Thorax 3 (Megan)

Question 2

Changes, such as branching of the _______ ducts, occur in the breast tissues during menstrual periods and pregnancy.

Answer 2

lactiferous

Question 3

Although __________ are prepared for secretion by mid-pregnancy, they do not produce milk until shortly after the baby is born.

Answer 3

mammary glands

Question 4

A creamy white to yellowish premilk fluid that may secrete from the nipples during the last trimester of pregnancy and during initial episodes of nursing.

Answer 4

Colostrum

Question 5

Colostrum is believed to be especially rich in _______, immune agents, and a growth factor affecting the infant’s intestines.

Answer 5

protein

Question 6

In ___ women, the breasts often become large and pendulous.

Answer 6

multiparous

Question 7

The breasts in elderly women are usually small because of the decrease in fat and the atrophy of _______ tissue.

Answer 7

glandular

Question 8

For the anatomical location and description of tumors and cysts, the surface of the breast is divided into four quadrants:

Answer 8

Superior lateral, superior medial, Inferior lateral, inferior medial

Question 9

The ___ breast is more affected breast for cancer compared to the ____ breast because it is usually larger and is composed of more granular tissue.

Answer 9

Left, right

Question 10

What quadrant of the breast has the greatest percentage of cancer?

Answer 10

Superior lateral

Question 11

The arterial supply of the breast derives from the:

Answer 11

• Medial mammary branches of perforating branches - Anterior intercostal branches of the internal thoracic artery - Lateral thoracic and thoracoacromial arteries - Posterior intercostal arteries

Question 12

Medial mammary branches of perforating branches and anterior intercostal branches of the internal thoracic artery originate from the ___________ artery.

Answer 12

subclavian

Question 13

Lateral thoracic and thoracoacromial arteries are branches of the ______ artery

Answer 13

axillary

Question 14

Posterior intercostal arteries are branches of the thoracic aorta in these three intercostal spaces:

Answer 14

2nd, 3rd, and 4th

Question 15

In breast cancer, cancer mostly spreads to the ____. However, for prostate cancer, the cancer spreads to the venous blood and bones.

Answer 15

brain

Question 16

The venous drainage of the breast is mainly to the axillary vein, but there is some drainage to the _____________

Answer 16

internal thoracic vein.

Question 17

The _______ of the breast is important because of its role in the metastasis of cancer cells.

Answer 17

lymphatic drainage

Question 18

Lymph passes from the nipple, areola, and lobules of the gland to the _______

Answer 18

subareolar lymphatic plexus.

Question 19

Most lymph (> 75%), especially from the lateral breast quadrants, drains to the axillary lymph nodes, initially to the ___ or _____nodes for the most part.

Answer 19

anterior or pectoral

Question 20

Some lymph may drain directly to other ____ nodes or even to interpectoral, deltopectoral, supraclavicular, or inferior deep cervical nodes.

Answer 20

axillary

Question 21

Most of the remaining lymph, particularly from the medial breast quadrants, drains to the _____lymph nodes or to the opposite breast.

Answer 21

parasternal

Question 22

Lymph from the inferior quadrants may pass deeply to ____ lymph nodes (subdiaphragmatic inferior phrenic lymph nodes).

Answer 22

abdominal

Question 23

Lymph from the skin of the ____, except the nipple and areola, drains into the ipsilateral axillary, inferior deep cervical, and infraclavicular lymph nodes and also into the parasternal lymph nodes of both sides.

Answer 23

breast

Question 24

Lymph from the axillary nodes drains into clavicular (infraclavicular and supraclavicular) lymph nodes and from them into the ______ lymphatic trunk, which also drains lymph from the upper limb.

Answer 24

subclavian

Question 25

Lymph from the _____ nodes enters the bronchomediastinal lymphatic trunk, which also drains lymph from the thoracic viscera.

Answer 25

parasternal

Question 26

When the viscera of the thoracic cavity is sectioned transversely, it is apparent that the thoracic cavity is ____ shaped: a transversely ovoid space deeply indented posteriorly by the thoracic vertebral column and the posteromedial parts of the ribs (heads and necks), which articulate with it.

Answer 26

kidney

Question 27

The thoracic cavity is divided into 3 compartments:

Answer 27

1. Right and left pulmonary cavities 2. Bilateral compartments 3. A central mediastinum

Question 28

The ____ of the thoracic cavity contain the lungs and pleurae (lining membranes) and occupy the majority of the thoracic cavity.

Answer 28

Bilateral compartments

Question 29

The \_\_\_\_\_\_is a thoracic cavity compartment intervening between and completely separating the two pulmonary cavities, which contains essentially all other thoracic structures - the heart, thoracic parts of the great vessels, thoracic part of the trachea, esophagus, thymus, and other structures (e.g., lymph nodes).

Answer 29

Mediastinum

Question 30

The mediastinum extends vertically from the superior thoracic aperture to the ____ and anteroposteriorly from the thoracic vertebral bodies to the \_\_\_\_

Answer 30

diaphragm, sternum

Question 31

The pulmonary cavities are lined by _________ that also reflect onto and cover the external surface of the lungs contained within the cavities.

Answer 31

pleural membranes (pleurae)

Question 32

The inner pleural membrane is called the \_\_\_\_\_\_

Answer 32

visceral pleura

Question 33

The outside pleural membrane is called the\_\_\_\_

Answer 33

parietal pleura

Question 34

During the embryonic period, the developing lungs invaginate (grow into) the _______ canals, the primordia (beginnings) of the pleural cavities.

Answer 34

pericardioperitoneal

Question 35

The invaginated coelomic epithelium covers the primordia of the lungs and becomes the \_\_\_\_\_\_\_.

Answer 35

visceral pleura

Question 36

The epithelium lining the walls of the pericardioperitoneal canals forms the\_\_\_\_\_\_\_

Answer 36

parietal pleura.

Question 37

During embryogenesis, the ______ cavities become separated from the pericardial and peritoneal cavities; however, a congenital diaphragmatic defect results in a diaphragmatic hernia connecting the peritoneal cavity with one of the pleural cavities (usually the left one), and the herniation of abdominal viscera into the thorax.

Answer 37

pleural

Question 38

Each lung is invested by and enclosed in a serous pleural sac that consists of two continuous membranes:

Answer 38

visceral and parietal pleura

Question 39

the \_\_\_\_\_\_pleura invests all surfaces of the lungs forming their shiny outer surface.

Answer 39

visceral

Question 40

the ____ pleura lines the pulmonary cavities.

Answer 40

parietal

Question 41

The pleural cavity - the potential space between the layers of pleura - contains a capillary layer of ______ \_\_\_\_\_\_\_ \_\_\_\_\_\_, which lubricates the pleural surfaces and allows the layers of pleura to slide smoothly over each other during respiration.

Answer 41

serous pleural fluid

Question 42

The surface tension of the pleural cavity also provides the _____ that keeps the lung surface in contact with the thoracic wall; consequently, the lung expands and fills with air when the thorax expands while still allowing sliding to occur.

Answer 42

cohesion

Question 43

The visceral pleura (pulmonary pleura) closely covers the lung and is adherent to all its surfaces, including the surfaces within the _______ and ______ fissures; it cannot be dissected from their surfaces.

Answer 43

horizontal and oblique

Question 44

The visceral pleura provides the lung with a smooth slippery surface, enabling it to move freely on the \_\_\_\_\_.

Answer 44

parietal pleura.

Question 45

The visceral pleura is continuous with the parietal pleura at the _____ of the lung, where structures making up the root of the lung (e.g., the bronchus and pulmonary vessels) enter and leave the lung.

Answer 45

hilum

Question 46

The parietal pleura lines the ______ cavities, thereby adhering to the thoracic wall, the mediastinum, and the diaphragm.

Answer 46

pulmonary

Question 47

The parietal pleura consists of four parts:

Answer 47

costal part mediastinal part diaphragmatic part cervical pleura

Question 48

The ______ part of the parietal pleura covers the internal surfaces of the thoracic wall.

Answer 48

costal

Question 49

The ____ part of the parietal pleura covers the lateral aspects of the mediastinum - the mass of tissues and organs separating the pulmonary cavities and their pleural sacs.

Answer 49

mediastinal

Question 50

The ________ part of the parietal pleura covers the superior or thoracic surface of the diaphragm on each side of the mediastinum.

Answer 50

diaphragmatic

Question 51

The ______ pleura of the parietal pleura extends through the superior thoracic aperture into the root of the neck, forming a cup-shaped pleural dome over the apex of the lung (the part extending above the 1st rib).

Answer 51

cervical

Question 52

\_\_\_\_\_ pleura can be damaged easily, especially in children.

Answer 52

cervical

Question 53

The costal part of the parietal pleura (costovertebral or costal pleura) is separated from the internal surface of the thoracic wall (sternum, ribs and costal cartilages, intercostal muscles and membranes, and sides of thoracic vertebrae) by \_\_\_\_\_\_\_\_

Answer 53

endothoracic fascia.

Question 54

The endothoracic fascia is an extrapleural layer of loose connective tissue that forms a natural cleavage plane for the surgical separation of the _______ from the thoracic wall.

Answer 54

costal pleura

Question 55

The ______ part of the parietal pleura covers the lateral aspects of the mediastinum, the partition between the pulmonary cavities.

Answer 55

mediastinal

Question 56

The mediastinal part of the parietal pleura (mediastinal pleura) continues superiorly into the root of the neck as \_\_\_\_\_\_

Answer 56

cervical pleura

Question 57

The mediastinal part of the parietal pleura (mediastinal pleura) is continuous with costal pleura anteriorly and posteriorly and with the _____ pleura inferiorly.

Answer 57

diaphragmatic

Question 58

Superior to the root of the lung, the mediastinal pleura is a continuous sheet passing anteroposteriorly between the sternum and the \_\_\_\_\_\_\_

Answer 58

vertebral column.

Question 59

At the ______ of the lung, the mediastinal pleura reflects laterally onto the structures making up the root of the lung and becomes continuous with the visceral pleura.

Answer 59

hilum

Question 60

Inferior to the root of the lung, this continuity between parietal and visceral pleura is an ‘empty’double layer of pleura, the \_\_\_\_\_\_\_, extending between the lung and the mediastinum, immediately anterior to the esophagus.

Answer 60

pulmonary ligament

Question 61

The \_\_\_\_\_\_\_covers the superior surface of the diaphragm, except along its costal attachments (origins) and where the diaphragm is fused to the pericardium, the fibroserous membrane surrounding the heart.

Answer 61

diaphragmatic part of the parietal pleura (diaphragmatic pleura)

Question 62

A thin, more elastic layer of endothoracic fascia, the \_\_\_\_\_fascia, connects the diaphragmatic pleura with the muscular fibers of the diaphragm.

Answer 62

phrenicopleural

Question 63

The _______ pleura is the dome-shaped cap of the pleural sac and is the superior continuation of the costal and mediastinal parts of the parietal pleura

Answer 63

cervical

Question 64

The cervical pleura covers the _____ of the lung that extends superiorly through the superior thoracic aperture into the root of the neck.

Answer 64

apex

Question 65

The summit of the cervical pleura is ______ cm superior to the level of the medial third of the clavicle at the level of the neck of the 1st rib.

Answer 65

2 - 3 cm

Question 66

The cervical pleura is reinforced by a fibrous extension of the endothoracic fascia - the \_\_\_\_\_\_\_\_\_, which attaches to the internal border of the 1st rib and the transverse process of C7 vertebra.

Answer 66

suprapleural membrane (Sibson fascia)

Question 67

The _____ do not occupy the pulmonary cavities completely during expiration; thus the peripheral diaphragmatic pleura is in contact with the lowermost parts of the costal pleura.

Answer 67

lungs

Question 68

The potential pleural spaces here are the \_\_\_\_\_\_\_\_, pleura-lined grooves, which surround the upward convexity of the diaphragm inside the thoracic wall.

Answer 68

costodiaphragmatic recesses

Question 69

Smaller pleural ____ are located posterior to the sternum where the costal pleura is in contact with the mediastinal pleura.

Answer 69

recesses

Question 70

The potential pleural spaces here are the costomediastinal recesses; the left recess is potentially larger (less occupied) because of the ______ in the left lung.

Answer 70

cardiac notch

Question 71

The inferior borders of the lungs move farther into the pleural recesses during deep ______ and retreat from them during expiration.

Answer 71

inspiration

Question 72

Because of the inferior slope of the 1st pair of ribs and the superior thoracic aperture they form, the cervical pleura and apex of the lung project through this opening into the neck, posterior to the inferior attachments of the ______ muscles.

Answer 72

sternocleidomastoid

Question 73

The lungs and pleural sacs may be injured in wounds to the base of the neck resulting in a \_\_\_\_\_, the presence of air in the pleural cavity.

Answer 73

pneumothorax

Question 74

The cervical pleura reaches a relatively higher level in ______ because of the shortness of their necks.

Answer 74

infants and young children

Question 75

The \_\_\_\_\_\_\_is especially vulnerable to injury during the first few years after birth.

Answer 75

cervical pleura

Question 76

The pleurae descend inferior to the costal margin in three regions, where an abdominal incision might accidentally enter a pleural sac: the \_\_\_\_\_\_\_and right and left costovertebral angles.

Answer 76

right part of the infrasternal angle

Question 77

The small areas of pleura exposed in the costovertebral angles inferomedial to the 12th ribs are posterior to the superior poles of the \_\_\_\_\_

Answer 77

kidneys

Question 78

The pleura is in danger (i.e., a ______ may occur) from an incision in the posterior abdominal wall when surgical procedures expose a kidney, for example.

Answer 78

pneumothorax

Question 79

Entry of air into the pleural cavity (pneumothorax), resulting from a penetrating wound of the parietal pleura from a bullet, for example, or from rupture of a pulmonary lesion into the pleural cavity (bronchopulmonary fistula), results in \_\_\_\_\_\_\_of the lung.

Answer 79

collapse

Question 80

\_\_\_\_ ribs may also tear the visceral pleura and lung, thus producing pneumothorax.

Answer 80

Fractured

Question 81

The accumulation of a significant amount of fluid in the pleural cavity (\_\_\_\_\_\_\_\_) may result from ______ (escape of fluid into the pleural cavity).

Answer 81

hydrothorax, pleural effusion

Question 82

With a chest wound, blood may also enter the pleural cavity (\_\_\_\_\_\_\_\_).

Answer 82

hemothorax

Question 83

Hemothorax results more commonly from injury to a major intercostal or internal thoracic ______ than from laceration of a lung.

Answer 83

vessel

Question 84

If both air and fluid (\_\_\_\_\_\_\_\_, if the fluid is blood) accumulate in the pleural cavity, an air-fluid level or interface (sharp line, horizontal regardless of the patient's position, indicating the upper surface of the fluid) will be seen on a radiograph.

Answer 84

hemopneumothorax

Question 85

During inspiration and expiration, the sliding of normally smooth, moist pleurae makes no detectable sound during auscultation of the lungs (listening to breath sounds); however, inflammation of the pleura, \_\_\_\_\_\_\_, makes the lung surfaces rough.

Answer 85

pleuritis or pleurisy

Question 86

Friction (pleural rub) is detectable with a \_\_\_\_\_\_\_

Answer 86

stethoscope

Question 87

\_\_\_\_\_\_ sounds like a clump of hair being rolled between the fingers.

Answer 87

Pleuritis (pleurisy)

Question 88

The __________ of pleura may also cause the parietal and visceral layers of pleura to adhere (pleural adhesion).

Answer 88

inflamed surfaces

Question 89

\_\_\_\_ pleuritis is marked by sharp, stabbing pain, especially on exertion, such as climbing stairs, when the rate and depth of respiration may be increased even slightly.

Answer 89

Acute