thorax Flashcards
1
Q
thorax
A
= chest
between neck and diaphragm
- cylinder that is more narrow at the top and wider at the bottom
2
Q
thoracic cavity parts
A
pleural cavities -2
mediastinum
3
Q
pleural cavities
A
right and left
each contain a lung
- each are separated one does not affect the other
4
Q
mediastinum
A
thick soft tissue partition between 2 pleural cavities
- can enter without entering pleural cavity
5
Q
what encloses the thoracic cavity ?
A
thoracic wall
6
Q
superior thorax
A
superior thoracic aperture
7
Q
inferior thorax
A
inferior thoracic aperture
- Filled by the diaphragm
8
Q
anterior thorax
A
contains sternum and costal cartilages
9
Q
posterior thorax
A
thoracic vertebrae and intervertebral discs and posterior portion of the ribs
10
Q
lateral thorax
A
ribs
11
Q
functions of thorax
A
ventilation
protection
conduit
12
Q
ventilation
A
breathing
- inspirations and expiration
- both have to do with changing air volume via diaphragm moving up and down [sides of diaphragm also contribute]
13
Q
protection
A
thoracic wall protects :
lungs, heart, liver, stomach, spleen, superior kidneys
14
Q
conduit
A
multiple structures pass though here as they move from one part of the body to another
connection of the thoracic regions to other body parts
15
Q
what are the bones that help make up the chest wall?
A
collectively called the thoracic/rib cage
- thoracic vertebrate = 2 and intervertebral disks
- ribs
- sternum
16
Q
costae
A
ribs
17
Q
sternum
A
hematopoietic structure
3 parts
18
Q
3 part of the sternum
A
manubrium - superior part
body - main part
xiphoid process - inferior part
19
Q
costal cartilage
A
connects the upper 10 ribs to sternum
20
Q
floating ribs
A
last 2 ribs since they have no skeletal connections
21
Q
manubrium
A
top part is called the sternal notch
bottom part touching body is Called the sternal angle
22
Q
shoulder girdle
A
clavicle and scapulae
not part of the appendicular skeleton
23
Q
pectoral region
A
“pecs”
outside the thoracic wall
contain breasts and other muscles
24
Q
intercostal muscles
A
fill in the space between the ribs and gives structural support to the chest well
help resist the intrathoracic pressures that drive respiration
25
intercostal blood supply
same structure as the rib cage
run in the intercostal spaces b/w the ribs
26
intercostal arteries
branches of the thoracic aorta or internal thoracic artery
27
intercostal veins
drain blood from thoracic wall into the azygos venous system
28
thoracic nervous system
12 spinal nerves
- exit foramen and divide into anterior/ventral and posterior/dorsal ramus
29
spinal nerves
have grey and white communicates that connect the spinal nerve to to the sympathetic trunk
30
posterior rami
run posteriorly to supply skin, muscles and joints of back
31
anterior rami 1-11
1-11 form the intercostal nerves
each runs with intercostal artery and vein to supply anterior/lateral parts of the chest wall, skin and muscles
32
12th anterior ramus
forms the subcostal nerve
33
dermatome
in the embryo- the body was created in segments by somites.
somites are blocks of tissue that form the bone, muscle, and skin.
dermatomes follow this patten
it is conserved,
help diagnose neurologic problems of the spinal nerve and cord.
34
shingles
herpes zoster
- comes from previous varicella infection
- unilateral and affects a single dermatome
usually a thoracic one or around the eyes
35
diaphragm
dome shaped skeletal muscle sheet
-fills the inferior thoracic aperture
36
diaphragm separates
thoracic and abdominal cavities
37
muscles fibers of the diaphragm
peripherally attach to the boundaries of the inferior thoracic aperture and converge to attache to the central tendon
38
diaphragm layout
anterior attachments are higher than the posterior attachments
back of dome is lower than the front
lateral are lower than the central
39
what is the lowest part of the thoracic cavity?
located along the posterolateral attachments of the diaphragm to the ribs
40
openings of the diaphragm
vena caval foramen
esophageal hiatus
arotic hiatus
41
vena caval foramen
at the horizontal T8 vertebra inferior vena cava
right of the midline
42
esophageal hiatus
horizontal level of the 10th thoracic vertebra
in midline
- for the esophagus and vagus x nerves
43
esophageal hiatus diaphragm fibers
the fibers that form this, help prevent gastro-esophageal reflux
44
arotic hiatus
located at the horizontal level of the 12th thoracic vertebra
in midline and technically beihind the diaphragm
there are no muscle fibers of the diaphragm that run posterior to the aorta
- contains decending aorta
thoracic duct
45
hiatal hernia
abnormal protrusion of n organ or other body structure through a defect / natural opening in a covering membrane/muscle. bone.
usually stomach though the esophageal hiatus
46
hiccup
involuntary spasmic contraction of the diaphragm.
it is the start of inspiration, but is checked by a sudden close of the glottis causing a sound
home remedies try to break the neurologic cycle
trying not to breathe until it stops
47
glottis
controlled by vagus nerve 10
48
respiration
contraction - flattens [increases size of the thoracic cavity and lowers pressure]
relaxes- thoracic cavity pressure increses
49
quiet breathing
only muscle that is moving is diaphragm
only moves during inspiration
expiration is passive
50
forced inspiration
also uses intercostal muscles to move the ribs apart
51
forced expiration
intercostal muscles pull the ribs together to make the cavity smaller
52
what is the weakest side of the abdominal cavity
superior part, so the organs move in that direction which decreases size of the thoracic cavity
this happens when the abdominal muscles compress the abdominal cavity with increases the pressure on abdomen
53
phrenic nerves
motor supply for the diaphragm
supplies sensory innervation to Both the fibrous pericardium and the portion go the parietal pleura lining the mediastinal wall
54
where do the phrenic nerves arise from?
cervical spinal cord levels
c3-5
arise in the neck and decend though the mediastinum along their respective lateral sides of the heart [b/w the fibrous pericardium and the mediastinal pleura
55
what do the phrenic nerves supply?
each supplies its specific half of the diaphragm
each piece through the diaphragm
they branch to distributed to the diaphragm on its inferior aspect
56
hemidiaphragms
2 sides of the diaphragm
57
diaphragm sensory innervation
most of the diaphragm including the central tendon is supplied though the phrenic nerves
peripheral parts of the diaphragm recieve innervation from the lower intercostal and subcostal nerves
58
side ache
from over-stretching of the diaphragm during exercise
because of the phrenic nerves
can cause referred pain elsewhere chest, neck and shoulders
59
mediastinum subdivisions
created at a transverse plane between T4 and T5
a. superior mediastinum
b. inferior mediastinum
60
inferior mediastinum divisions
divided by the pericardium into
a. anterior mediastinum [in front of the pericardium]
b. middle mediastinum [pericardium and its contents]
c. posterior mediastinum [behind the pericardium]
61
3 branches of the aorta
brachiocephalic trunk
left common carotid artery
left subclavian artery
62
what does the an anterior mediastinum contain?
lower part of the thymus
63
what does the middle mediastinum contain?
```
H: heart and pericardium
A: asending aorta
P: pulmonary trunk
S: superior vena cava - termination
I: inferior vena cava- termination
P: pulmonary veins -termination
P: phrenic nerve
```
64
great vessels
```
these are the blood vessels attaching to the heart:
aorta
pulmonary trunk
pulmonary veins
venae cavae [ superior and inferior]
```
65
posterior mediastinum contains?
```
thoracic aorta[ direct branches]
azygos venous sytem
esophagus
vagus nerve
thoracic duct
```
TATE V
66
what does the superior mediastinum contain?
```
B: brachiocephalic veins
A: aorta and 3 branch's
T: trachea
T: thymus [upper part]
L: left recurrent laryngeal nerve
E: esophagus - upper
```
P: phrenic nerve
V: vagus nerve
S: superior vena cava
T: thoracic duct
67
thymus
is not really a gland
it is a lymphatic organ located in there superior mediastinum - just behind the sternum
68
thymus function
main source of mature t lymphocytes
69
thymus and age
changes with age;
birth-adolescence : large and functional
adulthood: not really active and replaced by fat
70
visceral pleurae
portion lining the organ
there are 2- 1 for each lung [left and right visceral pleurae
fits into every nook and cranny
very thin the they can't be dissected from heart surface
71
parietal pleurae
portion lining the inside wall of the cavity
2- 1 for each lung [left and right parietal pleurae]
thicker than visceral pleura
small amount of fascia between it and the surfaces it covers, as a result it cannot be dissected away from the surfaces it associates with
72
pleural cavity
potential space between the 2 pleurae
contains serous pleural fluid
73
serous pleural fluid
keeps the surfaces of the pleurae moist and lubricates them so they can move upon each other easily
the surface tension created by this provides the cohesion needed to keep the lung surface in contact with the thoracic wall [ie. the parietal pleura]
- so when the chest expands the lungs expand and fill with air
74
hilum
where the structures of the root of each lung enter and exit
75
Where do the visceral and parietal pleura join?
at the hilum
this where where they are continuous with each other
76
cupula
the cervical part of each parietal pleura that extends superiorly thought the superior thoracic aperture into the root of the neck forms a cup shaped dome over the apex of the lung called this.
77
outer surface of the parietal pleura lining the mediastinum
is on contact with the fibrous pericardium
there is a small amount of fascia connecting these layers
in this fascia the phrenic nerve run though the chest
78
costadiaphragmatic recess
note during expiration, the lungs do not completely occupy all of the pleural cavities. there are places where the parietal and visceral pleura are not on contact with each other. they are called this.
form the lowest portions of the pleural cavities . excess fluid gathers here first.
79
visceral pleura innervation
not highly innervated, so not very sensitive
supplied by the visceral afferent fibers [nociceptive fibers] - mostly carried along sympathetic nerves originating from the thoracic spinal cord levels
80
parietal pleura innervation
richly innervated by somatic afferent fibers
| [nociceptive] via. the intercostal and phrenic nerves
81
painful stimuli of the parietal pleura
can causes local chest pain
and referred pain to the root of the neck and shoulder regions
82
pleurisy
=pleuritis
| = inflammation of the pleura
83
3 sulcus found on the surface of the heart
coronary sulcus
anterior inter ventricular sulcus
posterior inter ventricular sulcus
84
coronary sulcus
groove located where the atria meet the ventricles
= atrioventricular sulcus
85
anterior interventricular sulcus
groove is located at the anterior aspect of the inter ventricular septum
86
posterior interventricular sulcus
groove is located at the posterior aspect of the inter ventricular septum
87
infundibulum
= cornus arteriosus
88
aortic vestibule
leads to aorta
89
left atrioventricular valve
mitral valve = bicuspid valve
90
semilunar valves
left semilunar - aortic valve
right semilunar vales - pulmonary valve
91
coronary arteries
2 of them right and left
supply the heart wall - myocardium
branch off the ascending aorta
92
heart
end artery organ because there is little anastomosis between the coronary arteries
93
right coronary artery supplies what?
right atrium
sinoatrial node
atrioventricular node
most of the right ventricle
posterior aspect of the left ventricle
94
left coronary artery supplies what?
left atrium
most of the left ventricle
anterior aspect of the right ventricle
95
cardiac veins
veins that drain the heart
primarily return the blood into the right atrium.
NO VALVES IN ANY VENOUS STRUCTURE
96
coronary artery disease
decreased blood flow to myocardium
occlusion of coronary artery
97
thrombus
if a clot forms and plugs the vessel where it forms
98
embolus
if a clot forms and travels to a different place and lodges a vessel
99
infraction
plugged artery -> ischemia->necrosis
necrosis as a result of lack of blood
100
heart attack other name
myocardial infarction
101
capula clinical tie in
there are many neuromuscular structure in the root of the beck that can be compromised buy this
and pathologies in the root of the neck can affect adjacent pleura and lung
102
acute pleurisy
starts with a dry stage with the pleura are red and covered in a thin exudate
dry cough, fever, stitch in side and a rub [ rubbing sound upon listening with a stethoscope
103
liquid effusion stage of pleurisy
pleural cavity is filled with copious exudation of serum
inflamed pleura can have adhesions that become permanent
less pain but develops
dyspnea - trouble breathing
104
right lung
larger than left , but shorter b/c of liver [ hemidiaphragm is higher]
3 lobes: superior , middle, inferior
105
left lung
smaller since it has to make more room for the heart
2 lobes: superior and inferior
106
apex of lung
each lung has an apex, portion that extended into the root of the neck and projects outside the chest
107
3 surfaces of the lung
costal
diaphragmatic - base
mediastinal
108
mediastinal surface of the left lung
has a concavity called cardiac impression [to make took of the heart]
109
lingula
thin tongue like part of the upper lobe that forms the anterior part of the cardiac impression
110
how is the mediastinum connected to the lung
connected at the mediastinal surface of the lung via the root of the lung
111
what is the root of each lung made of?
1. primary bronchus - and blood supply
2. . pulmonary artery
3. superior and inferior pulmonary veins
4. pulmonary plexus of nerves[sympathetic [visceral afferent] and parasympathetic[ visceral afferents]
5. lymphatics
112
Sinus venarum
Where vena cava attach to rt atrium
Where sa node is
113
SA node
Sends impulse top down, so blood can travel down to up
Note cardiac skeleton insulates they ventricles from the stria so that the impulses cannot pass directly from the atria to the ventricles
