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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
Q

Describe the costovertebral joint

A

rib articulates with vertebral body

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26
Q

Describe costotransverse joint

A

rib articulates with TP

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27
Q

Identify

A
  1. costochondral joint
  2. sternocostal joint
  3. sternclavicular (SC) joint
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28
Q

Describe the costochondral joint

A

rib articulates with chondral cartilage

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29
Q

Describe the sternocostal joint

A

costal cartilage articulates with sternum

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30
Q

Describe SC joint

A

sternum articulates with clavicle

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31
Q

Why is the SC joint special?

A

only synovial attachment of the UE to the axial skeleton

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32
Q

Identify

A
  1. interchondral joint
  2. manubriosternal joint (sternal angle)
  3. xiphosternal joint
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33
Q

Describe the interchondral joint

A

“articulation” between costal cartilage and the lower ribs

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34
Q

Describe xiphosternal joint

A

articulation of sternum and xiphoid

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35
Q

What allows for inspiration at rest and during exercise?

A
  • rest = diaphragm
  • exercise = diaphragm & external intercostal
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36
Q

What are the accessory muscles that allow for inspiration during extreme exercise?

A
  • SCM
  • scalenes
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37
Q

What allows for expiration during rest and exercise?

A
  • rest = elastic recoil of lungs
  • exercise = internal intercostals & abdominals
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38
Q

Identify

A
  1. external intercostals
  2. internal intercostals
  3. innermost intercostals
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39
Q

Identify

A
  1. external intercostals
  2. internal intercostals
  3. innermost intercostals
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40
Q

Identify

A
  1. NAV
  2. innermost intercostals
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41
Q

Identify

A

transversus thoracis

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42
Q

What is the function of the transversus thoracis?

A

expiration

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43
Q

Identify

A

subcostal muscles

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44
Q

What is the function of the subcostal muscle?

A

inspiration

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45
Q

Identify

A

levator costarum

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46
Q

What is the function of levator costarum?

A

inspiration

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47
Q

What is the function of serratus posterior superior? inferior?

A
  • superior = inspiration
  • inferior = expiration
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48
Q

Identify

and

What is its innervation?

A
  • diaphragm
  • phrenic n.
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49
Q

Identify

A
  1. central tendon
  2. sternal region of diaphragm
  3. costal region of diaphragm
  4. lumbar region of diaphragm
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50
Q

Identify

A

phrenic n.

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51
Q

Identify

A
  1. anterior rami
  2. posterior rami
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52
Q

Identify

A

posterior intercostal a.

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53
Q

What does the posterior intercostal a. supply?

A

3rd-11th intercostal spaces

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54
Q

What artery runs inferiorly to the 12th rib?

A

subcostal a.

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55
Q

Identify

A
  1. costocervical trunk
  2. superior throacic a.
  3. deep cervical a.
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56
Q

What does the superior thoracic a. supply?

A

1st & 2nd intercostal space

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57
Q

Identify

A

internal thoracic a.

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58
Q

What does the internal thoracic a. supply?

A

anterior 1st - 9th intercostal spaces via anterior intercostal a.

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59
Q

Identify

A

internal thoracic a.

60
Q

Identify

A

internal thoracic v.

61
Q

Describe the return flow of blood from the lateral veins

A

intercostal spaces –> intercostal v. –> azygos posteriorly and internal thoracic anteriorly

62
Q

Identify

A
  1. azygos v.
  2. hemi-azygos
  3. accessory hemi-azygos
63
Q

Which intercostal space is under the nipple?

A

4th

64
Q

What are the two parts to the breast landmarks?

A
  • circular base
  • axillary tail
65
Q

Where are most breast pathologies?

A

laterally

66
Q

Describe the lymphatic drainage of the breast

A
  • 75% into axillary lymph nodes
  • remaining drain medially via parasternal lymph
67
Q

Describe the bifurcations of the tracheobronchial tree starting most superiorly

A

trachea

R/L primary bronchi

Lobular bronchi

Segmental bronchi

68
Q

Identify

A

trachialis muscle

69
Q

Identify

A
  1. primary bronchi
  2. lobar bronchi (L=2; R=3)
  3. segmental bronchi
70
Q

At which level/division does the cartilage begin to disappear in the tracheal tree?

A

bronchioles

71
Q

Where does gas exchange begin?

A

respiratory bronchioles

72
Q

What level is immediatly supperior to the location begining of gas exchange?

A

terminal bronchiole

73
Q

Identify

and

What is the cluster at the bottom known as?

A
  1. terminal bronchiole
  2. respiratory bronchioles

acinus

74
Q

Which pleural layer is closest to the lungs?

A

visceral

75
Q

Which pleural layer is closest to the thoracic cage?

A

parietal

76
Q

What is the space between the two layers of pleurae?

A

pleural cavity

77
Q

Identify

A
  1. visceral pleura
  2. parietal pleura
  3. pleural cavity
78
Q

Identify

A
  1. costodiaphragmatic recesses
  2. costomediastinal recesses
79
Q

Identify

A

costodiaphragmatic recess

80
Q

What is a treatment for fluid accumulation in the pleural cavity?

A

thoracocentesis

81
Q

Identify

A
  1. apex
  2. base
  3. costodiaphragmatic recess
82
Q

Identify

A

hilum/root

83
Q

What does the hilum contain?

A
  • primary bronchis
  • pulmonary NAV
  • bronchial vessels
  • lymph vessels
84
Q

Identify

A

1A. superior lobe

1B. middle lobe

1C. inferior lobe

2A. horizontal fissure

2B. oblique fissure

85
Q

Identify

A
  1. superior lobe
  2. oblique fissure
  3. inferior lobe
  4. lingula
  5. cardiac notch
86
Q

What is the equivelant in the left lung, of the middle lobe in right lung?

A

lingula

87
Q

Describe the endocardium

A

thin, smooth lining layer of the heart chambers

88
Q

What is myocardium?

A

cardiac muscle

89
Q

Describe the epicardium

A

blends into visceral pericardium

90
Q

List the layers of the heart from the inside out

A

endocardium

myocardium

epicardium

visceral pericardium

pericardial cavity

parietal pericardium

91
Q

Identify

A
  1. fibrous pericardium
  2. pericardiocophremic ligament
92
Q

Identify

A
  1. SVC/IVC
  2. opening to coronary sinus v.
  3. fossa ovalis
  4. tricuspid valve
93
Q

Identify

A
  1. tricuspid valve
  2. papillary muscle/cordae tendineae
  3. pulmonary valve
94
Q

Identify

A
  1. pulmonary a.
  2. left coronary a.
  3. bicuspid valve
  4. tricuspid valve
  5. right coronary a.
  6. aorta
95
Q

Describe the fibrous skeleton of the heart

A
  • four fibrous rings surrounding the orifaces
  • provides attachements
96
Q

Where do you auscultate for the tricuspid valve?

A

left sternal border @ 5th intercostal space

97
Q

Where do you ausculate the pulmonary valve?

A

left 2nd intercostal space

98
Q

Where do you auscultate the bicuspid valve?

A

left 5th intercostal space

99
Q

Where do you ausculatate the aortic valve?

A

right 2nd intercostal space

100
Q

What is the purpose of the SVC?

A
  • superior vena cava
  • returns blood to R atrium from areas superior to diaphragm
    • except heart and lungs
101
Q

What is the purpose of the IVC?

A
  • inferior vena cava
  • returns blood back to the R atrium from areas inferior to the diaphragm
102
Q

Identify

A
  1. pulmonary a.
  2. pulmonary v.
  3. IVC
  4. SVC
  5. aorta
103
Q

What does the pulmonary trunk do?

A
  • branches into R & L pulmonary a.
  • sends unoxygenated blood from R ventricle to lungs
104
Q

What does the pulmonary v. do?

A

returns oxygenated blood back from lungs to L atrium

105
Q

What does the aorta do?

A

sends oxygenated blood from L ventricle to body

106
Q

What are the branches off the aorta?

A
  • brachiocephalic
  • LCC
  • L subclavian a.
107
Q

How does blood get into coronary arteries?

A
  • 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
Q

Identify

A
  1. right coronary a.
  2. left coronary a.
109
Q

Identify

A
  1. right coronary a.
  2. marginal branch of right coronary a.
  3. posterior interventricular a. (right posterior descending)
110
Q

Identify

A
  1. left coronary a.
  2. circumflex a.
  3. anterior interventricular a. (left anterior descending a.)
111
Q

What is the widow maker and why is it called that?

A
  • anterior interventricular a.
  • most often site of major occlusion leading to MI
112
Q

Identify

A
  1. circumflex a.
  2. marginal branch
113
Q

What supplies the right ventricle?

A
  • marginal branches from the RCA
  • posterior interventricular a.
114
Q

What supplies the left ventricle?

A
  • anterior interventricular a.
  • circumflex a. from the LCA
  • marginal branch from the LCA
115
Q

What supplies the left atrium?

A

circumflex a. from the LCA

116
Q

Identify

A
  1. great cardiac v.
  2. small cardiac v.
  3. middle cardiac v.
  4. coronary sinus
117
Q

Where does the coronary sinus drain?

A

right atrium

118
Q

What is the function of the AV node?

A

allows for a 1/10s delay in signal for atrial contraction

119
Q

Describe the conducting pathway of the heart

A

SA node

AV node

AV bundle (of His)

L/R bundle branch

Purkinje fibers

120
Q

Name the 5 sides of the heart (pyramidish)

A

sternocostal (anterior)

diaphragmatic (inferior)

right & left pulmonary

base

121
Q

Identify

A
  1. apex
  2. base
122
Q

How is the mediastinum described?

A

in relation to the pericardium

123
Q

Identify

A
  1. superior
  2. inferior
  3. posterior
  4. middle
  5. anterior
124
Q

Identify

A
  1. thymus
  2. aorta
  3. trachea
125
Q

What are the contents of the superior mediastinum?

A
  • thymus in children; remnants in adults
  • aorta/great vessels
  • trachea
  • esophagus
126
Q

What are the contents of the anterior mediastinum?

A
  1. internal thoracic vessels
  2. fat
  3. few lymph nodes
127
Q

What are the contents of the middle mediastinum?

A
  • pericardium
  • heart
  • roots of great vessels
128
Q

What are the contents of the posterior mediastinum?

A
  • esophagus
  • thoracic aorta
  • thoracic duct
  • lymph nodes
129
Q

When are chest XRs taken?

A

during inspiration

130
Q

Why are chest XRs taken PA instead of AP?

A

PA gets the heart closer to the film so there is less distortion

131
Q

Identify

A
  1. aortic arch
  2. left ventricle
  3. apex
  4. left diaphragm
  5. right diaphragm
  6. right atrium
132
Q

Identify

A
  1. tracheal shadow
  2. right bronchi
  3. hilum; 3A. hilar points
  4. & 4A. costodiapragmatic recess
133
Q

Identify

A
  1. sternal angle
  2. heart shadow
  3. anterior mediastinum
  4. middle mediastinum
  5. posterior mediastinum
  6. costophrenic recess
  7. diaphragm
134
Q

List the muscles involved in inspiration

A
  • diaphragm
  • external intercostals
  • subcostals
  • levator costarum
  • serratus posterior superior
135
Q

List the muscles involved in expiration

A
  • internal intercostals
  • transversus thoracis
  • serratus posterior inferior
136
Q

Which is NOT a major source of circulation to the thoracic wall?

a. subclavian a.
b. thoracic aorta
c. subcostal a.
d. axillary a.

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
Q

Which thoracic wall vasculature branches off the thoracic aorta?

A
  • posterior intercostal a.
  • subcostal a.
138
Q

What branches off the axillary a.?

A

costocervical trunk

139
Q

What branches off the subclavian a.?

A

internal thoracic a.

140
Q

What does azygos SYSTEM drain?

A

back & thoracoabdominal walls

141
Q

What do the hemi- & accessory hemi-azygos v. drain?

A

left 5th-12th intercostals

142
Q

What does the azygos v. drain?

A
  • R intercostals
  • hemi- & accessory hemi-azygos v.
143
Q

Where does the L 1st-4th intercostal v drain?

A

directly into L brachiocephalic trunk

144
Q

Which is NOT a layer of the heart wall?

a. epicardium
b. pericardium
c. endocardium
d. myocardium

A

b. pericardium

Pericardium surrounds the heart.

145
Q

What attaches the pericardium to the sternum? to the diaphragm?

A
  • sternopericardial ligament
  • pericardiacophernic liagment
146
Q

What is the ‘point of maximal impact’?

A

apical impulse

Clin Anat I - Exam #2 (3 decks)

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