Thorax Flashcards
Subclavian artery branches
Vertebral
Internal thoracic
Thyrocervical
Costocervical trunk
Dorsal scapular
Epithlium trachea
Ciliated columnar
Hyaline cartilage
T2
Airway and joints
Elastic cartilage
T2
Ear larynx, eustachian tube
Fibro cartilage
T1
Tendins ligaments IV discs
No pericondrium
Synovial joint
- Covered by hyaline
- Surrounded by capsule
- Joint cavity
- Allows movement
- Surrounded by ligament
- Lined internally synovial membrane
Ribs
1-7 true
8-10 false
11-12 floating
Trachea
From c6 to sternal angle
Inferior thyroid and bronchial arteries
Symp fibres upper ganglia symp trunks
Phrenic
Motor and sensory diaphragm
C4
Behind subclav vein, in front of lung root
Diaphragm tendon on right, muscle on left
Lateral ant and post branches
Azygous
Drains post chest wall
Goes to SVC T4
Formed by the ascending lumbar vein and the right subcostal vein
receives the lower eight posterior intercostal veins
joined by the hemiazygos vein at the T8–T9
passes through the aortic opening of the diaphragm.
Lymph drainage lung
LLL right superior tracheobronchial nodes
Subpleural plexus drains parenchtna and visceral pleura
Eventually venous angle or r lymph duct or l thoracic duct
Embryonic septum transversum
Becomes fibrous pericardium and central tendon of diaphragm
Serratus anterior
Side wall thorax and medial wall axilla
Digitations upper 8 ribs
2nd upper scap, lower 4 lower scap
Supplied by long thoracic C5-7
5 upper 2
6 3rd and 4th
7 rest
Thoracic wall muscles
Inner: innermost IC, transversus thoracicus, subcostal
Middle: internal intercostal
Outer: external IC, serratus posterior inferior and superior, levator costae
Male trachea
1.6-2cm
12cm long
Half intrathoracic
12-20 cartilaginous c shapes with trachealis muscle posteriorly
Innervation parietal lung
Phrenic - med diaphragm and mediastinal
IC - lat diaphragm and costal
Lung fissure surface anatomuly
Oblique - T2 - 6th costal
Horizontal - oblique until 4th rin and costal
Thymus
Arteries: Anterior intercostal
Internal thoracic
Makes t lymphocytes, not active in thymus
Releases thymosin which stimulates maturation lymphocytes other organs
Oesophagus
25cm
C6 to t11
Anterior to prevertebral fascia cervically
Right crossed by azygous
Left crossed aortic arch
Heart border
Right - r 3rd costal to r 6th costal cart
Inf - r 6th to L 5th ic space (apex)
Left - apex to l 2nd costal cart 2cm from sternum
All lower edge
Atypical ribs
Typical:
Head with 2 articular facets
Neck curving into crest
Shaft
Atypical:
1, 2, 11, 12 and sometimes 10
1 - 1 articular facet, short wide, 2 grooves for vessels
2 - rough oatch for seratus anterior
11 - 1 articular facet, no tubercle, short neck
12 - 1 articular facet, no tubercle, short neck, no angle or costal groove
Borders heart
R - RA
Sup - RA + LA
L - LV + small amount LA
Inf - RV + small amount LV
Heart surfaces
Ant - RV
Diaphragmatic - LV + a bit RV
R - RA
L - LV
Pulmonary trunk
5cm long
3cm wide
Rib movement
3-5 pump handle
6-10 bucket handle
11-12 calliper
Muscle types
Smooth - non striated, 1 nucleus
Cardiac - straited, 1-2 nuclei
Skeletal - striated, multiple nuclei, T1 aerobic
Thoracic vertebrae
Typical T2-9
Bilateral costal demi facets paired
Costal facets on transverse processes
Long down sloping spinous process
Atypical
1 sup vert body facet not demi
10 only one pair facets on body/ pedicle
11 & 12 only one pair facets on pedicles
Sterno costal joint
Costovert/transverse
ScJ - 1 primary cartilagenous
2-7 synovial plane
Synovial plane
Accessory muscles breathing
Pec major
Pec minor
Serratus anterior
Scalene
Atypical thoracic nerves
T1 - brachial plexus, no ant cut
1+2 - internal surfave not sc groove
2+-3 - large ant cut, suplies axilla and arm, com medial brachial cutaneous
T7-11 - innervate parietal peritoneum
Post IC arteries
1-2 - supreme/ superior branch costocervical trunk from Subclav
3-11 from aorta
S cost from aorta
Between internal and innermost intercostal s
Anterior arterial intercostal
Internal thoracic 1-6 (branch subclav)
7-9 musculophrenic (branch internal thoracic
10-12 absent
Internal thoracic
Sc 1-6
6th ic space becomes musculophrenic and sup epigastric
Also gives rise pericardiophrenic
SC Vein drainage posterior thoracic wall
1 bcv bilat
L
2,3 become sup ic go to bcv
4-8 accessory hemiazygous
9-11 sc and asc lumbar hemiazygous
R
2-4 become sup IC got to svc with azygois
Rest azygous
Breasts
Bed - sternum to MAL rib 2-6, on pec major and serratus ant
15-20 lobules
Each lobule drained by lactiferous duct
FSH &LH cause increased size
Breast blood supply
Med - internal thoracic
Lat - lat thoracic from axillary and lat cut 2-4
Drain axillary and intern thoracic veins
Lymph drainage breast
75% lat - axillary +- pectoral to clavicle to sc trunk
Med to parasternal lymph or abdo lymph or other breast to bronchomediastinal trunk
All end thoracic duct/ r lymoatic duct or venous angle
Skin might also drain to deep cervical
Intercostal nerve
Ventral rami upper 11 thoracic nerves
Alveoli
Alveolar duct becomes alveolar sac (5-6) and alveoli come from this.
Interconnecting passages pores of Kohn
Top of lung root
Right - upper lobe bronchus and artery
Left - pulmonary artery
Bronchi cells
Wall - smooth muscle and hyaline cartilage, pseudostratified columnar ciliates
Terminal bronchioles no alveoli
T1 and 2 pneumocytes
Phospholipid reduces surface tension
Oesophagus vasc
Oesophageal inferior thyroid
Bronchial
Aortic branches oesophageal
Left gastric art from coeliac and l inf phrenic
Veins left gastric to portal or oesophageal to azygous
Lymph left gastric to coeliac
Oesophagus constrictions
Cervical at cricopharyngeus
Thoracic aorta then left main bronchus
Diaphragmatic
Coronary sinus receives
Great, middle, small cardiac veins
Post vein left ventricle
Oblique vein left atrium
(5 total)
Sternal angle
2nd costal cartilage
T4
Begining and end aortic arch
Bifurcation trachea
location Thoracic sympathetic trunk
On necks of ribs just lateral to heads
Anterior to vascular bundle
Separation trachea from lung
Right right vagus and right pleural apex
Left left common carotid and subclavian
Cardiac plexus
Superficial in arch of aorta
From left vagus and left cervical symp ganglion
Deep between trachea and aorta
Right cervic branches, vagal, cardiac nerves
Trachea blood supply
Inferior thyroid
Sup mid and inf bronchial
Epithelium trachea and bronchi
Ciliated columnar
Examples secondary cartilaginous joints (symphysis)
IV discs
Manubrosternal
Pubic symphysis
Saccrococcygeal symphysis
Examples primary cartilagenous joints - synchondrosis
Costochondral
1st sternocostal
Xiphisternal
Location lung hila
T4-5
3-4th ccs
Layer of pericardium no sensory
Visceral of serous pericardium (no innervation phrenic)
Visceral peritoneum never sensory
