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Anatomy of thorax > Thorax > Flashcards

Thorax Flashcards

1
Q

Which vertebra does the suprasternal plane correspond to

A

T2 posteriorly

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2
Q

Which vertebra does the sternal angle plane correspond to

A

T4/5 posteriorly

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3
Q

Which vertebra does the xiphisternal plane correspond to

A

T9 posteriorly

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4
Q

What are intercostal muscles innervated by

A

Intercostal nerves

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5
Q

What type of joint are intervertebral joints

A

Symphysis joints

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6
Q

What type of joint are costovertebral joints

A

Synovial joints

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7
Q

What type of joint are sternocostal joints

A

1st- primary cartilaginous

2-7- synovial plan joints

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8
Q

What type of joint is a sternoclavicular joint

A

Synovial

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9
Q

What type of joint is the costochondrial joint

A

Primary cartilaginous joint

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10
Q

What type of joint is an interchondral joint (adjacent border of 6-7, 7-8, 8+9 costal cartilage)

A

Synovial joint

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11
Q

Where does the phrenic nerve arise from

A

C3,4,5 (C345 keeps the diaphragm alive)

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12
Q

What is the course of the right phrenic nerve

A

Wall of SVC

Along side of fibrous pericardium over right atrium

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13
Q

What is the course of the left phrenic nerve

A

Over the arch of the aorta and pulmonary trunk

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14
Q

What does the phrenic nerve innervate

A

Diaphragm, pleura of mediastinum and pericardium

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15
Q

What symptoms does neurogenic thoracic outlet syndrome present with

A

Pain

Weakness and loss of muscle at base of thumb

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16
Q

What symptoms does venous thoracic outlet syndrome present with

A

Swelling, pain and blueness of light

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17
Q

What symptoms does arterial thoracic outlet syndrome present with

A

Pain, coldness and paleness of the arm

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18
Q

Where do internal thoracic arteries run and where does it arise from

A

Subclavian artery and runs along the anterior side of the ribcage (either side of the sternum)

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19
Q

What does the internal thoracic artery supply

A

Intercostal muscles in spaces 1-6

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20
Q

What does the internal thoracic artery divide into and what do these supply and run

A

Superior epigastric artery

Musculophrenic artery (supplies ics 7-9 and lower part of pericardium; also splits into anterior intercostals and pass between internal and innermost intercostal muscles to supply the intercostals, overlying skin, and parietal pleura)

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21
Q

How can you tell if the diaphragm is paralysed and why does this happen

A

One side is risen up because the R and L phrenic nerves supply different sides of the diaphragm. If the RHS is paralysed, then when the left contracts, the contents of abdomen push up against the diaphragm

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22
Q

What arteries does the subclavian artery give rise to that supply the thoracic wall and what do they supply

A 
Internal thoracic (ics1-6)
Supreme intercostal arteries (gives rise to the first and second posterior intercostal arteries, which supply blood to their corresponding intercostal space)
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23
Q

What arteries does the axillary artery give rise to that supply the contents of the thorax and what do they supply

A

Superior thoracic artery (supplies Serratus anterior)

Lateral thoracic artery (supplies Serratus anterior and breast)

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24
Q

What arteries supply the breast and where do they arise from

A

Internal thoracic artery (from subclavian)

Lateral thoracic artery and thoracoacromial arteries (from axillary artery)

Lateral mammary branches (from posterior intercostal arteries)

Mammary branch (from anterior intercostal artery)

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25
Where do the veins of the breast drain into
Axillary and internal thoracic veins
26
Where does the vagus nerve appear from
Between the common carotid artery and internal jugular vein
27
Course of the right vagus nerve
Runs anterior to beginning of subclavian artery [gives off right recurrent laryngeal nerve at origin of subclavian artery] Then forms oesophageal plexus
28
Course of left vagus nerve
Runs along lateral wall of common carotid artery Passes between the descending aorta and left pulmonary trunk [left recurrent laryngeal nerve branches off and loops around the arch of the aorta] Joins the right vagus nerve to make plexus
29
Which vagus nerve passes between the descending aorta and left pulmonary trunk
Left
30
Which vagus nerve gives off a laryngeal nerve which loops around the arch of the aorta
Left
31
Which vagus nerve runs anterior to the beginning of subclavian artery
Right
32
Which vagus nerve forms the oesophageal plexus
Both
33
Why is long lasting hoarseness sometimes a sign of lung cancer
Because laryngeal nerves innervate laryngeal muscles so if there's a lung tumour there can be pressure on laryngeal nerves causing hoarseness
34
What does the thoracic duct drain
lower extremities, pelvis, abdomen, left side of the thorax, left upper extremity, and left side of the head and neck
35
Where does the thoracic duct drain into (terminate)
junction of the left subclavian and left internal jugular veins
36
How does the thoracic duct enter the abdomen
through the aortic hiatus
37
Which structures pass through the diaphragm at level T8
Vena cava | R Phrenic
38
Which structures pass through the diaphragm at level T10
Oesophagus Left phrenic Vagus nerve
39
Which structures pass through the diaphragm at level T12
Thoracic duct Aortic Hiatus Azygos system
40
What's the diaphragm attached to anteriorly
Inferior 6 ribs and their costal margins and the xiphoid process
41
What is the supply of the diaphragm
Phrenic arteries
42
What is the origin of the pec minor muscle
3rd-5th ribs near costal cartilage
43
Where does the pec minor muscle insert
Medial border and superior surface of coracoid process
44
What is the action of the pec minor
Stabilise scapula by drawing it in inferably and anteriorly against the thoracic wall
45
What is the innervation of the pec minor
Medial pectoral nerves
46
What is the artery that supplies the pec minor
Thoracoacromial artery
47
Where is the origin of the pec major muscle
Anterior sternal half of clavicle Manubrium and sternum up to 6 costal cartilages Aponeurosis of abdominal external oblique
48
Where does the pec major insert
Bicipital groove of the humerus
49
What is the action of the pec major
Humerus flexion (lifting arm up) Humerus adduction (bringing arm towards body) Rotate humerus medially Keep arm attached to trunk
50
What is the innervation of the clavicular head of the pec major
C5,6 (lateral pectoral nerve)
51
What is the innervation of the sternocostal head of the pec major
C7, C8, T1 (medial pectoral nerve)
52
What are some of the structures that run through the superior thoracic aperture
``` Trachea Oesophagus Lung apex Thoracic duct L&R common carotids and subclavian aa Brachiocephalic and internal jugular vv Vagus and phrenic nerves ```
53
What are some of the structures that run through the inferior thoracic aperture
OSeophagus Thoracic duct Abdominal aorta Inferior vena cava
54
What is the origin of the Serratus anterior mm
Superior 8 or 9 ribs
55
What is the insertion of the serratus anterior mm
Vertebral border and inferior angle of scapula
56
What is the action of the serratus anterior mm
Abduction and rotate scapula upwards Elevate ribs when scapula stabilised
57
What is the nerve supply of the serratus anterior mm and its roots
Long thoracic nerve (C5-7)
58
What is the blood supply of the serratus anterior mm
Lateral thoracic artery (from the axillary artery)
59
In the RHS of the body, where do all the posterior intercostal veins drain into (except the first) and in turn where does this drain into
Azygos vein -> Right superior vena cava
60
Where does the azygos vein drain into
Right superior vena cava
61
In the LHS of the body, where do all the intercostal veins drain into (except upper 3 accessory hemiazygos veins)
Hemiazygos vein
62
Where do the upper 3 accessory hemi-azygos veins drain into (these are only found on the LHS)
Left brachiocephalic vein
63
Where do the anterior intercostal veins drain into and where does this drain into in turn
Internal thoracic vein -> Brachiocephalic vein
64
What are the accessory inspiratory muscles
Scalene muscles Infra-hyoid muscles Erector Spinae muscles Quadratus lamborum
65
What is the role of the scalene muscles in inspiration
Stabilise first ribs so when intercostal muscles contract, ribs are moved up to first rib
66
What is the role of the quadrates labour during inspiration
Stabilises 12th ribs so when diaphragm, contracts, ribs are moved away from 12th
67
How are external intercostals positioned
Inferiomedially
68
How are internal intercostals positioned
Inferolaterally
69
How are innermost intercostals positioned
Inferolaterally
70
What is thoracocentesis used for
Obtain sample for histology or to treat primary tension pneumothorax
71
where is the needle inserted in thoracocentesis
Inferior half of ics in; - 4th/5th midaxillary line - or 2nd ics in midaxillary line
72
What does the needle pass through in thoracocentesis
Intercostal muscles and parietal pleura
73
When is intercostal nerve block used
When there is pain due to shingles or localised chest wall pain
74
Where does the lateral thoracic artery come from and what does it supply
Axillary artery and supplies the - Serratus anterior - Breast
75
What is the origin of the lateral pectoral nerve (including the root values) and what does it supply
C5,6,7 --> Lateral cord of brachial plexus --> Lateral pectoral nerve --> Pec major
76
What is the origin of the medial pectoral nerve (including the root values) and what does it supply
C8+T1 --> Medial cord of brachial plexus --> Medial pectoral nerve -->Pec minor and major
77
What do the intercostal nerves supply
``` IC muscles Transverse thoracic muscle Subcostal muscle Levator costarum muscle Serratus posterior muscles Abs Thoracic and abd. skin Pleura ```
78
Where are the sites of oesophageal constriction
ABCD= - Cricoid cartilage (C6) - Arch of Aorta - Bronchus (LMB T4/5) - Diaphragm (oesophageal hiatus T11)
79
Why are the sites of oesophageal constriction important
Where foreign objects/food are most likely to become stuck and cause choking
80
What's winging of the scapula a sign of
Paralysis of the long thoracic nerve (C5-C7) which innervates serratus anterior

Anatomy of thorax (7 decks)

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