Thorax Flashcards

1
Q

Angle of Louie

A

Very important landmark esp if we need to count the rib or to find interspaces; corresponds to the second rib

Tells us where the bifurcation of trachea is

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2
Q

Where to insert chest tube?

A

Fourth intercostal space

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3
Q

Behind manubrium

A

arteries of aorta

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4
Q

Ribs

A

May be typical or atypical

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5
Q

Typical rib

A

round body

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6
Q

Atypical rib

A

flat

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7
Q

True ribs

A

Attached to the sternum; first to the 7th rib

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8
Q

False ribs

A

Below the 7th rib; not attached to the sternum; only attached to the ribs above

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9
Q

Inferior angle of rib

A

Costal Groove; where you find inTercostal VAN - vein arteries nerves

Insert needle just above the superior part of rib

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10
Q

First rib

A

There’s an elevation for tubercle where a muscle is attached.

There is a groove behind tubercle - for subclavian and brachial plexus: a network of nerves

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11
Q

Clavicle

A

Round end - attaches to sternum
Flat end - scapular; forms a joint with the acromion of scapula

How to know the inferior surface? Look for conoid tubercle.

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12
Q

Scapula

A

Not part of thoracic bony cage;

Spine of scapula on posterior; glen lid cavity: forms a joint with humerus; acromion (where clavicle is attached)

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13
Q

Boundaries of breast

A

Superior - once you reach clavicle
Along sternum
Inferior - six to the 7thrib; midaxillary line/latissimus Doris

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14
Q

Breast

A

15 to 20 lobules; divided into compartments by fibrous septa which are actually attached to the dermis of skin (suspensions ligament)

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15
Q

Breast

A

extension of breast - axillary tail of spens
Lobes will produce milk and
Suspenseful ligaments are attached to lobules. Tumor within the duct will pull down suspensory ligament - dimpling of skin; lymph vessels of breast will be obstructed by the tumor cells - orange fruit appearance of breast

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16
Q

3 major arterial supply for breast

A
  • Axillary artery - continuation of subclavian artery
    Branches coming from internal mammary artery
    Arteries between interspaces/intercostal arteries
17
Q

Axillary fat

A

Where lymph nodes are found

18
Q

Attachments of pectoral is muscle

A

Medial clavicle, sternum

Attached to clavicle is the muscle that moves arm -deltoid muscle which forms a groove with pectoralis major — along the groove is the cephalic

Attachments should be separated to be able to see structure behind it

19
Q

Sublca

A

Small muscle ends on first rib

20
Q

Lift pectoral is minor

A

Intercostal muscles will be seen

First layer of intercostal muscles - extend from rib above to rib below

Outermost later - external intercostal muscle

21
Q

Costafonrral

A

Joint formed by cartilaginous

22
Q

External intercostal membrane/ anterior ICM

A

Starts from posterior thoracic wall continues forward to sternum

Downward and backward

23
Q

Internal intercostal membrane/posterior intercostal membrane

A

Layer of muscles between the ribs after the internal intercostal

Fibers are oriented downward forward

EndS up along angle of rib and continues as membrnae

24
Q

Internal intercostal muscles

A

3rd later - inner most intercostal muscles - can span more than one interspace; can occupy two or more interspaces

25
Q

Thoracic wall muscles

A

Serratus anterior - lateral thoracic artery; long thoracic nerve; exposed during removal of breast - cut - paralysis

Posterolateral - latissimus dorsi; thoracodoral artery/nerve - cut - paralysis of lats

26
Q

Layers of thoracic wall that will be traversed in tube insertion

A

Skin, fasciae, serrated I

Innermost intercostal

27
Q

2 terminal branches

A

One branch would follow costal margin - usculoclinic artery

Other would go towards central portion of abdominal wall to become superior episgastric artery

These will be accompanied by veins with the same name .
Wins drain into azygous system before they drain to the vena cava.

28
Q

2 terminal branches

A

One branch would follow costal margin - usculoclinic artery

Other would go towards central portion of abdominal wall to become superior epigastric artery

These will be accompanied by veins with the same name .
Wins drain into azygous system before they drain to the vena cava.

29
Q

Jugular or Suprasternal notch

A

Superior most margin of the manubrium sternae

30
Q

Below skin

A

Subcutaneous connective tissue, which may be infiltrated by fat especially among females.

Fatty tissue of breast is part of SUBQ fat

31
Q

Sternal Angle or angle of Louie

A

Bump along the sternum
Joint formed between the manubrium of the sternum and body of sternum

allows us to count the rib levels and intercostal spaces

At the same level with second costal Cartilage and second rib

IMPORTANCE:

Important for invasive procedures - thoracentesis, thoracostomy tube insertion

Auscultation of heart sounds - there are areas of chest where we can hear heart sounds coming from four main valves of the heart

32
Q

Aortic valve

A

Sound is heard best at the level of second intercostal space (Right parasternal)

33
Q

Left parasternal (second intercostal space)

A

Auscultation area for pulmonic valve

34
Q

Right side - 5th intercostal space parastenal

A

Auscultation area for tricuspid valve (between right atrium and right ventricle)

35
Q

5th intercostal space - left midclavicular line

A

Auscultation area for the mitral valve;

it produces the loudest heart sound.

36
Q

Large and wide muscles that cover anterior chest wall

A
  • pectoralis major (mainly move upper extremities)

Pectoralis muscles are responsible for adduction and flexion fo shoulder joint.

37
Q

Groove between deltoid and pectoralis major

A

Cephalic vein passes through her. It’s a large superficial vein that starts from dorsal palmar arch of the hand (radial side) and courses up, passing through forearm and brachium. Also courses on lateral aspect for forearm (antebrachium).

Drain into the AXILLARY VEIN

Aka DELTOPECTORAL GROOVE

38
Q

Another important triangle found in the area of deltoid and pectoralis major - what are its boundaries?

A

Base of triangle as the clavicle
Lateral margin of triangle - medial border of deltoid muscle
Medial margin of triangle - margin of pectoralis major