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Anatomy BMSc > Thorax > Flashcards

Thorax Flashcards

1
Q

boundaries of the superior thoracic aperture

3

A

body of T1
1st pair of ribs + costal cartilages
superior border of manubrium

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2
Q

boundaries of inferior thoracic aperture

4

A

body of T12
11th and 12th pairs of ribs
costal cartilages of ribs 7-10 (costal margin)
xiphisternal joint

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3
Q

which vertebral body/bodies do ribs articulates with

A

mostly with its named body, but also partly with the body above
eg T7 articulates with T7 and partly with T6

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4
Q

typical ribs

A

3-9

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5
Q

describe head of typical rib

A

wedge shaped

2 articular facets separated by crest

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6
Q

which part of the rib articulates with the IV disc

A

crest

separates the two articular facets on head of rib

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7
Q

what is the function of the neck of typical ribs

A

connects head and body at tubercle

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8
Q

what connects to the articular and non-articular parts of the tubercle of the rib

A

articular part = transverse process of own vertebra

non-articular = costotransverse ligament

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9
Q

what is the costal angle

A

the most curved part of the body

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10
Q

what is the purpose of the costal groove and where is it found

A

protection for intercostal neurovascular bundle

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11
Q

which ribs are classed as atypical

A

1st
2nd
10-12th

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12
Q

describe the first rib (what makes it atypical)

A

single facet on the head (articulates with T1 only)
grooves for subclavian vessels on superior surface (vein more medial)
grooves separated by scalene tubercle

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13
Q

what attaches as the scalene tubercle of the 1st rib

A

anterior scalene muscles

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14
Q

describe the 2nd rib (what makes it atypical)

A

rough area on upper surface (tuberosity for serrates anterior)

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15
Q

describe ribs 10-12

A

only articulate with own vertebra

11/12 have no neck or tubercle (very short)

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16
Q

what are the true ribs and what does this mean

A

1-7

attach to sternum directly via their own costal cartilage

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17
Q

what are the false ribs and what does this mean

A

8-10

indirectly attach to sternum via cartilage of ribs above (costal margin)

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18
Q

what are the floating ribs and what does this mean

A

11-12

no connection to sternum

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19
Q

what are the sections and joints of the sternum

A 
manubrium, body and diploid process 
sternal angle (manubrium and body)
xiphisternal joint (body and diploid process
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20
Q

where is the first costal notch

A

manubrium

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21
Q

where is the second costal notch

A

sternal angle

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22
Q

which costal notch is at the xiphisternal joint

A

7th

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23
Q

which bone articulates with the sternum immediately superior to the first costal notch

A

clavicle

at clavicular notch

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24
Q

the 1st sternocostal notch is which type of joint

A

primary cartilaginous (synchondrosis)

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25
Q

sternocostal joints 2-7 are which type of joint

A

synovial plane

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26
Q

what type of joints are interchondral joints

A

synovial plane joints between ribs 6-7, 7-8 and 8-9

fibrous between 9 and 10

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27
Q

what are the articular surface of the costotransverse joints

A

transverse process of vertebra of same number as rib

tubercle of rib

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28
Q

describe the movements of the upper ribs (1-6)

A

pump-handle movement
more up and down
axis of movement is lateral

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29
Q

describe the movement of the lower ribs (7-12)

A

bucket-handle movement
more outward flaring
axis of movement more posterior

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30
Q

how is the AP diameter of the thoracic cage increased during respiration

A

sternum moves anteriorly and superiorly

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31
Q

how is the lateral diameter of the thoracic cage increased during respiration

A

lower ribcage moves laterally

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32
Q

how does the vertical volume of the thoracic cage increase during respiration

A

diaphragm descends

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33
Q

nerve supply of pec major

A

medial pectoral nerve C8/T1

lateral pectoral C5-7

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34
Q

nerve supply of pec minor

A

medial pectoral nerve C8/T1

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35
Q

nerve supply of external oblique

A

anterior rami T7-12

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36
Q

nerve supply rectus abdominis

A

anterior rami T7-12

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37
Q

nerve supply of serratus anterior

A

long thoracic C5-7

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38
Q

nerve supply of serratus posterior superior

A

2-5 intercostal nerves

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39
Q

nerve supply of serratus posterior inferior

A

anterior rami T9-12

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40
Q

nerve supply of anterior scalene

A

anterior rami C3-7

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41
Q

nerve supply of middle scalene

A

anterior rami C4-7

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42
Q

nerve supply of posterior scalene

A

anterior rami C5-7

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43
Q

direction of fibres of external intercostal muscles

A

downwards and forwards

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44
Q

attachments of external intercostal muscles

A

start at levels of tubercles and stop at junction of costal cartilage

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45
Q

function of external intercostals

A

raise ribs on inspiration

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46
Q

direction of fibres of internal intercostals

A

downwards and backwards

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47
Q

attachments of internal intercostals

A

start at edge of sternum and reach angle of ribs

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48
Q

function of internal intercostals

A

interosseous parts depress the ribs

interchondral parts raise the ribs

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49
Q

direction of fibres of innermost intercostals

A

downwards and backwards

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50
Q

where are the subcostal muscles and transversus thoracis found

A

deep to the ribs

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51
Q

describe subcostal muscles

A

found near the angle of the ribs
spans 1 or 2 intercostal spaces
fibres blend with innermost intercostals

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52
Q

describe transversus thoracis

A

radiates from side of sternum to costal cartilages 2-6

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53
Q

which vessels are associated with anterior surface of transversus thoracis

A

internal thoracic artery

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54
Q

which structures are found int he intercostal space

A

intercostal muscles

neurovascular bundle

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55
Q

where is the neurovascular plane found

A

between internal and innermost intercostal muscles

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56
Q

order of neurovascular vessels in intercostal space

A

vein
artery
nerve
VAN

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57
Q

the neurovascular bundle runs above/below the rib

A

below

in costal groove on inferior surface of body of rib

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58
Q

internal thoracic artery supplies which aspect of the thoracic wall

A

anterior

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59
Q

where do posterior intercostal arteries mainly arise from

A

thoracic aorta

3-11 and subcostal (12)

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60
Q

where do the 1st and 2nd posterior intercostal arteries arise from

A

supreme intercostal artery

branch of costocervical trunk from subclavian artery

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61
Q

where do the first 6 anterior intercostal arteries arise from

A

internal thoracic artery

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62
Q

which artery supplies intercostal spaces 7-9

A

musculophrenic artery

branch of internal thoracic

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63
Q

the internal thoracic artery branches into which two arteries

A

musculophrenic artery

superior epigastric artery

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64
Q

where do intercostal veins drain

A 
anterior = internal thoracic vein 
posterior = azygous system
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65
Q

where do the lateral mammary branches arise from to supply the breast

A

lateral thoracic artery

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66
Q

where do the medial mammary branches arise from to supply the breast

A

internal thoracic

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67
Q

3 main division of thoracic cavity

A

mediastinum
right hemithorax
left hemithorax

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68
Q

what are the sections of the parietal pleura

A

cervical
costal
diaphragmatic
mediastinal

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69
Q

in which area is there a loosening of the pleura and why

A

at the lung hilum the pleura hangs down to form the pulmonary ligament
to allow vessels entering the hilum to change diameter whiteout stretching or damaging the pleura

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70
Q

how is the parietal pleura attached to the thoracic wall

A

endothoracic fascia

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71
Q

what is the supra pleural membrane and what is its function

A

tough fibrous membrane that attaches the lung to the 1st rib and transverse process of C7
stop lung inflating beyond the thoracic inlet

72
Q

what is the anterior surface marketing of the visceral pleura

A

midclavicular line 6th rib

73
Q

what is the lateral surface marking o the visceral pleura

A

midaxillary line 8th rib

74
Q

what is the posterior surface marking of the visceral pleura

A

scapular line 10th rib

75
Q

what is the anterior surface marketing of the parietal pleura

A

miclavicular line 8th rib

76
Q

what is the lateral surface marketing of the parietal pleura

A

midaxillary line 10th rib

77
Q

what is the posterior surface marketing of the parietal pleura

A

scapular line 12th rib

78
Q

what are the surfaces of the lungs

A

costal
diaphragmatic
mediastinal

79
Q

how many lobes in each lung

A

3 in right

2 in left

80
Q

describe the locations of the structures of the lung hilum

A

pulmonary veins inferiorly and anteriorly
pulmonary artery superiorly
bronchus posteriorly

81
Q

which vascular structures are associated with each lung

A

right lung: arch of azygous and SVC

left lung: descending aorta and arch of aorta

82
Q

the phrenic nerve runs ________ in relation to the hilum

A

anterior

83
Q

the vagus nerve runs ________ in relation to the hilum

A

posterior

84
Q

describe the course of the recurrent laryngeal nerve in the thorax

A

left: branches from left vagus and loops around arch of aorta
right: branches from right vagus and loops around subclavian artery

85
Q

at which level does the trachea spilt

A

T4

86
Q

left lung lobes/segments

A

2 lobes

5 segments each

87
Q

right lung lobes/segments

A

3 lobes
3 segments upper
2 segments middle
5 segments lower

88
Q

describe the course of lymph from the lungs

A

pulmonary nodes&raquo_space;> bronchopulmonary (hilarity) nodes&raquo_space;> inferior tracheobracheal (carinal) nodes&raquo_space;> superior tracheobrachial nodes&raquo_space;> paratracheal nodes

89
Q

what separates the superior and inferior mediastinum

A

transverse thoracic plane

level of sternal angle

90
Q

what are the borders of the anterior mediastinum

A

body of sternum
pericardium
transverse thoracic plane
diaphragm

91
Q

what is contained in the anterior mediastinum

A

loose connective tissue
lymphatics
thymus in children

92
Q

what are the content of the middle mediastinum

A

heart and serous pericardium lining the fibrous pericardium

93
Q

structures adjacent to middle mediastinum

A

great vessels
phrenic nerves
lung root structures

94
Q

which structures does the fibrous pericardium blend with superiorly and inferiorly

A

tunica adventitia of great vessels superiorly

central tendon of diaphragm inferiorly

95
Q

describe the course and function of pericardiophrenic artery

A

arises from internal thoracic artery at level of lower margin of manubrium and runs with the phrenic nerve
supplies the phrenic nerve, pleura, pericardium and diaphragm (minimal contribution)

96
Q

what is the pericardial cavity

A

between the parietal and visceral layers of serous pericardium

97
Q

the visceral serous pericardium is also known as

A

epicardium

98
Q

where is the transverse pericardial sinus found

A

between the inflow and outflow great vessels

99
Q

where is the oblique pericardial sinus found

A

space behind the heart, extending where the pulmonary veins enter the left atrium

100
Q

base of heart

A

left atrium (posteriorly)

101
Q

right border of heart

A

right atrium

102
Q

inferior border of heart

A

right ventricle

103
Q

apex of heart

A

wall of left ventricle

104
Q

left border of heart

A

left ventricle

105
Q

superior border of heart

A

right and left atria and auricles

106
Q

what is the ligament arteriosum

A

fibrous remnant of ductus arteriosus

107
Q

what is the relation of the left recurrent laryngeal to the ligament arteriosum

A

left recurrent laryngeal nerve runs posterior to ligament arteriosum

108
Q

where do cardiac veins drain

A

into coronary sinus

APART from anterior cardiac veins&raquo_space;> directly into right atrium

109
Q

what are the ridges in the right atrium called

A

musculae pectinatae

110
Q

what is the crest terminalis

A

border between smooth part of wall and muscular ridged wall in right atrium

111
Q

what is the sinus venarum

A

smooth venous area in right atrium

opening of IVC, SVC and coronary sinus

112
Q

which valve separates the right atrium and ventricle

A

tricuspid

113
Q

what are the ridges in the right ventricle called

A

trabecular carneae

114
Q

which structure is unique to the right ventricle

A

moderator band

115
Q

what is the moderator band

A

band of tissue running from the inter ventricular septum to the anterior wall
carries part of the conducting system
ensures papillary muscles contract at the same time as rest of heart muscle

116
Q

which valve separates the left atrium and ventricle

A

bicuspid/mitral

117
Q

semilunar valves are closed in high/low pressure

A

low

118
Q

function of the semilunar valves

A

to prevent back flow of blood back into ventricles

119
Q

cuspid valves are closed in high/low pressure

A

high

120
Q

describe how cuspid valves work

A

ventricles contract&raquo_space;> increased pressure&raquo_space;> papillary muscles contract&raquo_space;> creates tension in cordae tendineae&raquo_space;> keeps leaflets closed

121
Q

what is the function of the fibrous skeleton of the heart

A

support for the valves

electrical insulation between atria and ventricles

122
Q

autonomic innervation of the heart

A

from cardiac plexus (SA node)
SA node depolarises&raquo_space;> spreads through atria (contraction)&raquo_space;> reaches AV node, causing depolarisation&raquo_space;> passed down AV bundle&raquo_space;> bundle of His&raquo_space;> purkinje fibres

123
Q

parasympathetic innervation of heart

A

vagus (CN X)

cardiac plexus to intrinsic ganglia

124
Q

sympathetic innervation of heart

A

T1-5/6

cervical and superior thoracic paravertebral ganglia of (sympathetic chain)

125
Q

what are the boundaries of the superior mediastinum

A 
manubrium
bodies of T1-4 vertebrae 
transverse thoracic plane 
thoracic inlet 
parietal pleura
126
Q

what is the level of the transverse thoracic plane

A

sternal angle and T4/5 IV disc

127
Q

what is contained in the superior mediastinum

A 
thymus (in children)
brachiocephalic veins and SVC
arch of aorta 
trachea 
oesophagus 
phrenic and vagus nerve 
lymphatics
128
Q

which structures are found only in the superior mediastinum (not in any part of the inferior mediastinum)

A

thymus
brachiocephalic veins
arch of aorta
trachea

129
Q

branches of the arch of the aorta

A

brachiocephalic trunk
left common carotid
left subclavian

130
Q

what are the branches of the brachiocephalic trunk

A

right subclavian and right common carotid

131
Q

describe the course of the right vagus nerve in the superior mediastinum

A

anterior to right subclavian

gives off right recurrent laryngeal nerve that loops under right subclavian artery

132
Q

where does the right recurrent laryngeal nerve run as it ascends the superior mediastinum

A

in space between trachea and oesophagus

133
Q

describe the course of the left vagus nerve in the superior mediastinum

A

runs between left common carotid and left subclavian

gives off left recurrent laryngeal which loops under arch of the aorta (posterior to ligament arteriosum)

134
Q

what does the vagus nerve innervate in the thorax

A

gives branches to cardiac plexus deep to arch of aorta

gives branches to right and left pulmonary plexus on right and left main bronchi

135
Q

describe the oesophageal plexus

A

left and right vagus nerves combine to form an anterior and posterior oesophageal plexus
they then continue as anterior and posterior vagal trunks

136
Q

which vagus nerve provides the majority of the fibres of the anterior and posterior vagal trunks

A 
anterior = mostly left vagus nerve fibres 
posterior = mostly right vagus nerve fibres
137
Q

nerve roots of phrenic nerve

A

C3,4,5

138
Q

describe the course of the right phrenic nerve in the thorax

A

runs alongside the right brachiocephalic vein, SVC and pericardium over the right atrium
anterior to root of right lung

139
Q

where does the right phrenic nerve pierce the diaphragm

A

near the caval opening

140
Q

describe the course of the left phrenic nerve in the thorax

A

lies between left subclavian artery and vein, to the left of the arch of the aorta and anterior to vagus
anterior to root of left lung hilum onto surface of pericardium over left atrium and ventricle

141
Q

where does the left phrenic nerve pierce the diaphragm

A

to the left of the pericardium

142
Q

what type of innervation does the phrenic nerve provide

A

motor innervation to diaphragm

sensory innervation to fibrous pericardium

143
Q

where does the trachea begin

A

C6/7

below larynx

144
Q

where does the trachea bifurcate and what is the name of the bifurcation

A

T4/5

carina

145
Q

describe the structure of the trachea and how this aids its function

A

C-shaped cartilages anteriorly with trachealis muscle posteriorly
cartilage keeps airway patent
muscle allows expansion of oesophagus which lies posteriorly

146
Q

which lymph nodes are associated with the trachea

A

bronchopulmonary

carinal

147
Q

where does the oesophagus begin

A

C6

continuation of pharynx

148
Q

describe the course of the oesophagus through the thorax

A

initially lies to the right of the aorta

crosses anteriorly prior to piercing the diaphragm

149
Q

where does the oesophagus pierce the diaphragm

A

T10

150
Q

what causes the constrictions of the oesophagus visible on imaging studies

A

arch of aorta
left bronchus
diaphragm

151
Q

what are the boundaries of the posterior mediastinum

A

transverse thoracic plane
bodies of T5-12
pericardium and diaphragm
parietal pleura

152
Q

branches of thoracic aorta

A 
oesophagus 
pericardium 
bronchi 
thoracic wall
diaphragm
153
Q

where is the azygous vein

A

runs to the right of the VC

154
Q

which intercostal veins drain directly into the azygous vein

A

right T2-11 and subcostal

155
Q

how do the left intercostal veins drain into the azygous system

A

1-4 drain straight into brachiocephalic vein
5-8 to accessory hemiazygous
9-11 and subcostal to hemiazygous

156
Q

where does the thoracic duct lie

A

between the azygous vein and aorta

157
Q

which vein does the thoracic duct arch over to connect to the left venous angle

A

internal jugular

158
Q

which veins make up the venous angle

A

internal jugular and subclavian

159
Q

which rami communicantes are associated with sympathetic inflow and outflow

A 
inflow = grey 
outflow = white
160
Q

sympathetic outflow occurs at which vertebral levels

A

T1-L2/3

161
Q

which vertebral levels make up the greater splanchnic nerves

A

T5-9

162
Q

which ganglia do the greater splanchnic nerves innervate

A

coeliac and superior mesenteric

163
Q

which vertebral levels make up the lesser splanchnic nerves

A

T10-11

164
Q

which ganglia do the lesser splanchnic nerves innervate

A

superior mesenteric and aorticorenal

165
Q

which vertebral levels make up the least splanchnic nerves

A

T12

166
Q

which ganglia do the least splanchnic nerves innervate

A

aorticorenal

167
Q

what is the function of the thoracic splanchnic nerves

A

supply sympathetic innervation to the abdominal viscera

168
Q

what level is the caval opening

A

T8 (VENA CAVA has 8 letters)

169
Q

what passes through the caval opening of the diaphragm

A

IVC

170
Q

what forms the caval opening of the diaphragm

A

opening in the central tendon

171
Q

what level os the oesophageal hiatus

A

T10 (OESOPHAGUS has 10 letters)

172
Q

what passes through the oesophageal hiatus

A

oesophagus and vagal trunks

173
Q

what level is the aortic hiatus

A

T12

174
Q

what forms the aortic hiatus

A

space posterior to the median arcuate ligament

175
Q

what passes through the aortic hiatus

A

aorta, thoracic duct, azygous vein

176
Q

which structures pass through the opening of the diaphragmatic crura

A

greater and lesser splanchnic nerves

177
Q

which structures pass behind the medial arcuate ligament

A

least splanchnic nerve and sympathetic trunk

Anatomy BMSc (9 decks)

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