Thorax Flashcards

1
Q

Right dome of the diaphragm

A

can rise to the level of the upper border of the 5th rib

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2
Q

Left dome of the diaphragm

A

can rise to the level of the lower border of the 5th rib

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3
Q

central tendon

A

peripheral muscular fibres of the diaphragm attach to the inferior margin of the thoracic cage and the lumbar vertebrae, then converge on the central tendon

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4
Q

right crus

A

muscular extension of the diaphragm, originates from the anterolateral surface of the upper 3 lumbar vertebrae

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5
Q

left crus

A

muscular extension of the diaphragm, originates from the anterolateral surface of the upper 2 lumbar vertebrae

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6
Q

caval opening

A

in central tendon at T8 is an opening for the IVC (IVC situated in the posterior thorax on the right side)

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7
Q

esophageal opening

A

in the right crus at T10 is an opening for the esophagus

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8
Q

where is the esophagus in relation to the thoracic aorta

A

the esophagus deviates left as it descends through the thorax, lying anterior to the thoracic aorta

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9
Q

aortic hiatus

A

between the right and left crus anterior to T12 is the opening for the abdominal portion of the aorta (located on the left side of the posterior thorax)

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10
Q

external intercostals

A

fibres run anteroinferiorly from the lower border of the rib

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11
Q

internal intercostals

A

fibres run posterosuperiorly from the upper border of the rib

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12
Q

manubriosternal joint (sternal angle)

A

the inferior border of the manubrium articulates with the superior part of the sternal body at the manubriosternal joint – in line with T4&T5

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13
Q

xiphisternal joint

A

the xiphoid process attaches to the sternum at the xiphisternal joint – in line with T9

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14
Q

internal thoracic arteries

A
  • lateral to sternum

- main blood supply of the anterior thoracic wall

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15
Q

where do the posterior and anterior intercostal arteries originate from?

A

the thoracic aorta and internal thoracic arteries give rise to pairs of posterior and anterior intercostal arteries

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16
Q

subcostal arteries

A

12th pair of arteries in intercostal space, run inferior to costal margin compared to intercostal arteries

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17
Q

venous drainage of the thorax

A

parallels arterial supply – internal thoracic veins

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18
Q

where do the anterior intercostal, posterior intercostal and subcostal veins go?

A

they drain deoxygenated blood into the heart

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19
Q

intervertebral discs

A
  • between vertebral bodies
  • consist of annulus fibrosus and a central nucleus pulposus
  • act as shock absorbers
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20
Q

annulus fibrosis

A
  • outer ring of disc made up of fibrocartilage

- resists sheer forces

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21
Q

nucleus pulposus

A

gelatinous structure that functions to resist compressive forces

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22
Q

herniated disc

A
  • intervertebral discs do not come in contact with the contents of the intervertebral or vertebral foramens except if there is structural damage to the disc (ie. herniated disc)
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23
Q

rami of the thoracic spinal nerves

A
  • the thoracic spinal nerves pass through intervertebral foramina
  • after exiting intervertebral foramen, thoracic spinal nerve divides into dorsal ramus and ventral ramus
24
Q

ventral rami of thoracic spinal nerves

A
  • called intercostal nerves

- run in costal grooves of corresponding ribs

25
Q

dorsal rami of thoracic spinal nerves

A
  • supply deep muscles of the back segmentally and the overlying skin
26
Q

branches of the intercostal spinal nerves

A
  • intercostal nerves give off cutaneous (sensory) branches to innervate skin of thoracoabdominal wall
  • lateral cutaneous branch
  • terminal anterior cutaneous branch
  • also give off muscular branches for motor innervation
27
Q

intercostal nerves 1-6

A
  • distributed in their intercostal spaces

- innervate intercostal muscles of thoracic wall and overlying skin

28
Q

intercostal nerves 7-11 (and subcostal nerves T12)

A
  • continue anteriorly from intercostal spaces to anterior abdominal wall
  • supply abdominal muscles and overlying skin
29
Q

phrenic nerve

A
  • formed by union of C3,4,5
  • L & R phrenic nerve provide motor innervation to diaphragm
  • carry sensory info to central area of diaphragm (central tendon)
  • sensory innervation from heart
  • sensory innervation to fibrous pericardium and serous parietal pericardium
30
Q

where is the pectoralis major in relation to the intercostals

A

the pectoralis major is anterior to the intercostals

31
Q

internal structure of breast

A
  • 12-20 lobes per breast that contain mammary glands
  • lobes separated by radial septa called suspensory ligaments (of Cooper) that help support the breast
  • lactiferous ducts
32
Q

arterial supply of lateral breast

A

lateral thoracic arteries (branches of axillary artery)

33
Q

arterial supply of medial breast

A

branches of internal thoracic (mammary) artery – lateral to sternum

34
Q

lymphatic drainage of lateral breast

A

axillary nodes

35
Q

lymphatic drainage of medial breast

A

parasternal nodes

36
Q

lymphatic drainage of superior breast

A

supraclavicular nodes

37
Q

apex of heart

A

directed forward, downward and to the left

38
Q

pericardium

A
  • covers the heart

- sac that encloses heart and roots of great vessels entering and leaving

39
Q

left ventricular outflow tract

A

superior portion of the left ventricle consists of smooth walled vestibule leading to aortic orifice

40
Q

aortic valve

A

consists of 3 semilunar cusps and 3 aortic sinuses (@ aortic orifice)

41
Q

right ventricular outflow tract

A

superior wall of right ventricle is smooth and funnel shaped, forming infundibulum/conus arteriosus (RVOT), leads to pulmonary trunk carrying deoxygenated blood to lungs

42
Q

pulmonary valve

A

consists of 3 semilunar cusps (@ pulmonary orifice)

43
Q

interventricular septum

A
  • divides left and right ventricles
  • isolates oxygenated and deoxygenated blood
  • thick muscular part
  • thin upper membranous part
44
Q

ventricular septal defects

A
  • ventricular walls and interventricular spetum thicken
  • b/c pressure is higher in left ventricle than right, lesion associated with left-to-right (acyanotic) shunting of blood flow
  • most common in membranous part of septum
45
Q

skeleton of the heart

A
  • dense CT site of attachment of atrial and ventricular muscles as well as heart valve
46
Q

what are the 3 main branches of the aorta

A

brachiocephalic artery
left subclavian artery
left common carotid artery

47
Q

brachiocephalic artery (branches)

A

the brachiocephalic artery ascends then bifurcates into the right common carotid and right subclavian arteries

48
Q

origin of the right internal thoracic artery

A

right subclavian artery

49
Q

origin of the left internal thoracic artery

A

left subclavian artery

50
Q

what lies anterior and lateral to the internal thoracic arteries

A

the innermost, internal and external intercostals

51
Q

what lies posterior to the internal thoracic arteries

A

transversus thoracis muscle

52
Q

what lies inferior to the internal thoracic arteries

A

the diaphragm

53
Q

sinuses of the aorta

A
  • aorta has 3 dilations called sinuses located above the aortic valve
  • left sinus gives rise to left coronary artery
  • right sinus gives rise to right coronary artery
  • posterior sinus does not give rise to any vessels
54
Q

coronary circulation

A

the left and right coronary arteries anastomose with each other to form a circle in the coronary sulcus (between atria and ventricles)
- the anastomosis creates a “backup” blood supply in case plaque creats blockage, blood can reroute through loop

55
Q

superior thoracic aperture (thoracic inlet)

A
  • allows passage between thorax and neck

- formed by manubrium, rib 1 and body of T1

56
Q

inferior thoracic aperture (thoracic outlet)

A
  • allows passage between thorax and abdomen

- formed by xiphoid process, costal margin, rib 11&12 and body of T12