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Anatomy > Thorax > Flashcards

Thorax Flashcards

1
Q

Superior thoracic aperture

A

Manubrium
Rib 1 and costal cartilage
T1 vertebrae

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2
Q

Inferior thoracic aperture

A 
Xiphoid process
Costal margin
Rib 12
T12 vertebra
Diaphragm
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3
Q

Root of neck

A

Junctions area between thorax and neck

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4
Q

Root of neck viscera

A

Trachea

Esophagus

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5
Q

Root of neck nerve

A

Sympathetic trunks
Vagus nerve
Phrenic nerve
Roots/trunks of brachial plexus

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6
Q

Root of neck vasculature

Veins

A

Subclavian Vs
Venous angle
Anterior jugular Vs
Jugular venous arch

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7
Q

Root of neck vasculature arteries

A

Subclavian aa and branches

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8
Q

Branches of subclavian artery

Part 1 medial

A

Vertebral
Internal thoracic
Thyrocervical - suprascapular, transverse cervical, inferior thyroid (ascending cervical)

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9
Q

Branches of subclavian artery

Part 2 : posterior

A

Costocervical trunk
Superior supreme intercostal
Deep cervical

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10
Q

Branches of subclavian artery

Part 3 lateral

A

Dorsal scapular

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11
Q

When describing branches of subclavian artery what are they in relation to

A

Anterior scalene muscle

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12
Q

Thoracic outlet syndrome

A

Group of disorders that occur when blood vessels or nerves in the space between clavicle and first rib (thoracic outlet) are compressed
Symptoms are dependent on structure that is compressed

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13
Q

Neurogenic thoracic outlet syndrome

A

Characterized by compression of the brachial plexus

In the majority of thoracic outlet syndrome the symptoms are neurogenic

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14
Q

Vascular thoracic outlet syndrome

A

Occurs when veins (venous thoracic outlet syndrome) or arteries (arterial thoracic outlet syndrome) are compressed

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15
Q

Layers of the thoracic wall

Superficial to deep

A 
Skin
Superficial fascia
Pectoral fascia
Skeletal elements, musculature, neurovascular bundle
Endothermic can fascia
Pleura
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16
Q

Thoracic cage

A

Thoracic vertebrae and intervertebral discs
Ribs
Sternum
Costal cartilages and joints

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17
Q

Thoracic vertebrae articulation

A 
All articulate with ribs but points of articulation vary between
T1
T2-t8
T9
T10
T11-12
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18
Q

True ribs

A

Ribs 1-7

Sternum attach directly to sternum

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19
Q

False ribs

A

Share costal cartilage that attach to sternum

Ribs 8-10

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20
Q

Floating ribs

A

No attachment to sternum just vertebra

Ribs 11-12

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21
Q

Typical vertebrae

A 
Head
2 Demi facets
Neck
Tubercle with facet
Angle
Shaft
Strong costal groove
Eternal end - costal cartilage is
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22
Q

Atypical ribs

A 
1
2
10
11
12
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23
Q

Ribs 1

A 
No tubercle associated with them 
Shorter
Distinguishing features
Single facet on head
Scalene tubercle
Grooves for vasculature
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24
Q

Rib 2

A

Longer neck than other ribs

Tuberosity for serratus anterior

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25
Q

Sternum

A

3 separate bones - can fuse
Manubrium
Body
Xiphoid process

Clavicular notch
Jugular notch
1st costal notch
Eternal angle/ angle of Louis - 2nd costal notch. Where manubrium and body come together. Palpate in opp.

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26
Q

Costoverebral joints

A

Joints of heads of ribs

Costotransverse joints

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27
Q

Joints of heads of ribs

Ligaments

A

Associated ligaments: radiate introa articulate
Head of rib to ivd
intraarticulate
Attaches head to both of vertebrae

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28
Q

Costotransverse joints

Ligaments

A

Vertebral facet and costal tubercle of rib
Costotransverse -
Lateral costotransverse
Superior costotransverse

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29
Q

Interchondral

A

Joint formed between costal cartilage and lower ribs

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30
Q

Costochondral

A

Sternal ribs to costal cartilage

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31
Q

Manubriosternal

A

Manubrium and body of sternum

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32
Q

I phi stern also

A

Body and xiphoid process

33
Q

Intercostal muscles

A

External intercostal
Internal intercostal
Innermost intercostal

All innervation by intercostal nerves

34
Q

External intercostal muscles

A

Anterior muscles replaced by external intercostal membrane

Most active during inspiration

35
Q

Internal intercostal muscles

A

Posterior muscle fibers replaced by internal intercostal membrane
Most active during forced expiration (interosseous portion)
Interchondral portion active during forced inhalation

36
Q

Innermost intercostal muscle

A

Similar to internal intercostal muslce

Most evident in lateral thoracic wall

37
Q

Subcostal muscles

Subcostales aka

A

On internal surface of ribs
Span multiple ribs
Active during expiration
Inner ate dinner by intercostal nerves.

38
Q

Trans versus thoracis muscles

A

Weak expiratory function and probably proprioception
Innervation by intercostal nerves keeps internal thoracic vessels attached to wall.
Posterior part of the anterior wall.
Attach from sternum body to ribs.

39
Q

Thoracic wall innervation

A

Ventral rami of t1-t11 spinal nerves (intercostal nerves) and ventral rami of t12 (subcostal nerve)

40
Q

Branches of thoracic wall innervation

Ventral rami of t1-t12

A 
Lateral cutaneous
Anterior cutaneous
Collateral branches - inner most spaces
Muscular branches
Rami communicates.
41
Q

Landmarks associated with dermatomes

T4

A

Nipple

42
Q

Structural landmarks associated with dermatomes

T10

A

Umbilicus

43
Q

Arterial supply of thoracic wall

A

Primarily from anterior and posterior intercostal aa.

44
Q

Posterior intercostal aa

A

Mostly arise from thoracic aorta

45
Q

Anterior intercostal aa

A

Arise from internal thoracic a to supply spaces 1-6

Arise from musculophrenic a to supply spaces 7-9

46
Q

Venous drainage

Anterior intercostal veins

A

Drain into internal thoracic veins then to brachiocephalic veins

47
Q

Venous drainage

Posterior intercostal veins

A 
Drain into azygos system
Lower left (spaces 7-11) empty into hemiazygos v. 
Upper left side empty into accessory hemiazygoes
Right side empties into azygos v.

Hemiazygos and accessory hemiazygos empty into azygos v.

48
Q

Intercostal nerve block

A

Local anesthesia injected into intercostal space.

Usually does not result in complete loss of sensation due to overlap in innervation.

49
Q

Herpes zoster infection of spinal ganglion (Shingles).

A

Typically distributed along a dermatome associated with infected ganglion.

50
Q

Diaphragm

A

Primary muscle of inspiration

Dome shaped musculofibrous partition with a central tendon

51
Q

Diaphragm attachments

A

Costal margin
Xiphoid process
L1-l3 vertebrae

52
Q

Diaphragm innervation

A 
Phrenic nn (c3,c4,c5) motor to all and sensory to most
Intercostal and subcostal nn (T6-t12) - sensory to periphery of diaphragm.
53
Q

Pulmonary ventilation

A

Pressure differences between atmosphere and intrathoracic cavity determine air flow in and out of lungs

54
Q

Intrathoracic and atmospheric pressures during inspiration

A

Intrathoracic < atmospheric

55
Q

Intrathoracic and atmospheric pressures during expiration

A

Intrathoracic > atmospheric

56
Q

Muscle involvement during passive inspiration

A

Contraction of diaphragm and external intercostals

Bucket and pump handles are raised

57
Q

Muscle involvement in passive expiration

A

Relaxation of diaphragm and external intercostal s

58
Q

Muscle involvement in forced inspiration

A 
Contraction of 
Diaphragm
External intercostals
Sternocleidomastoid
Trapezius
Pectoralis minor
Scalenes
59
Q

Muscle involvement in forced expiration

A

Relaxation of:
Diaphragm
External intercostals
Contraction of abdominal muscles

60
Q

Lymphatic drainage of the breasts

A

Most lymph drains to axial lymph nodes, initially to pectoral lymph nodes
Remaining lymph drains mostly to parasternal lymph nodes.

61
Q

T4/t5 vertebral level

A

Sternal angle lies on a transverse plane that passes through the intervertebral disc between vertebrae t4 and t5
Ascending aorta ends and arch begins
More posteriorly the aortic arch ends and thoracic aorta begins
Trachea bifurcated.

62
Q

Superior thoracic aperture structures passing through (12)

A 
Trachea
Esophagus
Lung spices
Brachiocephalic veins
Brachiocephalic trunk
Left common carotid a 
Left subclavian a 
Vagus nerves
Phrenic nerves
Recurrent laryngeal nerves
Sympathetic trunk
Lymphatics
63
Q

Rib 1 characteristics

A

Round head with single facet
Grooves for subclavian artery and vein
Scalene tubercle
NO costal groove

64
Q

Rib 2 characteristics

A

Two Demi facets
LONG neck
SLIGHT costal groove
Tuberosity for serratus anterior

65
Q

Rib 10 characteristics

A

Single facet

STRONG costal groove

66
Q

Rib 11-12 characteristics

A 
Single facet
NO tubercle
No costal groove
NO pit on sternal end 
R12 shorter than r11
67
Q

Posterior intercostal arteries

A

Upper 2 arise from superior intercostal a

Remainder posterior intercostal and subcostal a arise from descending aorta.

68
Q

Anterior arteries

A 
Derived from internal thoracic a 
Anterior intercostal a - spaces 1-6
Musculophrenic a - spaces 7-9
Superior epicanthic a - abdominal wall 
Contributions from superior thoracic and lateral thoracic aa
69
Q

Lymphatic drainage of thoracic wall

A

Drainage will be mainly to
Parasternal node > bronchomediastinal trunks
Intercostal nodes
Upper> bronchomediastinal trunks
Lower> thoracic duct
Diaphragmatic nodes interconnect with numerous nodes.

70
Q

Precuts carinatum

A

Pigeon chest
Chest juts out due to unusual growth of sternum, ribs, and associated cartilage
Usually no symptoms though sob may occur.
Usually treated with a brace

71
Q

Precuts excavated

A

Funnel chest
Sunken sternum
If severe may interfere with function of heart and lungs
Can be surgically corrected

72
Q

Flail chest

A

Multiple rib fractures

Chest wall collapses inward during inspiration and balloons outward on expiration.

73
Q

Carcinomas of the breast

A

Malignant tumors usually adenocarcinomas arising from epithelial cells of the lactiferous ducts in mammary gland lobules

74
Q

What causes the peak d’orange sign and nipple deviation/retraction of breast cancer

A

Interference with dermal lymphatics as cancer enters lymphatic system may cause lymphedema

75
Q

What is dimpling caused by in breast cancer

A

Cancerous invasion of glandular tissue and fibrosis which causes shortening or places traction on suspensory ligaments

76
Q

Polymastia

A

Accessory breast

77
Q

Polythelia

A

Accessory nipple

78
Q

Amastia

A

No breast development

79
Q

Gynecomastia

A

Breast hypertrophy in males after puberty
May be age or drug related
May be due to an imbalance between estrogen in and androgenic hormones or from change in metabolism of sex hormones by liver.

Anatomy (12 decks)

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