Thorax Flashcards
What is the first rib to sternum joint?
Primary cartilaginous joint
What are the ribs 2-7 joints to the sternum?
Synovial planar
What is the weakest part of the rib?
Where it angles round
What side of the ribs are broken?
Right
What is a ‘stove in chest’ ?
Loose segment of rib caused by a break
- flail chest
Chest moves inward during inhale rather than out, it gets sucked in
What muscles lie in between ribs?
Intercostal muscles
What are the 3 types/layers of intercostal muscles?
External, internal and innermost
What are the nerves of the ribs?
Anterior primary rami of thoracic nerves
Where do you feel pain when intercostal nerves are irritated?
How would you anaesthetise intercostal space?
How would you prevent damage to the neurovascular bundle during posterolateral thoracotomy?
When you breathe in, what is the movement of the ribs?
- Superior and anterior movement
- Elevation of lateral shaft of rib
What ribs do the breast cover?
2nd to 6th
What muscle do the breast lie over?
Pectoral is major
What are lobules suspended by in the breast?
Coopers ligaments
How many lobules are in the breast?
15-20
What arteries supply the breast?
Internal thoracic
Lateral and thoracoacromial
Intercostal
(From the aorta)
Why is a lesion in the breast critical?
Rich blood supply, can effect many systemic areas
What nodes are associated with the breast?
Axillary
Parasternal
Abdominal
What is the pleura?
Mesothelial lining of each hemithorax
What is the visceral pleura?
Lines the lungs
What is the parietal pleura?
Covers the internal surface of the thorax cavity
What are the parts of the parietal pleura?
Costal
Diaphragmatic
Mediastinal
Cervical
What produces serous fluid in the lung?
Capillary layer of serous fluid produced by the mesothelium
What is the roe of the serous fluid?
Reduce friction
What created cohesion between the lung and thoracic wall?
Surface tension
What is pneumothorax?
- presence of free air or gas in the pleural cavity
- collapse of the ipsilateral lung due to pressure change and disruption of surface tension
- potential for mesiastinal shift
What is pleural effusion?
Accumulation of fluid in the pleural space
What is empyema?
Potential sequelete to exudative effusion
How would you drain fluids in the pleural cavity?
Usually inserting wide-bore needle
Between 4th and 5th ribs
What is the danger of inserting the bore needle above the 7th rib posteriorly?
Danger of penetrating the diaphragm
What is the mediastinum?
Space between two pleural sacs
What does the superior mediastinum contain?
Great vessels
Trachea
Oesophageal
Thoracic duct
2 vagi
Left recurrent laryngeal nerve
Phrenic neves
Where does the superior mediastinum lie?
Just under the second rib
What is in the anterior mediastinum?
Thymus or remnants
What is in the middle mediastinum?
Contains heart , pericardium, vessels, bronchi and nerves
What is in the posterior mediastinum?
Oesophagus
Aorta
Vagus nerve
What is the relationship of the oesophagus to trachea, left bronchus and left atrium? And the clinical significance?
What part of the heart does the vagus nerve touch?
Left atrium
What nerves are associated with the right mediastinal surface?
Right vagus nerve and right phrenic nerve
What nerves are associated with the left mediastinal surface?
Left phrenic nerve
Left Angus nerve
Left recurrent laryngeal nerve
What side of the mediastinal surface can you see the azygous nerve?
Right
What are floating ribs?
Attach posteriorly, not anteriorly
Where does the azygos vein drain from?
Posterior thoracic wall
What are the 3 opening in the diaphragm?
Aortic
Oesophageal
IVC
What vertebrae is the aortic diaphragm opening?
T12
What vertebrae is the oesophageal opening in the diaphragm?
T10
What vertebrae is the IVC opening in the diaphragm ?
T8
What opening of the diaphragm transmits the IVC and right phrenic nerve?
IVC
Wat does the IVC transmit?
IVC and right phrenic nerve
What does the oesophageal opining transmit?
Oesophagus
Left gastric arterial branches and vein
Two vagi
What does the aortic opening of the diaphragm transmit?
Abd. Aorta
Thoracic duct
Azygos vein
What is the lymph drainage system of the thoracic duct? (Left)
From the - cisterns chyli to the left brachiocephalic vein
What does the cisterna chyli drain lymph from? (Left)
Abdomen and left thorax
What drains the right thorax?
Right lymphatic duct
Name A and B
