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Anatomy - Thorax, Back > Thorax > Flashcards

Thorax Flashcards

1
Q

True ribs

A

Attach directly to sternum

1st-7th ribs

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2
Q

False ribs

A

Indirect attachment to sternum (cartilages are connected to cartilage of the rib above them)

8th, 9th, usually 10th ribs

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3
Q

Floating ribs

A

Do not connect to sternum

11th, 12th (sometimes 10th) ribs

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4
Q

Typical ribs and their components

A

3rd-9th ribs

  • Head (2 facets to articulate with 2 vertebrae)
  • Neck
  • Tubercle (articulates with TP)
  • Body
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5
Q

Atypical ribs and their components

A

1st, 2nd, 10th-12th ribs

Head (1 facet, single vertebra)

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6
Q

Intercostal spaces

A

Separate the ribs and their costal cartilages from one another

Named according to rib forming superior border of the space

(4th intercostal space is between 4th and 5th ribs)

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7
Q

Space below 12th rib

A

Subcostal space

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8
Q

Parts of the sternum

A

Manubrium
Body
Xiphoid process

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9
Q

Manubrium

A

Trapezoidal

Widest, thickest part of sternum

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10
Q

Jugular notch

A

Concave center of superior border of manubrium

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11
Q

Manubriosternal joint

A

Junction of manubrium and the body of the sternum

Sternal angle

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12
Q

Sternal angle (of Louis)

A

Manubriosternal joint

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13
Q

Body of sternum

A

Longer, narrower, thinner than manubrium

Located T5-T9 level

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14
Q

Xiphoid process

A

Smallest part of sternum
Thin and elongated
Inferior end lies at T10

Becomes ossified around age 40

May fuse with sternal body in elderly

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15
Q

Superior thoracic aperture

A

Borders: T1 to top of manubrium to 1st pair of ribs

Contents: esophagus, trachea, nerves & BV supply the head, neck and UE

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16
Q

Inferior thoracic aperture

A

Borders: T12 to 11-12th ribs, costal margins of 7-10th ribs, xiphisternal joint

Content: allows esophagus/IVC/aorta to pass inferior to abdominal cavity

Much more spacious than superior

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17
Q

Costovertebral joints

A

Posterior thorax

Rib articulation with vertebral body

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18
Q

Costotransverse joints

A

Posterior thorax

Rib articulation with TP

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19
Q

Intervertebral joints

A

Posterior thorax

Disc and facets

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20
Q

Costochondral joints

A

Anterior thorax

Rib articulation with chondral cartilage

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21
Q

Sternocostal joints

A

Anterior thorax

Costal cartilage and sternum

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22
Q

Sternoclavicular joints

A

Anterior thorax

Sternum and clavicle

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23
Q

Interchondral joints

A

Anterior thorax

“Articulation” between costal cartilages of lower ribs

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24
Q

Xiphosternal joint

A

Xiphoid and sternum

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25
Q

Inspiration

A

“Bucket handle” motion of ribs

Increase in AP and lateral diameter as well as length

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26
Q

Inspiration is controlled by (at rest, exercise, extreme exercise)

A

Rest - diaphragm
Exercise - diaphragm + external intercostals
Extreme exercise - accessory muscles (SCM & scalenes) on top of the normal controllers

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27
Q

Expiration is controlled by (at rest, exercise)

A

Rest - elastic recoil of lungs

Exercise - internal intercostals, abdominal muscles (rectus abdominus, int/ext obliques)

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28
Q

External intercostals action

A

Inspiration

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29
Q

Internal intercostals action

A

Expiration

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30
Q

Innermost intercostals

A

Elevate ribs? Not completely understood

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31
Q

Transversus thoracis location and action

A

Location: internal anterior thoracic cage

Action: expiration (depresses ribs)

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32
Q

Subcostal muscles location and action

A

Location: internal posterior thoracic cage

Action: inspiration (elevate ribs)

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33
Q

Levator costarum location and action

A

Location: external posterior attach to ribs and TP

Action: Inspiration (elevate ribs)

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34
Q

Serratus posterior superior action

A

Inspiration (elevates the ribs)

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35
Q

Serratus posterior inferior action

A

Expiration (depresses ribs)

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36
Q

Diaphragm innervation, action

A

Innervation: phrenic nerve (C3-C5)

Action: inspiration

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37
Q

Regions of diaphragm

A

Sternal
Costal
Lumbar

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38
Q

Intercostal nerves pathway

A
  • 12 thoracic spinal nerves exit spinal IVF
  • Each nerve branches into anterior and posterior rami
  • Anterior rami supplies intercostal spaces
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39
Q

VAN

A

Each intercostal space has a bundle of vein, artery, nerve

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40
Q

Three major sources of circulation to thoracic wall

A

Thoracic aorta
Axillary artery
Subclavian artery

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41
Q

Branches of thoracic aorta

A

Posterior intercostal arteries

Subcostal artery

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42
Q

Posterior intercostal arteries supply

A

3rd-11th intercostal spaces

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43
Q

Subcostal artery supplies

A

Inferior to 12th rib

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44
Q

Thoracic branch of subclavian artery

A

Costocervical trunk

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45
Q

Costocervical trunk

A

Superior thoracic arteries branch off to supply the 1st-2nd intercostal spaces

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46
Q

Superior thoracic artery

A

Branches off of costocervical trunk of subclavian artery

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47
Q

Branch of subclavian artery

A

Costocervical trunk > Superior thoracic artery

Internal thoracic artery

48
Q

Internal thoracic artery branch

A

Anterior intercostal arteries branch off to supply anterior 1st-9th IC spaces

49
Q

Venous supply of IC spaces

A

Intercostal veins

50
Q

Intercostal veins drain (posteriorly and anteriorly)

A

Posteriorly: into Azygos
Anteriorly: into internal thoracic veins

51
Q

Azygos system

A

“Unpaired”

Drains the back and thoracoabdominal walls

52
Q

Hemiazygos and Accessory hemizacygos veins

A

Receive blood from L side 5th-12th intercostals

53
Q

Azygos vein

A

Receives blood from R sight intercostals, hemiazygos, accessory hemiazygos

Drains back to the heart via SVC

54
Q

Left side 1st-4th IC veins drain

A

Directly into L brachiocephalic trunk

55
Q

Nipple location

A

Approx. 4th IC space

Apex of heart is just inferior & medial to left nipple

56
Q

Circular base of female breast extends from ____ to ____

A

Sternum to mid-axillary line

Ribs 2-6

57
Q

Axillary tail of breast

A

Tail of Spence

Inferior border of pec toward axilla

58
Q

Lymphatic drainage of breast

A

75% into axillary LNs

The rest drains medially via parasternal LNs

59
Q

Trachea “begins” where

A

Inferior to larynx (cricoid cartilage)

60
Q

Trachea cross section

A

D-shaped

Incomplete C shaped rings of cartilage

61
Q

Carina

A

Bifurcation of trachea into R/L bronchi at sternal angle

62
Q

Lobar bronchi

A

3 on right, 2 on left side

63
Q

Segmental bronchi supply

A

the 10 bronchopulmonary segments

64
Q

Cartilage disappears at

A

Bronchioles

65
Q

Acinus

A

1 terminal bronchiole, many respiratory bronchioles & alveolar ducts/sacs with alveoli

66
Q

Pleural lining

A

Visceral + parietal pleura

67
Q

Visceral pleura

A

Lines the lungs

68
Q

Parietal pleura

A

Lines thoracic wall and diaphragm

69
Q

Pleural cavity

A

Space between visceral and parietal pleura

70
Q

Costodiaphragmatic recess

A

Large pleural recess located in posterolateral region

71
Q

Costomediastinal recess

A

Smaller pleural recess located anterolateral region (posterolateral to sternum)

72
Q

Thoracentesis

A

Removal of fluid in IC space via hypodermic needle

73
Q

Apex of lungs

A

Top portion

74
Q

Base of lungs

A

Inferior portion (sits on diaphragm)

75
Q

Hilum / Root of lungs

A

Site where lung becomes covered by visceral pleura

Contains: primary bronchus, pulmonary + bronchial vessels + lymph vessels

76
Q

R lung description

A

3 lobes (superior, middle, inferior)

Oblique + horizontal fissures

10 bronchopulmonary segments - 3 superior, 2 middle, 5 inferior

77
Q

L lung description

A

2 lobes (superior, inferior)

Oblique fissure only

Lingula - “similar” to middle lobe of R lung

Cardiac notch in anterior view

10 bronchopulmonary segments - 5 superior, 5 inferior lobe

78
Q

Layers of heart wall

A

Endocardium
Myocardium
Epicardium

79
Q

Pericardium

A

Double walled fibrous sac

Outside = fibrous
Inside = serous
-Two layers of serous (parietal and visceral)

80
Q

Visceral Pericardium

A

Part of the serous layer of pericardium

Synonymous with epicardium

81
Q

Pericardial cavity

A

Space between parietal and visceral layers of serous pericardium

82
Q

Right atrium features

A

SVC/IVC openings
Coronary sinus opening
Fossa ovalis
Tricuspid valve

83
Q

Fossa ovalis

A

A thumbprint size depression in the right atrium

Remnant of foramen ovale

84
Q

Tricuspid valve

A

Separates R atrium and ventricle

Papillary muscles and chordae tendineae anchor cusps of the valve

Auscultate along left sternal border at 5th (or 4th) IC space

85
Q

Chordae tendineae

A

Tendinous cords (“strings”) that connect papillary muscles to tricuspid valve

86
Q

Pulmonary valve

A

Separates right ventricle and pulmonary artery

Auscultate along left 2nd IC space

87
Q

Right ventricle features

A

Tricuspid valve
Papillary muscle/chordae tendineae
Pulmonary valve

88
Q

Left atrium features

A

Foramen ovale
4 openings of pulmonary veins
Bicuspid (mitral) valve

89
Q

Bicuspid valve

A

Mitral valve
Separates L atrium and L ventricle

Auscultate along apex (left 5th IC space)

90
Q

Left ventricle features

A

Bicuspid valve
Papillary muscle/chordae tendineae
Aortic valve

91
Q

Aortic valve

A

Separates left ventricle and aorta

Auscultate along right 2nd IC space

92
Q

Description and function of fibrous skeleton

A

4 fibrous rings that surround orifices of the heart valves

Provides:

  • Attachment for myocardium of atria & ventricles
  • Attachment for cardiac valves
  • Electrical insulation b/w atria & ventricles
93
Q

SVC

A

Returns blood back to RA from areas superior to diaphragm (except heart and lungs)

94
Q

IVC

A

Returns blood back to RA from areas inferior to diaphragm

95
Q

Pulmonary trunk

A

Sends unoxygenated blood from R ventricle to lungs

96
Q

R/L Pulmonary veins

A

Returns oxygenated blood back to LA from lungs

97
Q

Aorta

A

Sends blood to body from L ventricle

98
Q

Where do coronary arteries originate

A

Aorta

99
Q

How and when does blood get into coronary arteries

A

Aortic pressure creates “backflow” gradient into coronary arteries

Occurs during early diastole (relaxation)

100
Q

RCA branches and what they supply

A

Nodal - supply SA/AV nodes

Marginal - supplies RV

Posterior interventricular (R posterior descending) - supplies R ventricle

101
Q

LCA branches and what they supply

A

LAD - supplies septum + L ventricle

Circumflex - supplies L atrium + L ventricle

Marginal - supplies L ventricle

102
Q

Coronary veins pathway

A
  • Most cardiac veins drain into coronary sinus
  • Coronary sinus drains into RA
  • Great, middle, small cardiac veins and oblique vein of LA all empty into coronary sinus
  • Anterior cardiac vein and smallest cardiac veins empty directly into RA
103
Q

Conducting pathway of heart

A 
SA node
AV node (1/10 sec delay allows for atrial contraction)
AV bundle of His
L/R bundle branch
Purkinje fibers
104
Q

Sternocostal surface of heart

A

Anterior

Mostly R ventricle

105
Q

Diaphragmatic surface of heart

A

Inferior

Mostly L ventricle, partially R ventricle

106
Q

Pulmonary surface of heart

A

Left

Mostly L ventricle

107
Q

Point of maximal impact

A

Apical impulse (apex)

108
Q

Mediastinum

A

Region in thoracic cavity between R/L pleurae

109
Q

Mediastinum regions

A

Superior

Inferior (Anterior, Middle, Posterior)

110
Q

Superior mediastinum content

A
  • Thymus in children (remnants in adults)
  • Arch of aorta/great vessels
  • Trachea
  • Esophagus
111
Q

Anterior mediastinum content

A
  • Internal thoracic vessels
  • Fat
  • Few LNs
112
Q

Middle mediastinum content

A

Pericardium
Heart
Roots of great vessels

113
Q

Posterior mediastinum content

A

Esophagus
Descending Aorta
Thoracic duct
LNs

114
Q

CXR is taken during:

A

Inspiration

115
Q

AP view of x-ray, heart shadow is:

A

Distorted/widened

Anatomy - Thorax, Back (2 decks)

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