Thorax Flashcards
Phrenic Nerve
Originates C3-C5 ventral rami; passes between the heart and lung to pierce the diaphragm. It is important for breathing and passes motor information to diaphragm.
Travels with the pericardiacophrenic artery.
Ductus Venosus
Shunt that bypasses the liver in fetus. Later will turn into ligamentum venosum.
Foramen Ovale
Shunt located in the right atrium–>left atrium that does R–>L shunt; later will be closed off by a valve formed by the septum primum
Ductus arteriosus
Shunt located between the left pulmonary artery and the aorta which allows baby to skip circulation to the lung; later it will turn into the ligamentum arteriosum.
Mitral/Bicuspid Valve
Left Atrium to Left Ventricle
Tricupid Valve
Right Atrium to Right Ventricle
To remove fluid from a pleural effusion, where should needle be inserted?
For pleural effusion that is in the lung, best place to insert the needle will be in the midaxillary line superior to the inferior rib (because all intercostal nerves are located below each rib).
Lingula
Located on the left lung, bottom left corner.
3 Blood Vessels that come off Aortic Arch
Brachiocepahlic trunk, left common carotid, left subclavian artery
Tachycardia
abnormally rapid heart rate
Atrial septal defect
hole in the septum wall of the two atriums (where foramen ovale is). This is usually present in birth if the hole didn’t close properly (to form septum primum)
Coarctation of aorta
diagnosed as hypertension and differential pressures in the upper and lower extremities.
Patent ductus arteriosus
condition where the ductus arteriosus fails to close after birth. Will have characteristics such as tachycardia (rapid heart rate), machine line murmur, and bounding peripheral pulses.
costodiaphragmatic recess
is the lowest extent of the pleural cavity or sac. Because this is the most inferior part of the pleural sac, fluid in the sac will fall to this region when a patient sits up. This is also the area into which a needle is inserted for a thoracocentesis.
cupola
part of the pleural cavity which extends above the level of the 1st rib into the root of the neck. Covers the apex of lungs
hilar reflection
point at the root of the lung where the mediastinal pleura is reflected and becomes continuous with teh visceral pleura
oblique sinus
“cul de sac” in the heart. located behind the left atrium of the heart where the serous pericardium reflects onto the inferior vena cava and pulmonary veins
transverse sinus
you can slip your fingers into this space; it is located between the aorta and pulmonary trunk
Descending aorta region
T3-T11
Fascia Planes
Can have things (such as products of infection) make its way down to the thorax/chest cavity. from the head and neck
Azygos Vein
Drains into the superior vena cava
Hemiazygos Vein & Accessory Hemiazygos Vein
Accessory: receives bronchial veins from left lung, upper 3-5 left posterior intercostal veins and will then join either azygos/hemiazygos vein.
Hemiazygos- drains lower eight/night left posterior intercostal veins and will join the azygos vein
Least Splanchnic Nerve
T12; innervates gonads, kidneys, proximal uterus
Splanchnic Nerve
a preganglionic sympathetic fiber that goes into the sympathetic chain and will come out of it WITHOUT synapsing.
These are seen in celiac, superior mesenteric ganglion, and inferior mesenteric ganglion.
Vagus Nerve
originates from the head and goes all the way to the abdomen. In the esophagus, it will be split up into smaller branches. Left side will go anterior, right side will go posterior. Both anterior and posterior will go into vagal trunks.
Also innervates part of the trachea (vasocontrictor)
also, carries preganglionic parasympathetic fibers to cardiac plexuses, which from there post ganglionics will reach the heart (remember parasympathetic decreases heart rate)
Diaphragm Thoracic Piercings
IVC- T8
Esophagus - T10
Aorta- T12
True Ribs
Ribs 1-7; connected to sternum
False Ribs
Ribs 8-12; Do not directly connect to the sternum, instead they are fused to the costal cartilages which connect directly to the sternum. Only 11 and 12 don’t connect to a costal cartilage.
Floating Ribs
Ribs 11-12; Do not connect to any intercostal cartilages and therefore have no connection (directly/indirectly) to the sternum/chest wall.
Parts of the Sternum
Manubrium, Sternum angle (2nd rib), Sternum body, xiphoid process
Mediastinum
Middle section of the thoracic cavity that separates the lungs/pleural cavities. It contains the thoracic organs: heart, thymus, trachea, esophagus)
Pleural cavity aka pleaural potentional space
thin fluid-filled space between the partial pleural and the visceral pleural of the lung.
costomediastinal recess
is a potential space located at the middle (mediastinal) of the left lung. It is irrelevant on the right lung because it is so small.
Sternocleidomastoid muscle
accessory muscle involved in inspiration; helps to elevate the sternum and clavicle thus expanding the thoracic cavity
Scalene muscles
3 of them: anterior, middle, and posterior. Accessory muscles important for inspiration.
They attach to the first 2 ribs and elevate the ribs therefore expanding the thoracic cavity.
External & Internal intercostal muscles
principal muscles in inspiration, they elevate the ribs.
Root of Lung Location
at the mediastinal surface
Hilus of lung
Located at the root of the lung, It is a piece of tissue or something that encases the main bronchus and vasculature (1 pulmonary artery, 2pulmonary veins, lymphatics).
Right lung characteristics
Superior, middle and inferior lobes; has more capacity than left lung and it is also shorter and wider than left lung, has both oblique (5th intercostal space) and horizontal (minor) fissure (3rd intercostal space)
Left lung characteristics
superior and inferior lobes; has the lingula and cardiac notch, has the costomediastinal recess, oblique fissures only
Right Main Bronchus
Shorter and wider than left main bronchus and is more in line with the trachea
Cisterna Chyli
membranous structure located at the end of the thoracic duct into which lymph from intestinal trunk and lumbar flows into
Anterior Interventricular Artery (LAD) travels with?
Great cardiac vein
Right Marginal branch of Right coronary artery travels with?
small cardiac vein
Posterior interventricular artery travels with?
middle cardiac vein
