Thorax

Question 1

axillary line

Answer 1

is a coronal line on the anterior torso marked by the anterior axillary fold. It’s the imaginary line that runs down from the point midway between the middle of the clavicle and the lateral end of the clavicle; the lateral end of the collarbone is the end closer to the arm.

Question 2

types of axillary lines:

Answer 2

anterior medial posterior

Question 3

Terminal duct Lobular Unit

Answer 3

lactiferous sinus, lactiferous duct, terminal duct, acini, lobules,

Question 4

chest anatomy inside out:

Answer 4

intercostal muscle, intercostal vessels, intercostal fascia, superficial abdominal fascia,

Question 5

intercostal vessels

Answer 5

arteries
Posterior intercostal arteries
Highest intercostal artery
Anterior intercostal branches of internal thoracic artery
veins
Supreme intercostal vein
Superior intercostal vein
Posterior intercostal veins

Question 6

suspensory ligaments

Answer 6

Cooper’s ligaments (also known as the suspensory ligaments of Cooper and the fibrocollagenous septa) are connective tissue in the breast that help maintain structural integrity.

Question 7

mammary lobes

Answer 7

The breast or mammary gland is a highly efficient organ mainly used to produce milk and is a mass of glandular, fatty, fibrous tissues. Mammary glands are exocrine glands that are enlarged and developmentally are modified sweat glands that are actually part of the skin. They are also classified as tubualveolar glands and are located in the breast lying on the top of the pectoralis major muscles. These glands are present in males and females; however, they normally function in the latter gender only.

Question 8

lactiferous ducts

Answer 8

Lactiferous ducts form a tree branched system connecting the lobules of the mammary gland to the tip of the nipple. They are also referred to as galactophores, galactophorous ducts, mammary ducts, mamillary ducts and milk ducts. They are the structures which carry milk toward the nipple in a lactating female.

Question 9

lactiferous sinus

Answer 9

an expansion in a lactiferous duct at the base of the nipple in which milk accumulates

Question 10

interlobular connective tissue

Answer 10

The interlobular septae are located between secondary pulmonary lobules and are continuous with both the subpleural interstitium (peripheral connective tissue) and the peribronchovascular interstitium (axial connective tissue) as well as the more delicate intralobular septa.

These septae are composed of connective tissues within which run the pulmonary veins and lymphatics which drain towards the pleura (NB a second set of lymphatics runs along with arteries and drains centrally).

Question 11

mammary glands:

Answer 11

lined with milk-secreting cuboidal cells and surrounded by myoepithelial cells
top medial 15%, lower medial 5%, lateral side is 60%,10%,10%

Question 12

mammary glands are

Answer 12

apocrine and merocrine glands

Question 13

vascular supply to breast:

Answer 13

subcalavian vein and artery, axillary artery vein (lateral side), internal thoracic artery and vein (medial side), lateral thoracic artery, vein, medial mammary branches,, lateral mammary branches

Question 14

Venous route of metastases

Answer 14

Breast cancer may metastasize to the vertebral column, brain, etc. as well as the lungs.

Question 15

Lymphatic drainage of the breast

Answer 15

Most lymphatic vessels drain superficially toward the nipple to form a subareolar plexus.
The major collecting vessels from the subareolar plexus drain along the course of the lateral thoracic veins to lymph nodes in the axilla.
A smaller medial portion of the breast drains to parasternal nodes along the internal thoracic artery.

Question 16

Vascularity of thorax

Answer 16

cephalic vein, thoracoacromial artery

Question 17

Radical mastectomy

Answer 17

breast, axillary nodes, and pectoralis muscle are removed

Question 18

Modified radical mastectomy

Answer 18

breast and lateral and central axillary nodes are removed

Question 19

Simple (total) mastectomy

Answer 19

breast, but no axillary nodes or muscle are removed

Question 20

true ribs

Answer 20

The first seven pairs are attached directly to the sternum by costal cartilages and are called true ribs.

Question 21

false ribs

Answer 21

The 8th, 9th, and 10th pairs— false ribs—do not join the sternum directly but are connected to the 7th rib by cartilage.

Question 22

floating ribs

Answer 22

The 11th and 12th pairs—floating ribs—are half the size of the others and do not reach to the front of the body. Each true rib has a small head with two articular surfaces—one that articulates on the body of the vertebra and a more anterior tubercle that articulates with the tip of the transverse process of the vertebra.

Question 23

atypical rib

Answer 23

The first rib is not like the others and is known as atypical rib. It is of great importance clinically because of its close relation with the brachial plexus subclavian vessels (main vessels of the arm). Unlike other ribs, it is flattened from above downwards. It has a tubercle, known as the scalene tubercle, on the inner border. The scalenus anterior muscle is inserted into this tubercle. Anterior to this tubercle, the subclavian vein crosses over the rib while coming out of the upper limb. Posterior to the tubercle, there is a groove known as the subclavian groove through which the subclavian artery and the lower trunk of the brachial plexus cross the rib.

Question 24

costal articulation of first rib

Answer 24

The first costal cartilage of both sides attach to the manubrium sterni. At this joint, no movement is possible.

Question 25

costal articulation of second rib

Answer 25

The second costal cartilage articulates with the body of sternum and the manubrium sterni by a synovial joint where movement is possible. The third to seventh costal cartilages articulate with lateral border of the body of sternum at mobile synovial joints. The mobility of these joints allows the movements of respiration to take place in the rib cage. The sixth, seventh, eighth, ninth and tenth costal cartilages are jointed with each other along the borders by synovial joints. The eleventh and twelfth ribs are floating, which means that they do not articulate in front with the sternum and are embedded in the musculature of abdominal wall.

Question 26

costal articulation of the third-seventh costal cartilage:

Answer 26

The third to seventh costal cartilages articulate with lateral border of the body of sternum at mobile synovial joints. The mobility of these joints allows the movements of respiration to take place in the rib cage.

Question 27

costal articulation of the lower ribs;

Answer 27

The sixth, seventh, eighth, ninth and tenth costal cartilages are jointed with each other along the borders by synovial joints. The eleventh and twelfth ribs are floating, which means that they do not articulate in front with the sternum and are embedded in the musculature of abdominal wall.

Question 28

intercostal space and muscles

Answer 28

External intercostal muscle and membrane—note the direction of fibers
Internal intercostal muscle—note the 90° change in direction of fibers
Innermost layer
Intercostal vein, artery and nerve in the costal groove below the rib
Collateral branch along the superior border of the next rib

Question 29

internal thoracic artery is a branch of the:

Answer 29

subcalavian artery

Question 30

thoracic pleura

Answer 30

A pleura is a serous membrane which folds back onto itself to form a two-layered membranous pleural sac. The outer pleura (parietal pleura) is attached to the chest wall, but is separated from it by the endothoracic fascia. The inner pleura (visceral pleura) covers the lungs and adjoining structures, including blood vessels, bronchi and nerves. The pleural cavity can be viewed as a potential space because the two pleurae adhere to each other (through the thin film of serous liquid) under all normal conditions.

Question 31

pulmonary pleura

Answer 31

the pleural cavity is the thin fluid-filled space between the two pulmonary pleurae (visceral and parietal) of each lung.

Question 32

mediastinum

Answer 32

The mediastinum is the central compartment of the thoracic cavity surrounded by loose connective tissue, as an undelineated region that contains a group of structures within the thorax. The mediastinum contains the heart and its vessels, the esophagus, trachea, phrenic and cardiac nerves, the thoracic duct, thymus and lymph nodes of the central chest.

Question 33

pericardial cavity

Answer 33

The pericardiumis a double-walled sac containing the heart and the roo ts of the great vessels. The pericardial sac has two layers, a serous layer and a fibrous layer. It encloses the pericardial cavity which contains pericardial fluid.

The pericardium fixes the heart to the mediastinum, gives protection against infection, and provides the lubrication for the heart.

Question 34

pleural cavity

Answer 34

The parietal pleura is the outer membrane which is attached to the inner surface of the thoracic cavity. It also separates the pleural cavity from the mediastinum. The parietal pleura is innervated by the intercostal nerves and the phrenic nerve. Between the membranes is a fluid filled space called the pleural cavity.

Question 35

which type of secretion is not used by the mammary gland? epocrine, merocrine, holocrine, apocrine?

Answer 35

holocrine

Question 36

at what intercostal location are you most likely to find lung tissue when inserting a needle along the midclavicular line?

Answer 36

T7

Question 37

The pleural recesses are:

Answer 37

T8-T9 (no more lung), T10-12 (no more pleura)