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Clin Anat I - Exam #2 > Thorax > Flashcards

Thorax Flashcards

1
Q

What two structures are found at the sternal angle?

A
  • carina
  • aortic arch
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2
Q

What is the carina?

A
  • bifurcation of trachea
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3
Q

Identify

A
  1. jugular notch
  2. sternal angle
  3. 2nd rib
  4. intercostal space (3rd)
  5. costal margin/angle
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4
Q

Identify

and

Why is this area clinically relevant?

A
  • costovertebral angle
  • kidneys are located here
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5
Q

Identify

A
  1. anterior median line (midsternal line)
  2. midclavicular line
  3. anterior axillary line
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6
Q

Identify

A
  1. anterior axillary line
  2. midaxillary line
  3. posterior axillary line
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7
Q

What forms the anterior axillary line? posterior axillary line?

A
  • pec major
  • lat & teres major
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8
Q

Describe the location of ascultation alley

A

space between posterior median line & scapular line

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9
Q

What is the function of the thoracic cage?

A

protect thoracic content

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10
Q

Identify

A
  1. manubrium
  2. sternum (body)
  3. xiphoid
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11
Q

What are the rib’s classification?

A
  • true
  • false
  • floating
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12
Q

Describe true ribs

A
  • 1-7
  • attach “directly” to sterum
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13
Q

Describe false ribs

A
  • 8-10
  • attach “indirectly” to sterum
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14
Q

Describe floating ribs

A
  • 11 & 12
  • do not attach to sternum
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15
Q

Which ribs are typical vs. atypical?

A
  • 3-9, typical
  • 1, 2, & 10-12, atypical
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16
Q

Identify

A

1A - true

1B - false

1C - floating

2A - typical

2B - atypical

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17
Q

Identify

A

typical rib

A - head

B - neck

C - tubercle

D - shaft

E - facets

F - costal angle

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18
Q

What is the function of the facets of the ribs?

A

articulates with two vertebrae

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19
Q

What is the function of the tubercle of the rib?

A

articulates with the TP

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20
Q

Where is a common site of rib fractures and the weakest point of a rib?

A

costal angle

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21
Q

Identify

A
  1. SP
  2. TP
  3. costal facets
  4. transverse costal facets
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22
Q

T/F: Costal facets are on all the t-spine vertebrae

A

False - not on T9-12, no ribs

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23
Q

Identify

A
  1. SP
  2. TP
  3. costal facet
  4. tranverst costal facet
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24
Q

Identify

A
  1. costovertebral joint
  2. costotransverse joint
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25
Describe the costovertebral joint
rib articulates with vertebral body
26
Describe costotransverse joint
rib articulates with TP
27
Identify
1. costochondral joint 2. sternocostal joint 3. sternclavicular (SC) joint
28
Describe the costochondral joint
rib articulates with chondral cartilage
29
Describe the sternocostal joint
costal cartilage articulates with sternum
30
Describe SC joint
sternum articulates with clavicle
31
Why is the SC joint special?
only synovial attachment of the UE to the axial skeleton
32
Identify
1. interchondral joint 2. manubriosternal joint (sternal angle) 3. xiphosternal joint
33
Describe the interchondral joint
"articulation" between costal cartilage and the lower ribs
34
Describe xiphosternal joint
articulation of sternum and xiphoid
35
What allows for inspiration at rest and during exercise?
* rest = diaphragm * exercise = diaphragm & external intercostal
36
What are the accessory muscles that allow for inspiration during extreme exercise?
* SCM * scalenes
37
What allows for expiration during rest and exercise?
* rest = elastic recoil of lungs * exercise = internal intercostals & abdominals
38
Identify
1. external intercostals 2. internal intercostals 3. innermost intercostals
39
Identify
1. external intercostals 2. internal intercostals 3. innermost intercostals
40
Identify
1. NAV 2. innermost intercostals
41
Identify
transversus thoracis
42
What is the function of the transversus thoracis?
expiration
43
Identify
subcostal muscles
44
What is the function of the subcostal muscle?
inspiration
45
Identify
levator costarum
46
What is the function of levator costarum?
inspiration
47
What is the function of serratus posterior superior? inferior?
* superior = inspiration * inferior = expiration
48
Identify and What is its innervation?
* diaphragm * phrenic n.
49
Identify
1. central tendon 2. sternal region of diaphragm 3. costal region of diaphragm 4. lumbar region of diaphragm
50
Identify
phrenic n.
51
Identify
1. anterior rami 2. posterior rami
52
Identify
posterior intercostal a.
53
What does the posterior intercostal a. supply?
3rd-11th intercostal spaces
54
What artery runs inferiorly to the 12th rib?
subcostal a.
55
Identify
1. costocervical trunk 2. superior throacic a. 3. deep cervical a.
56
What does the superior thoracic a. supply?
1st & 2nd intercostal space
57
Identify
internal thoracic a.
58
What does the internal thoracic a. supply?
anterior 1st - 9th intercostal spaces via anterior intercostal a.
59
Identify
internal thoracic a.
60
Identify
internal thoracic v.
61
Describe the return flow of blood from the lateral veins
intercostal spaces --\> intercostal v. --\> azygos posteriorly and internal thoracic anteriorly
62
Identify
1. azygos v. 2. hemi-azygos 3. accessory hemi-azygos
63
Which intercostal space is under the nipple?
4th
64
What are the two parts to the breast landmarks?
* circular base * axillary tail
65
Where are most breast pathologies?
laterally
66
Describe the lymphatic drainage of the breast
* 75% into axillary lymph nodes * remaining drain medially via parasternal lymph
67
Describe the bifurcations of the tracheobronchial tree starting most superiorly
trachea R/L primary bronchi Lobular bronchi Segmental bronchi
68
Identify
trachialis muscle
69
Identify
1. primary bronchi 2. lobar bronchi (L=2; R=3) 3. segmental bronchi
70
At which level/division does the cartilage begin to disappear in the tracheal tree?
bronchioles
71
Where does gas exchange begin?
respiratory bronchioles
72
What level is immediatly supperior to the location begining of gas exchange?
terminal bronchiole
73
Identify and What is the cluster at the bottom known as?
1. terminal bronchiole 2. respiratory bronchioles acinus
74
Which pleural layer is closest to the lungs?
visceral
75
Which pleural layer is closest to the thoracic cage?
parietal
76
What is the space between the two layers of pleurae?
pleural cavity
77
Identify
1. visceral pleura 2. parietal pleura 3. pleural cavity
78
Identify
1. costodiaphragmatic recesses 2. costomediastinal recesses
79
Identify
costodiaphragmatic recess
80
What is a treatment for fluid accumulation in the pleural cavity?
thoracocentesis
81
Identify
1. apex 2. base 3. costodiaphragmatic recess
82
Identify
hilum/root
83
What does the hilum contain?
* primary bronchis * pulmonary NAV * bronchial vessels * lymph vessels
84
Identify
1A. superior lobe 1B. middle lobe 1C. inferior lobe 2A. horizontal fissure 2B. oblique fissure
85
Identify
1. superior lobe 2. oblique fissure 3. inferior lobe 4. lingula 5. cardiac notch
86
What is the equivelant in the left lung, of the middle lobe in right lung?
lingula
87
Describe the endocardium
thin, smooth lining layer of the heart chambers
88
What is myocardium?
cardiac muscle
89
Describe the epicardium
blends into visceral pericardium
90
List the layers of the heart from the inside out
endocardium myocardium epicardium visceral pericardium pericardial cavity parietal pericardium
91
Identify
1. fibrous pericardium 2. pericardiocophremic ligament
92
Identify
1. SVC/IVC 2. opening to coronary sinus v. 3. fossa ovalis 4. tricuspid valve
93
Identify
1. tricuspid valve 2. papillary muscle/cordae tendineae 3. pulmonary valve
94
Identify
1. pulmonary a. 2. left coronary a. 3. bicuspid valve 4. tricuspid valve 5. right coronary a. 6. aorta
95
Describe the fibrous skeleton of the heart
* four fibrous rings surrounding the orifaces * provides attachements
96
Where do you auscultate for the tricuspid valve?
left sternal border @ 5th intercostal space
97
Where do you ausculate the pulmonary valve?
left 2nd intercostal space
98
Where do you auscultate the bicuspid valve?
left 5th intercostal space
99
Where do you ausculatate the aortic valve?
right 2nd intercostal space
100
What is the purpose of the SVC?
* superior vena cava * returns blood to R atrium from areas superior to diaphragm * except heart and lungs
101
What is the purpose of the IVC?
* inferior vena cava * returns blood back to the R atrium from areas inferior to the diaphragm
102
Identify
1. pulmonary a. 2. pulmonary v. 3. IVC 4. SVC 5. aorta
103
What does the pulmonary trunk do?
* branches into R & L pulmonary a. * sends unoxygenated blood from R ventricle to lungs
104
What does the pulmonary v. do?
returns oxygenated blood back from lungs to L atrium
105
What does the aorta do?
sends oxygenated blood from L ventricle to body
106
What are the branches off the aorta?
* brachiocephalic * LCC * L subclavian a.
107
How does blood get into coronary arteries?
* L ventricle contracts opening aortic valve which flaps over opening to coronary a. * L ventricle relaxes allowing aortic valve to relax and shut * coronary a. fills with backflow of blood with not enough pressure to continue in aorta
108
Identify
1. right coronary a. 2. left coronary a.
109
Identify
1. right coronary a. 2. marginal branch of right coronary a. 3. posterior interventricular a. (right posterior descending)
110
Identify
1. left coronary a. 2. circumflex a. 3. anterior interventricular a. (left anterior descending a.)
111
What is the widow maker and why is it called that?
* anterior interventricular a. * most often site of major occlusion leading to MI
112
Identify
1. circumflex a. 2. marginal branch
113
What supplies the right ventricle?
* marginal branches from the RCA * posterior interventricular a.
114
What supplies the left ventricle?
* anterior interventricular a. * circumflex a. from the LCA * marginal branch from the LCA
115
What supplies the left atrium?
circumflex a. from the LCA
116
Identify
1. great cardiac v. 2. small cardiac v. 3. middle cardiac v. 4. coronary sinus
117
Where does the coronary sinus drain?
right atrium
118
What is the function of the AV node?
allows for a 1/10s delay in signal for atrial contraction
119
Describe the conducting pathway of the heart
SA node AV node AV bundle (of His) L/R bundle branch Purkinje fibers
120
Name the 5 sides of the heart (pyramidish)
sternocostal (anterior) diaphragmatic (inferior) right & left pulmonary base
121
Identify
1. apex 2. base
122
How is the mediastinum described?
in relation to the pericardium
123
Identify
1. superior 2. inferior 3. posterior 4. middle 5. anterior
124
Identify
1. thymus 2. aorta 3. trachea
125
What are the contents of the superior mediastinum?
* thymus in children; remnants in adults * aorta/great vessels * trachea * esophagus
126
What are the contents of the anterior mediastinum?
1. internal thoracic vessels 2. fat 3. few lymph nodes
127
What are the contents of the middle mediastinum?
* pericardium * heart * roots of great vessels
128
What are the contents of the posterior mediastinum?
* esophagus * thoracic aorta * thoracic duct * lymph nodes
129
When are chest XRs taken?
during inspiration
130
Why are chest XRs taken PA instead of AP?
PA gets the heart closer to the film so there is less distortion
131
Identify
1. aortic arch 2. left ventricle 3. apex 4. left diaphragm 5. right diaphragm 6. right atrium
132
Identify
1. tracheal shadow 2. right bronchi 3. hilum; 3A. hilar points 4. & 4A. costodiapragmatic recess
133
Identify
1. sternal angle 2. heart shadow 3. anterior mediastinum 4. middle mediastinum 5. posterior mediastinum 6. costophrenic recess 7. diaphragm
134
List the muscles involved in inspiration
* diaphragm * external intercostals * subcostals * levator costarum * serratus posterior superior
135
List the muscles involved in expiration
* internal intercostals * transversus thoracis * serratus posterior inferior
136
Which is NOT a major source of circulation to the thoracic wall? ## Footnote a. subclavian a. b. thoracic aorta c. subcostal a. d. axillary a.
c. subcostal a. True, it is an artery of the thoracic wall but it branches off thoracic aorta to supply inferior to the 12th rib.
137
Which thoracic wall vasculature branches off the thoracic aorta?
* posterior intercostal a. * subcostal a.
138
What branches off the axillary a.?
costocervical trunk
139
What branches off the subclavian a.?
internal thoracic a.
140
What does azygos SYSTEM drain?
back & thoracoabdominal walls
141
What do the hemi- & accessory hemi-azygos v. drain?
left 5th-12th intercostals
142
What does the azygos v. drain?
* R intercostals * hemi- & accessory hemi-azygos v.
143
Where does the L 1st-4th intercostal v drain?
directly into L brachiocephalic trunk
144
Which is NOT a layer of the heart wall? ## Footnote a. epicardium b. pericardium c. endocardium d. myocardium
b. pericardium Pericardium surrounds the heart.
145
What attaches the pericardium to the sternum? to the diaphragm?
* sternopericardial ligament * pericardiacophernic liagment
146
What is the 'point of maximal impact'?
apical impulse

Clin Anat I - Exam #2 (3 decks)

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