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Anatomy > Thorax > Flashcards

Thorax Flashcards

1
Q

Sternal angle

A
  • change in direction from manubrium to sternum
  • 140 deg
  • where rib counting begins
    bifurcation of trachea into 2 brachia
  • IV disks between T4 & T5
  • Pulmonary trunk divides into left and right pulmonary arteries before entering the lungs
  • palpable landmark at end of costal cartilage
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2
Q

true ribs

A

ribs 1-7

attach directly to sternum

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3
Q

false ribs

A

ribs 8-10

  • cartilages are joined to the rib immediately superior to them
  • indirect connection to sternum
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4
Q

floating/free/vertebral ribs

A

ribs 11 & 12
- cartilage doesn’t connect to sternum
end in posterior abdominal musculature

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5
Q

typical rib #

A

ribs 3 - 9

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6
Q

typical rib head

A
  • wedge shaped
  • 2 facets separated by crest of head
  • one for articulation with numerically corresponding vert
  • one for articulation with vertebrae superior to it
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7
Q

typical rib head

A

connects head with body at the level of the tubercle

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8
Q

typical rib tubercle

A
  • smooth, articular part for corresponding transverse process of the vertebra
  • rough, nonarticular part for the attachment of the costotransverse ligament
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9
Q

typical rib shaft

A
  • thin, flat, curved
  • greatest curvature at the costal angle
  • costal groove - internal surface that protects intercostal nerves & vessels
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10
Q

atypical rib #

A

1, 2, 10, 11, 12

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11
Q

rib 1 features

A

(atypical)

  • broadest, shortest, most sharply curved rib
  • head
  • single facet that articulates with T1 (typical ribs have 2 facets)
  • two transversely directed grooves over superior surface of subclavian vein (under clavicle & over rib 1)
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12
Q

rib 2 features

A
  • thinner, less curved and longer than 1st rib
  • head
  • 2 facets for articulation
  • tubercle for muscle attachment
  • atypical shape & size
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13
Q

ribs 10-12 features

A

have one facet on head

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14
Q

ribs 11 & 12 features

A

short
no neck
no tubercle

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15
Q

true & atypical ribs

A

1 & 2

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16
Q

true & typical ribs

A

3 - 7

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17
Q

false & typical ribs

A

8 & 9

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18
Q

false & atypical ribs

A

10

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19
Q

floating & atypical ribs

A

11 & 12

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20
Q

subcostal space

A

below 12th rib

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21
Q

subcostal nerve

A

anterior rams of spinal nerve T12

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22
Q

manubrium

A
  • superior part of sternum
  • trapezoidal
  • at levels of the bodies of T3 & T4
  • Jugular notch - superior border
  • clavicular notch - articulated w medial end of clavicle – fuses w cartilage of rib 1
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23
Q

sternal body

A
  • connects to manubrium via syphosis joint
  • T5 - T9 vertebral level
  • longer & narrower than manubrium
  • Costal notches – articulates with costal cartilages
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24
Q

xiphoid process

A

T10 vertebral level

  • smallest & most variable part of sternum
  • midline marker for the upper limit of the liver/central tendon of the diaphragm/inferior border of heart
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25
Q

thoracic outlet syndrome

A

compression of nerves & arteries to the lower neck & upper limb

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26
Q

costoclavicular thoracic outlet syndrome

A

compression of subclavian artery – this runs under clavicle and over first rib
- pressure put on the shoulder can cause arteriole compression, – this causes decrease in circulation to the upper extremity
- pallor & coldness
PEDIATRIC ISSUE WITH BACKPACKS

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27
Q

symphysis joints examples

A
  • intervertebral

- manubriosternal

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28
Q

synovial joint examples

A 
plane joints-
costoverebral
costotransverse
sternocostal (at ribs 2-7)
interchondral

saddle joints-
sternoclavicular

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29
Q

cartilage joint

A

sternocostal (at 1st rib to manubrium)
costochondral
xiphisternal

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30
Q

retromammary space

A

loose connective tissue behind breast, allowing movement on deep pectoral fascia

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31
Q

mamillary glands

A

reproductive accessory in females

  • suspensory ligaments
  • modified sweat glands
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32
Q

lymphatic drainage of breast

A
  • lateral quadrant is responsible for greater than 75% of lymph via axillary lymph nodes to subclavian lymphatic trunk
  • important for OTs b/c: women with breast cancer may need to do a mastectomy – often with this axillary lymph nodes are removed, causing secondary lymphadema
  • OT Job: lymphadema management of the upper extremity
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33
Q

Anterior rami of T12

A

subcostal nerves

  • abdominal innervation most likely
  • runs under rib 12
  • communicates with L1
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34
Q

Anterior rami of T1-T11

A

intercostal nerves

- runs under the intercostal groove of the first 11 ribs

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35
Q

Posterior rami

A

supplies bones, joints, deep muscles, and skin of the back in the thoracic region

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36
Q

posterior intercostal arteries

A
  • branches of the thoracic aorta
  • run in intercostal spaces 3 - 11
    (spaces 1 & 2 are supplied by subclavian artery)
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37
Q

internal thoracic arteries

A
  • branches of subclavian
  • runs vertically, deep to costal cartilage, 1 inch lateral to sternum
  • in spaces 1-6 — gives off a pair of anterior intercostal arteries that come together with poster intercostal arteries
  • at level 6 of costal catlage it bifurcates into:
  • – musculophrenic artery
  • –superior epigastric artery
38
Q

musculophrenic artery

A
  • from the bifurcation of the internal thoracic arteries at costal level 6
  • helps support diaphragm
  • gives off anterior intercostal arteries to lower spaces
39
Q

superior epigastric artery

A
  • continues into abdominal wall

- runs on deep surface of rectus abdominis muscle

40
Q

posterior intercostal veins

A
  • drains into azygos vein of the superior vena cava
41
Q

anterior intercostal veins

A
  • drains into internal thoracic veins to brachiocephalic veins on each side
42
Q

pleurisy

A

inflamed surfaces rub – painful

43
Q

Pleural cavity

A
  • space enclosed by thoracic wall
  • 3 compartments
  • 2 pulmonary cavities (lateral)
  • 1 mediastinum (central)
44
Q

Pleurae

A

serous sac consisting of 2 membranes that invests and encloses each lung
- holds lunging place - surface tension creates a force between visceral and parietal pleura

45
Q

visceral pleura

A
  • covers the lungs
  • adherent to all lung surfaces
  • can’t be dissected from lungs
46
Q

parietal pleura

A
  • lines pulmonary cavities

- adheres to thoracic wall, mediastinum & diaphragm

47
Q

pleural sleeve

A

encloses root of lung

48
Q

root of lung

A

only area that attaches the lung to anything

49
Q

pleural ligament

A

inferior to root

  • continuity between parietal and visceral pleura
  • between lung & mediastinum
50
Q

pleural cavity

A

potential space between visceral and parietal pleura

    • if you get stabbed in the lung that space is there (upon lung collapse)
  • capillary layer of serous pleura fluid to lubricate surfaces and allow for frictionless gliding during breathing
51
Q

surface tension

A

provides cohesion that keeps lungs surface in contact with thoracic wall

52
Q

costal pleura

A

covers internal surface of thoracic wall – separated from wall by endothoracic fascia

53
Q

mediastinum pleura

A

covers lateral aspect of mediastinum

54
Q

diaphragmatic pleura

A

covers superior surface of diaphragm at each side of mediastinum

55
Q

cervical pleura/cupula of pleura

A

forms a cup shaped dome over apex of lung

56
Q

lines of pleural reflection

A

lines along which the parietal pleural changes direction from one wall of the parietal cavity to the other

57
Q

sternal line of pleural reflection

A

where costal pleura becomes continuous with mediastinal pleura anteriorly

58
Q

costal line of pleural reflection

A

where costal pleura becomes continuous w diaphragmatic pleura inferiorly

59
Q

vertebral line of pleural reflection

A

where costal pleura becomes continuous with the mediastinal pleura posteriorly

60
Q

pleural recesses

A

space where lungs don’t extend and parietal pleural touches vertebral pleura

61
Q

costodiaphragmatic recesses

A

potential spaces between peripheral diaphragmatic pleura and costal pleura

62
Q

costomediastinal recesses

A

potential spaces between costal pleura and mediastinal pleura (posterior to sternum)

63
Q

pulmonary collapse

A
  • too much air enters pleural cavity - surface tension holding visceral to parietal pleura breaks
  • lungs collapse to elastic recoil
  • potential space becomes real space
64
Q

pneumothorax

A
  • air into pleural cavity (bullet wound, rib fracture)
65
Q

hydrothorax

A

fluid accumulation into pleural cavity (b/c of pleural effusion)

66
Q

hemothorax

A

blood accumulation in pleural cavity

67
Q

chylothorax

A

lymph accumulation in pleural cavity (b/c of torn thoracic duct)

68
Q

pleuritis

A 
inflammation of pleurae
- makes smooth surfaces rough = friction
visceral pleura constanty rubbing on rough surface 
- sharp stabbing pain
especially during exertion
69
Q

hilum

A

area on medial surface of each lung

- at the point at which the structures forming the root enter and leave the lung

70
Q

fissures

A

divide lobes into lungs

71
Q

right lung

A
  • 3 lobes
  • horizontal & oblique fissure
  • larger and heavier
  • shorter and wider
72
Q

left lung

A
  • 2 lobes
  • only oblique fissure
  • cardiac notch at anteroinferior aspect of the superior lobe
73
Q

lingula

A

extension below the cardiac notch slides in and out of the costomediastinal recess during respiration
- small jutting piece

74
Q

apex

A

point
- blunt superior end of lung
ascends above the level of 1st rib and into root of neck

75
Q

3 surfaces

A

costal, mediastinal, diaphragmatic

76
Q

pneumonectomy

A
  • removal of a lung
77
Q

lobectomy

A

removal of a lobe

78
Q

segmentectomy

A

removal of one or more brachopulmonary segments

– knowledge of segment is removed and used during drainage and clearance techniques - pneumonia and cystic fibrosis

79
Q

right main bronchus

A

wider, shorter, and runs more vertically than the left (as it passes directly to the hilum)

80
Q

left main bronchus

A

passes inferolaterally, inferior to the arch of the aorta and anterior to the esophagus and thoracic aorta

81
Q

pulmonary arteries

A

go to the lungs

O2 poor - just for O2/CO2 exchange in the lungs

82
Q

bronchiole arteries

A

goes to lungs
supply lungs with O2

left bronchiole art: from thoracic aorta

right bronchiole art: from superior posterior intercostal artery, trunk off thoracic artery, OR superior bronchiole artery

83
Q

bronchiole veins

A

drain only proximal root of lungs

  • majority of bronchiole artery supply drained by pulmonary veins
    right: drains into azygos vein
    left: drains into accessory hemiazygos vein
84
Q

pulmonary embolism

A
  • obstruction of a pulmonary artery

- embolism from leg travels to the right side of the heart to the lung through a pulmonary artery

85
Q

large embolism

A
  • occlusion of pulmonary artery

- acute respiratory distress

86
Q

medium embolism

A
  • occlusion of artery to bronchopulmonary segment
87
Q

pulmonary infarct

A

necrotic lung tissue

- pulmonary segment dies off

88
Q

parasympathetic fibers - efferent

A

(from vagas nerve CNX)

  • motor to smooth muscle of bronchial tree (BRONCHOCONSTRICTER)
  • inhibitory to pulmonary vessels (VASODIALATOR)
  • secretory to glands of the bronchiole tree
89
Q

parasympathetic fibers - afferents

A

(from vagas nerve CNX)

  • to bronchiole mucosa – tactile with cough reflexes
  • bronchiole muscles - stress receptors
  • interalveolar connective tissue
90
Q

Blood pressure levels

A
  • taken at pulmonary arteries
  • O2 poor
  • when sending blood to the lungs we do not care how oxygenated it is - only care how effective the blood is in getting there
  • pressure determines effectiveness
91
Q

blood gas levels

A
  • taken at pulmonary veins
  • O2 rich – just came from the lungs
  • need to measure how effective my lungs were in oxygenating
92
Q

sympathetic fibers

A
  • inhibitory to bronchiole muscle (BRONCHODIALATION)
  • Motor to pulmonary vessels (VASOCONSTRICT)
  • inhibitory to alveolar glands of bronchiole tree
  • decrease secretion of alveolar branch during constriction

Anatomy (6 decks)

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