Thorax Flashcards
Which nerve supplies the pleura and intercostal muscles, and where are they located?
Intercostal nerves, located between the ribs.
Which nerve supplies the muscles of the pharynx and larynx?
The vagus nerve.
Which nerve innervates the diaphragm, and where does it arise?
Phrenic nerve, from C3, C4, and C5.
What is the arrangement of the pulmonary artery and main bronchi in the hilum of the lung?
Right Anterior, Left Superior.
At which vertebral level is the horizontal fissure of the right lung?
Follows 4th rib and costal cartilage from sternum to oblique fissure.
At which vertebral level is the right oblique fissure?
Starts at spinous process of T4, crosses 5th intercostal space axillary, follows 6th rib and costal cartilage anteriorly.
What is the vertebral level of the left oblique fissure?
Starts from between the spinous processes of T3 and T4, crosses 5th intercostal space laterally, follows 6th rib anteriorly.
What is divided posteriorly by the superior margin of the scapulae?
The superior and inferior lobes of the lungs.
Where is the azygous vein?
Right side of vertebral column, posterior mediastinum, empties into superior vena cava.
Which vertebral level is the caval opening in the diaphragm, and what passes through?
C8 - inferior vena cava.
Which vertebral level is the oesophageal hiatus in the diaphragm, and what passes through?
C10 - oesophagus and vagus trunks.
Which vertebral level is the aortic hiatus in the diaphragm, and what passes through?
C12 - descending aorta.
What is the function of the internal intercostal muscles?
Resist intercostal in-drawing.
Where is the internal thoracic artery, and what artery does it arrive from?
The internal thoracic artery runs down the anterior thoracic wall along the side of the sternum, it arises from the subclavian artery.
At which vertebral level is the carina?
T4/T5
At which vertebral level is the inferior margin of the lung in the midline, midclavicular line, midaxillary line, and next to the vertebral column?
Where is the costodiaphragmatic recess?
Parasternally - T4 Midclavicular line - T6 Midaxillary line - T8 Vertebral column - T10 (Costodiaphragmatic recess is 2 vertebral levels lower, so T6, T8, T10, T12)
Name the two pleural recesses (where two layers of parietal pleura become opposed).
Costodiaphragmatic recess
Costomediastonal recess
What is a bronchopulmonary segment?
The smallest areas flung that can be isolated and removed without affecting the others.
What is the stringy bit on the bottom of the lung hilum called?
Pulmonary ligament.
What are the borders of the mediastinum?
Superior thoracic aperture to diaphragm, sternum to vertebral bodies.
At what level is the margin between the superior and inferior mediastinum?
T4/T5 - the sternal angle (2nd rib)
What is contained in the superior mediastinum?
Aortic arch and its branches, brachiocephalic veins, trachea, oesophagus, thoracic duct, vagus and phrenic nerves.
What is contained in the anterior mediastinum?
Thymus gland (fibrofatty connective tissue in adults), lymph nodes, sternopericardial ligaments, internal thoracic vessels.
What is contained in the middle mediastinum?
Pericardium, heart, phrenic nerve, deep cardiac plexus, pulmonary arteries, origin of great vessels.
What is contained in the posterior mediastinum?
Oesophagus, vagus nerve, thoracic duct, descending thoracic aorta, azygous vein, hemiazygous and accessory azygous veins, lymph nodes.
Where does the hemiazygous vein empty?
Superior vena cava
Which lymph nodes do mediastinal structures track up to first?
Supraclavicular nodes.
What is paroxysmal nocturnal dyspnoea?
Waking up in the middle of the night panting for breath because lying flat has allowed fluid to fill the lungs.
What travels through the opening in the diaphragm at T8?
Caval opening - Inferior vena cava
What travels through the opening in the diaphragm at T10?
Oesophageal hiatus - oesophagus, vagus nerve (anterior and posterior vagal trunks)
What travels through the opening in the diaphragm at T12?
Aortic hiatus - aorta, azygous and hemiazygous vein, thoracic duct, sympathetic trunk
Where in the mediastinum is the thymus gland?
Anterior part of the superior mediastinum, extending into the anterior mediastinum particularly in childhood.
What lies behind the thymus gland?
Thymus -> left brachiocephalic vein -> aortic arch -> proximal brachiocephalic trunk and left common carotid artery -> fibrous pericardium
What are the 6 layers in bronchial mucosa?
Pseudostratified ciliated columnar epithelium Lamina propria Smooth muscle Submucosa Hyaline cartilage Tunica adventitia
