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MRCS Anatomy > Thorax > Flashcards

Thorax Flashcards

1
Q

Mediastinum

A 
Separated into 4 
Superior mediastinum
Anterior mediastinum
Posterior mediastinum
Middle mediastinum
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2
Q

Superior mediastinum - borders

A

Superior: thoracic inlet
Inferior: sternal angle
Anterior: Manubrium
Posterior: thoracic body

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3
Q

Content of superior mediastinum

A

Arch of aorta/branches
SVC/brachiocephalic vein - azygos, superior intercostal, supreme intercostal veins
trachea, oesophagus, thymus
phrenic nerve - anterior to hilum of lungs
vagus nerve - right one parallel to trachea posterior to SVC; left one anterior to arch but posterior to bronchus

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4
Q

Anterior mediastinum - borders

A

Superior - sternal angle
Inferior - diaphragm
anterior - body of sternum (T1-T4)
posterior - pericardium

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5
Q

Anterior mediastinum - content

A

Phrenic nerves
Thymus
Lymph nodes

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6
Q

Thymus

A

3rd pharyngeal pouch
immunological organ, diminish in size after puberty
Supply - internal thoracic artery
THYMIC APLASIA in DiGeorge syndrome

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7
Q

Posterior mediastinum - borders

A

Superior - sternal angle
inferior - diaphragm
anterior - pericardium
posterior - thoracic verterbral body (T5-12)

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8
Q

Posterior mediastinum - contents

A 
Descending aorta (T12)
posterior intercostal, bronchial, oesophageal, superior phrenic arteries
Azygos/hemiazygos/accessory azygos veins
Thoracic duct
oesophagus
vagus nerve
sympathetic trunk
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9
Q

middle mediastinum - content

A 
Heart
Aortic root
pulmonary trunk
SVC
Hilum/bronchus
lymph nodes
cardiac plexus
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10
Q

Thoracic spine

A

Demifacets - to articulate with head of ribs
Costal facet - to articulate with tubercles of ribs
Costotransverse ligaments
Radiate ligaments of head of rib

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11
Q

Muscles of the thorax

A 
Intercostal - external, internal, innermost
Transversus thoracis
Subcostals
Pectoralis major/minor
Serratus anterior
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12
Q

external intercostal

A

runs inferioanteriorly from lower of border of rib to superior border of rib below
ELEVATES rib

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13
Q

Internal intercostal

A

runs inferioposteriorly from rib above to rib below

DEPRESSES rib

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14
Q

innermost intercostal

A

separated by internal by neurovascular bundle

medial edge of costal groove to superior border of rib below

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15
Q

Transversus thoracis

A

posterior surfave of sternum to costal cartilage 2-6

depressed the ribs

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16
Q

Diaphragm

A

Innervated by phrenic nerve C3-C5
arises from right & left crura
right crus - L1-L3; act as the physiological sphincter of oeseophagus
Left crus - L1-2
3 attachments - lumbar vertebrae & arcuate ligaments; costal cartilage ribs 7-12; xiphoid process of sternum
supplied by superior phrenic and inferior phrenic (aorta)

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17
Q

opening of diaphragm

A

T8 - IVC, right phrenic nerve
T10 - oesophagus, vagus nerve, oesophageal branches of left gastric
T12 - aorta, thoracic duct, azygos vein

18
Q

Breast - surface anatomy

A

lateral border of sternum to midaxillary line
2nd to 6th costal cartilage
Circular body - nipple, areolae
Axillary tail

19
Q

Anatomical structure of the breast

A

mammary glands - lobules drain to lacterous duct
connective tissue stroma - suspensory ligament of cooper
pectoral fascia - separates it from pectoralis major

20
Q

Blood supply & lymphatics of breast

A

Supplied internal thoracic artery mainly but also from lateral thoracic and thoracoacromial arteries (axillary artery) and lateral mammary branches (intercostal)
Lymphatics drains into axilla, parasternal, posterior intercostal
Skin above drains into axillary, inferior deep cervical/infraclavicular nodes

21
Q

Pleura - surface anatomy

A 
2.5cm above at medial third of clavicle
midline at 2nd rib
left - diverges at 4th rib
right - diverges at 6th rib 
midclavicular line - 8th 
midaxillary line - 10th
posterior - 12th
22
Q

Pleura - structure

A

Mesothelial cells, serous membrane, both layers are continuous at the hilum
Parietal - internal surface of thoracic wall,
Visceral - covers the lungs

23
Q

Surface anatomy of the lung

A 
2.5cm above at medial third of clavicles
hila lies at level of 3/4 ribs
mid clavicular line at 6th rib
midaxillary line at 8th rib
posterior at 10th rib
24
Q

Anatomy of lung

A

right - 3 lobes
left - 2lobes + lingular
Has pulmonary arteries, veins and bronchial arteries and veins
Nerve - pulmonary plexus
parasympathetic - vagus, secretion from glands
sympathetic - dilatation of smooth muscles
Hilum - bronchus posterior to artery & vein

25
Q

Tracheobronchial tree

A

C-shaped with trachealis muscles
pseudostratified columnar epithelium and goblet cells
Right bronchus - wider, shorter, straight down
Bronchus divides into lobar bronchi then to segmental bronchi - bronchopulmonary segments

26
Q

Bronchopulmonary segments

A

individual units of lung (has its own artery, vein, lymphatics)
right side - 10 segments
upper - 3 = apical, anterior, posterior
middle - 2 = lateral and medial
lower - 5 = apical, anterior, posterior, medial, lateral
left side = 8-9 segments
upper - 2 = apico-posterior, anterior
lingular - 2 = inferior and superior
lower - 4 = superior, anteromedial, posterior, lateral

27
Q

Bronchioles

A

no cartilage nor goblet cells
simple cuboidal epithelium with club cells that produce surfactant lipoprotein (reduces compliance)
at the end divides into alveoli (simple squamous epithelium) type 2 alveolar cells secretes surfactant in alveoli

28
Q

Pericardium

A

Fibrous - fixes the position and protect from infection
Serous - parietal and visceral layer with serous fluid inside, lubricates the motion of the heart
Transverse pericardial sinus - results of the embryological folding of the heart tube, divides the venous and arterial vessels
Innervated by phrenic nerve

29
Q

Surface anatomy of the heart

A

Superior - right 3rd costal cartilage and left 2nd ICS
right side - down to 6th costal cartilage
apex - 5th ICS at midclavicular line
right border formed by right atrium
left border formed by left atrium and ventricle

30
Q

Right atrium

A

receives blood from IVC/SVC and coronary veins/sinus
2 sections separated by crista terminalis
sinus venarum - smooth due to sinus venosus
atrium proper - rough due to pectinate muscles
Fossa ovalis - remnant of foramen ovale
originally formed by septum primum with ostium primum then by spetum secundum and ostium secondum

31
Q

Left atrium

A

Receives blood from pulmonary veins
posterior aspect of the heart
Inflow portion - smooth from pulmonary vein
outflow portion - pectinate muscles from embryonic atrium

32
Q

Right ventricle

A

Pumps towards pulmonary trunk
anterior border of the heart
Inflow portion - trabeculae carnae = ridges, bridges, pillars (papillary muscles - attached to chordae tendineae)
outflow - conus arteriosus

33
Q

Left ventricle

A

Pumps outwards to the aorta
forms the apex of the heart
inflow - trabeculae carnae
outflow - aortic vestibule

34
Q

Atrioventricular valves

A

Tricuspid - 3 valves
Mitral - 2 valves
attached to chorda tendineae which is attached to papillary muscles

35
Q

Semilunar valve

A

Pulmonary valve - 3 cusp
Aortic valve - 3 cusp
left anterior and posterior aortic sinus, where left has Left coronary artery and anterior has right coronary artery

36
Q

Conduction of the heart

A

SAN - AVN - Bundle of His - Purkinje fibres
SAN is found at the crista terminalis where the SVC opens in
AVN is in the intraventricular septum - triangle of Koch

37
Q

Coronary arteries

A

LCA - LAD (anterior interventricular groove) then left marginal & circumflex
RCA (coronary sulcus) - Right marginal & posterior interventricular

38
Q

Cardiac veins

A

Great cardiac follows LAD then into coronary sinus
small cardiac follows RCA then into coronary sinus
middle cardiac, left marginal, left posterior veins joins the coronary sinus

39
Q

Layers of the heart

A

Endocardium
Myocardium
Epicardium

40
Q

Endocardium

A

innermost layer
lies the cavities and valve of the heart
loose connective tissue with simple squamous epithelial tissue
regulates contraction
Subendocardial layers has purkinje fibres

41
Q

myocardium

A

involuntary striated muscles

42
Q

epicardium

A

visceral layer of serous pericardium

simple squamous epithelial cells

MRCS Anatomy (8 decks)

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