Thorax Flashcards
Mediastinum
Separated into 4 Superior mediastinum Anterior mediastinum Posterior mediastinum Middle mediastinum
Superior mediastinum - borders
Superior: thoracic inlet
Inferior: sternal angle
Anterior: Manubrium
Posterior: thoracic body
Content of superior mediastinum
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
Anterior mediastinum - borders
Superior - sternal angle
Inferior - diaphragm
anterior - body of sternum (T1-T4)
posterior - pericardium
Anterior mediastinum - content
Phrenic nerves
Thymus
Lymph nodes
Thymus
3rd pharyngeal pouch
immunological organ, diminish in size after puberty
Supply - internal thoracic artery
THYMIC APLASIA in DiGeorge syndrome
Posterior mediastinum - borders
Superior - sternal angle
inferior - diaphragm
anterior - pericardium
posterior - thoracic verterbral body (T5-12)
Posterior mediastinum - contents
Descending aorta (T12) posterior intercostal, bronchial, oesophageal, superior phrenic arteries Azygos/hemiazygos/accessory azygos veins Thoracic duct oesophagus vagus nerve sympathetic trunk
middle mediastinum - content
Heart Aortic root pulmonary trunk SVC Hilum/bronchus lymph nodes cardiac plexus
Thoracic spine
Demifacets - to articulate with head of ribs
Costal facet - to articulate with tubercles of ribs
Costotransverse ligaments
Radiate ligaments of head of rib
Muscles of the thorax
Intercostal - external, internal, innermost Transversus thoracis Subcostals Pectoralis major/minor Serratus anterior
external intercostal
runs inferioanteriorly from lower of border of rib to superior border of rib below
ELEVATES rib
Internal intercostal
runs inferioposteriorly from rib above to rib below
DEPRESSES rib
innermost intercostal
separated by internal by neurovascular bundle
medial edge of costal groove to superior border of rib below
Transversus thoracis
posterior surfave of sternum to costal cartilage 2-6
depressed the ribs
Diaphragm
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)
opening of diaphragm
T8 - IVC, right phrenic nerve
T10 - oesophagus, vagus nerve, oesophageal branches of left gastric
T12 - aorta, thoracic duct, azygos vein
Breast - surface anatomy
lateral border of sternum to midaxillary line
2nd to 6th costal cartilage
Circular body - nipple, areolae
Axillary tail
Anatomical structure of the breast
mammary glands - lobules drain to lacterous duct
connective tissue stroma - suspensory ligament of cooper
pectoral fascia - separates it from pectoralis major
Blood supply & lymphatics of breast
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
Pleura - surface anatomy
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
Pleura - structure
Mesothelial cells, serous membrane, both layers are continuous at the hilum
Parietal - internal surface of thoracic wall,
Visceral - covers the lungs
Surface anatomy of the lung
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
Anatomy of lung
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