterior (or sternocostal) – Right ventricle.
Posterior (base of the pyramid) – Left atrium.
Inferior (or diaphragmatic) – Left and right ventricles.
Right pulmonary – Right atrium.
Left pulmonary – Left ventricle.
The right lung contains a horizontal fissure. What rib does this fissure follow the course of?
4th rib
Which part of the mediastinum does the phrenic nerve pass
The phrenic nerve passes through the middle mediastinum to innervate the diaphragm
Which anatomical level does the superior vena cava become surrounded by pericardium?
2nd costal cartilage
What percentage of lymph node drainage from the breast goes into the axilla
The axillary nodes receive approximately 75% of the lymph drainage from the breast, and so are the most likely site for metastasis in breast cancer.
What is the sensory innervation of the trrachea
The trachea receives sensory innervation from the recurrent laryngeal nerve, a branch of the vagus nerve
What is the relation of thoracic duct and oesophagus in the posterior mediastinum
Thoracic ducts is posterior and to the left of the aorta at the level of the T5
Where does the thoracic duct normally drain into
Left BCV
What pases through the diaphragm
Caval Foramen T8: IVC, lymph nodes and right phrenic nerve
Oesphadeal hiatus T10: Eso, Vagal trunk and branches of the left gastric
Aortic T12: Aorta, Azygous and Thoracic duct
Cupola
Cervical fascia
How many BP segments per lung
10 in right and 8 in left
Which Crus of the diaphragm does the oesophagus pass
Right Crus
What causes scapular winging
Damage to the long thoracic nerve and hence dysfunctional serratus anterior muscles
What type of joint is the manubriosternal joint
sec cart joint
What is the main blood supply of the lat dors
Thoracodorsal
Where does the fossa ovalis lie in relation to the right atrium
Posteromedial wall
Azygos lobe
Commonest accessory lobe of the lung and is commonly seen in the right upper zone
How does the phrenic vein travel
Ant to the sub clav art and post to the vein. Towards the medial border of the ant scalene
Transverse pericardial sinus use
Can be used to put pressure on the cardiac vessels to interrupt blood flow
Aortic arches
1st and 2nd disappear
3rd: Carotid artery
4th: Subclavian artery on the right and aortic arch on the left
5th: disappears
6th: Pulmonary artery
When does the fusion between the septum primum and the septum second take place to form the fossa ovalis from the foramen ovale
3 months of age.
What is ostium secondum
If formen is only partially covered then it leads to the formation of ostium secondum
How is the diaphragm formed
Pleuroperitoneal membrane, fibrous central tendon also known as septum transversum and ingrowth from the body wall along with mesentery of foregut all fuse together
What muscles are wasted in cervical rib
C8 to T1 dermatome and myotome
What are the medial and lateral arcuate ligaments
Medial arcuate ligament arises from the fascia of the psoas major and joining medially to form the median arcuate ligament
Lateral comes from Quad lumb fascia
What is the moderator band?
Travels down the interventricular septum of the heart and prevents overdistension of the ventricles
What is the Pemberton’s test
SVC obstruction can be assessed clinically by performing Pemberton’s test. The patient is asked to raise both arms above their head – a positive test is indicated if facial oedema or cyanosis occurs after approximately 1 minute.
Where does the horizontal fissure of the right lung meet the oblique fissure
At the 4th rib
Where does the pulmonary trunk split into the left and right pulmonary
T5-T6
What forms the coronary sinus
Generally, it is the great cardiac vein
Where does the SVC enter the right atrium
At the level of the third costal cartilage
Where can you visualise the azygous lobe
Right upper zone. Is the most common accessory lobe
Where is the inferior epigastric vessels found
Between transverse abdominis muscle and the peritoneum
FACT
Phrenic nerve is anterior in relation to SCA but post to SCV and towards the medial border of the scalene ant
FACT
The thoracic duct passes left and posterior to the esophagus at the T5 level. It empties into the left subclavian vein
Mid sternotomy and heavy bleeding
BCV
Where does the IVC enter the right atrium
Behind the third costal cartilage
Where is the pulmonary valve in relation to the aortic valve
Anterior
Where is the ansa cervicalis embeded
In the carotid sheath
Thyroid vein drain
Inferior drains into the brachiocephalic vein and the superior and middle is the internal jugular
At what level does the azygous vein enter the SVC
T4/T5
Important heart nomenclature
Right atria has inflow and outflow portions separated by the CRISTA TERMINALIS. The inflow is called sinus venerum and the outflow is called atrium proper
Left ventricle also has inflow and outflow portions and the outflow is lined with PECTINATE MUSCLES.
Right ventricle inflow portion is called TRAB CARNAE and outflow is called CONUS ARTERIOSUS
