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Anatomy > Thorax > Flashcards

Thorax Flashcards

0
Q

What makes up the thoracic wall skeleton?

A

12 pairs of ribs and costal cartilages
12 thoracic vertebrae and intervertebral discs
Sternum

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1
Q

Ribs are classified as what type of bones and do they contain bone marrow?

A

Flat bones, and yes they have BM.

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2
Q

Name the parts of sternum

A

Manubrium, body, xiphoid process

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3
Q

Divide ribs into true, false and floating. What makes them fall into these categories?

A

1-7 true. Attached directly to sternum
8-10 false. Attached to the cartilage of the superior rib
11&12 floating. Not connected to sternum

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4
Q

Where can you find the costal groove of a rib and what is its function?

A

On the internal surface of a rib. Protects the costal nerve/vessels.

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5
Q

Name the parts of a typical rib and give main features of each

A

Head: has 2 facets for vertebra above and below it.
Neck: connects the head to the body at the level of tubercle
Tubercle: smooth, connects to transverse process
Body: thin, flat, curved

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6
Q

You are about to perform a thoracocentesis on a patient in the ER. Would you choose to insert the needle just above or below a rib and why?

A

Just above the rib to avoid the vessels that run just below a rib.

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8
Q

Name the atypical ribs

A

1,2,10,11,12

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9
Q

The shortest, broadest, most curved and almost horizontal rib.

A

What is the 1st rib

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9
Q

These ribs only have one facet on their heads.

A

1, 10-12

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10
Q

How many grooves run on superficial surface of the 1st rib and what is its/their function?

A

2

Subclavian vessels run here.

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11
Q

These ribs have no heads or tubercles

A

11 and 12

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12
Q

The first two ribs are the strongest and it takes a great amount of force to break them. You have a patient with a fracture of these ribs what do you suspect and what tests would you do?

A

The injury must be worse that it looks. Orders CXR, MRI, CT to check for internal injuries.

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14
Q

Characteristics of a thoracic vertebrae

A

Body, arch, 7 processes
BL costal facets
costal facets of transverse processes(except for inferior 2 or 3)
Long, inferior slanting spinous process

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15
Q

Sternal angle or angle of Loius significance

A

RAT PLANT
Rib 2*
Aortic arch*
Tracheal bifurcation*

Pulmonary trunk
Ligamentum arteriosum 
Azygous vein enters SVC
Nerve plexi (cardiac and pulmonary)
Thoracic duct
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15
Q

Trapezoidal bone at level of T3-T4 with two BL clavicular notches

A

Manubrium

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16
Q

Flat elongated bone forming the anterior part of thoracic cage

A

Sternum

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17
Q

Bone on the anterior chest with costal notches

A

Body of sternum

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18
Q

Sword like shaped structure

A

Xiphoid process

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20
Q

Length of xiphoid is constant and never has a hole in it. T or F?

A

F

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20
Q

Inflamation of a rib or the cartilage connecting a rib.

A

Costochondritis

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21
Q

Name the thoracic apertures

A

Superior and inferior

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22
Q

Modified sweat glands on anterior surface of the chest

A

Breasts

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23
Q

Locate circular base of a breast

A

From lateral border of the sternum to midaxillary line.

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25
Q

What attaches breast to the skin?

A

Suspension ligament of Cooper

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26
Q

Define areola

A

Pigmented area around the nipple

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26
Q

Name the thoracic compartments

A

2 lateral - pulmonary

1 central - mediastinum

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27
Q

Accessory muscles of respiration

A

Pectoralis major/minor
Sarratus anterior
Scalenes

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28
Q

A fist in a balloon

A

What are pleurae (visceral and parietal)

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29
Q

Serous sack surrounding the lungs

A

Pleura

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30
Q

Differentiate btwn visceral and parietal pleura

A

Visceral - adherent to lungs, cannot be dissected form them

Parietal - adherent to thoracic wall, mediastinum and diaphragm

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31
Q

Define pleural sleeve

A

Area of continuity of visceral and parietal pleurae enclosing the root of the lung

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32
Q

4 parts of parietal pleura

A

Costal, mediastinal, diaphragmatic and cervical

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33
Q

Name the otential space btwn the 2 pleurae with capillary layer of serous fluid

A

Pleural space

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34
Q

What are costodiaphragmatic and costomediastinal recesses?

A

Potential spaces in pleural cavity at the respective junctions

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35
Q

Name the lines of pleural reflection and define each.

A

Sternal - where costal becomes continuous with mediastinal anteriorly
Costal- where costal becomes continuous with diaphragmatic
Vertebral- where costal becomes continuous with mediastinal posteriorly

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36
Q

Define lung root

A

Connects lung to trachea and heart. Formed by structures entering and leaving the lung at the hilum

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37
Q

How many lobes in each lung

A

Right - 3

Left - 2

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38
Q

Names and give the functions of lung fissures

A

Horizontal and oblique

Divide lung into lobes

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39
Q

Locate cardiac notch and lingula

A

Margin of the left lung

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40
Q

What is lingula?

A

Projection of the upper lobe of the Left lung

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41
Q

A blunt superior end of the lung ascending into root of neck

A

Apex of the lung

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42
Q

3 surfaces and 3 borders of the lungs

A

Costal, mediastinal and diaphragmatic surfaces

Anterior, posterior, inferior borders

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43
Q

Main bronchi pass from bifurcation of trachea to lung. T or F?

A

T

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44
Q

Left main bronchus is wider, shorter and more vertical than the right. T or F?

A

F. This is true about the right one.

45
Q

What is carina?

A

A cartilaginous ridge within the trachea that runs antero-posteriorly between the two primary bronchi at the site of tracheal bifurcation

46
Q

Pulmonary arteries raise from the pulmonary trunk at …..( hint: significant landmark)

A

Sternal angle.

47
Q

Pulmonary arteries carry ‘venous blood’ and pulmonary veins carry ‘arterial blood’. T or F?

A

T

49
Q

This compartment contains almost all thoracic viscera, extends from superior thoracic apertures to diaphragm, from sternum to vertebrae, and primarily consists of air or fluid filled structures.

A

Mediastinum (central)

49
Q

Give location of Inferior mediastinum and into what parts it divides.

A

From sternal angle to diaphragm

Divided into anterior, middle and posterior

50
Q

A part of mediastinum from superior thoracic aperture to sternal angle and the structures located here

A 
Superior mediastinum:
SVC
Brachiocephalic vein
Arch of aorta
Thoracic duct
Trachea
Esophagus
Thymus
Vagus nerves
Left recurrent laryngeal nerve*
Phrenic nerve
51
Q

Name the smallest subdivision of inferior mediastinum, give its location and it’s structures

A

Anterior mediastinum
From sternum to pericardium
Contains inferior part of thymus in kids

52
Q

This part of inferior mediastinum contains the heart, pericardium, ascending aorta, pulmonary trunk, SVC, arch of azygous vein, main bronchi

A

Middle mediastinum

53
Q

Locate the posterior mediastinum and name its structures.

A 
Anterior to T5-T12.
Thoracic aorta
Thoracic duct
Azygous and Hemizygous veins
Esophagus and esophageal plexus
Thoracic sympathetic trunks
Thoracic splenic nerves
54
Q

Double wall membrane enclosing the heart

A

Pericardium

55
Q

What does the nerve supply to pericardium consist of.

A

Phrenic nerves, sympathetic trunks, vagus (X)

56
Q

Cardiac cycle begins with diastole/systole and ends with diastole/systole.

A

Diastole( period of elongation and filling)

Systole ( shortening and emptying)

57
Q

Thick layer of heart - cardiac muscle

A

Myocardium

58
Q

Name the heart wall formed by visceral layer of pericardium

A

Epicardium

59
Q

Heart layer covering the valves

A

Endocardium

60
Q

Give location and orientation of the heart’s apex

A

Posterior to the left 5th intercostal space (9cm from median plane)
Directed anteriorly and to the left

61
Q

Functions of fibrous rings in the heart

A

Keep valves open
Attachment for leaflets and cusps of valves
Attachment for myocardium
Electrical insulator between atria and ventricle

62
Q

4 surfaces of the heart

A

Anterior, diaphragmatic, left and right pulmonary

63
Q

Describe the base of the heart

A

Posterior aspect, formed by LA and slightly the RA.

Receives the pulmonary veins and SVC/IVC

65
Q

Anterior surface of the heart is aka as____ and consists of?

A

Sternocostal

Mainly RV

65
Q

Left pulmonary surface of the heart is made up of?

A

Mainly LV and forms cardiac impression of left lung

66
Q

Diaphragmatic surface of the heart is aka as ____ and consists of?

A

Inferior

LV and partially RV

67
Q

Right pulmonary surface of the heart is made up of?

A

Mainly RV

69
Q

What and where is the coronary sinus?

A

Collection of veins delivering blood from coronary circulation to RA. Located on posterior inferior surface of the heart, medial to IVC

69
Q

Obliquely placed partition btwn R and L ventricles. What structure, pertaining to electricity, runs through it.

A

Intraventricular septum

Right bundle of AV node

70
Q

What is right auricle and its function?

A

Clonical pouch shaped projection on RA, increases its capacity

71
Q

Give location of bi/tricuspid valves.

A

Tricuspid right heart
Bicuspid (mitral) left heart

Tri (3) right lung has 3 lobes
Bi (2) left lung has 2 lobes

72
Q

What is conus arteriosus?

A

Conical pouch formed from upper RV that leads to pulmonary trunk. (cone)

73
Q

Wall of the RA is slightly thicker than the one of LA. T or F?

A

False. It’s the opposite

74
Q

Wall of the LV is 4-5 times thicker than the wall of RV. T or F?

A

F. 2-3 times

75
Q

What vessels supply the myocardium and where do they arise from?

A

Coronary arteries

Right and left arise from aortic sinuses at proximal part of ascending aorta just above the aortic valve

76
Q

This artery supplies RA, most of RV, part of LV, part of IV septum, SA node (60%), AV node (80%)

A

RCA

77
Q

This artery arises from coronary sinus, runs in coronary sulcus, supplies the SA node, gives a right marginal branch.

A

RCA

78
Q

This artery divides into LAD and circumflex.

A

LCA

79
Q

This artery runs to the apex of the heart, then swings posteriorly to anastomoses with posterior IV branch of RCA.

A

LAD

80
Q

This artery supplies LA, most of LV, part of RV, most of IV septum (ant2/3), SA node.

A

LAD

81
Q

This structure initiates and regulates the impulses and is located at junction of SVC and RA

A

SA node

83
Q

Small collection of nodal tissue in posteroinferior region of Intra atrial septum near coronary sinus

A

AV node

83
Q

Name sequence of conducting system

A

SA nodes initiates impulse
Impulse reaches AV
Signal spread from AV node through AV bundle into R/L bundle bunches
Signal reaches purkinje fibers

84
Q

What are purkinje fibers?

A

Right and left bundle branches of AV bundle travel along the IV septum and then into subendocardial branches called purkinje fibers.

85
Q

Lymphoid organ in anterior chest, rich in blood supply undergoes involution after puberty.

A

Thymus

86
Q

This great vessel is formed by union of internal jugular vein and subclavian veins.

A

Bravhiocephalic vein

87
Q

Brachiocephalic veins merge to form …..

A

SVC

88
Q

Left brachiocephalic is twice as long as the right one. T/F?

A

T

89
Q

Left brachiocephalic vein receives lymph from thoracic duct. T/F?

A

T. Right gets it from right lymphatic duct

90
Q

Returns blood from all structures superior to diaphragm except lungs and heart , ends at 3rd costal cartilage where it enters the RA.

A

What is SVC

91
Q

Location of right phrenic nerve

A

Between SVC and mediastinal pleura

92
Q

Which side of the vertebral column does the descending aorta run?

A

Left

93
Q

What’s the correlation between Ligamentum arteriosum and antibiotics in pregnancy.

A

May close prematurely (normally close shortly after birth) if antibiotics are taken in third trimester.

94
Q

What is Ligamentum arteriosum?

A

A small ligament (remnant of fetal ductus arteriosus) attached to superior surface of the left pulmonary artery and the proximal descending aorta.

95
Q

Name the branch of the aortic arch that is largest, anterior to trachea , posterior to left brachiocephalic vein, and what does it divide into?

A

Brachiocephalic trunk. Divides into mom on carotid and right subclavian arteries.

96
Q

Second branch of aortic arch, posterior to Manubrium, ascends anteriorly to left subclavian artery.

A

Left common carotid artery

97
Q

Branch of the aortic arch arising from posterior part, has no branches in mediastinum, as it leaves the thorax it passes posterior to left sternoclavicular joint and lateral to left common carotid.

A

Left subclavian artery

98
Q

Position of vagus nerve in relation to common carotid arteries.

A

Lies posterolaterally to the arteries.

99
Q

Vagus (x) nerve arises from which part of the brain?

A

Medulla

100
Q

Describe the position of the right vagus nerve as it enters the thorax in relation to subclavian artery and what it gives rise to.

A

It runs anterior to subclavian artery and gives off the right recurrent laryngeal nerve.

101
Q

Describe the position of the left vagus nerve as it enters the thorax in relation to adjunct arteries and what it gives rise to.

A

Enters thorax between left common carotid and left subclavian arteries and posterior to left brachiocephalic vein. It gives of the left recurrent laryngeal nerve.

102
Q

The only motor supply to diaphragm.

A

Phrenic nerves

103
Q

Location of trachea in relation to esophagus and where does it end?

A

Anterior to esophagus. Ends at sternal angle

104
Q

Trachea does not incline right or left as it descent. T/F?

A

F. Inclines to the right a little.

105
Q

Cartilaginous rings encircle the trachea completely. T/F?

A

F. Posterior surface is flat, rings incomplete.

106
Q

Esophagus initially inclines to the left as it descends. What moves it back to median plane?

A

Aortic arch

107
Q

Fibrousmuscular tube extending from pharynx to the stomach

A

Esophagus

108
Q

Location of thoracic aorta

A

Posterior mediastinum
On the left side of T5-T12
Posterior to root of the lung, pericardium and esophagus.

109
Q

Locate azygous vein

A

Descents on right side of aorta and accompanies it through aortic hiatus of diaphragm.

111
Q

Esophagus is compressed in three places. Name them*

A

Aortic arch, left main bronchus, diaphragm

112
Q

where does the 2nd rib attach anteriorly?

A

btwn manubrium and the body at sternal angle

Anatomy (10 decks)

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