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MRCS part A > Thorax Anatomy > Flashcards

Thorax Anatomy Flashcards

1
Q

What are the nerve roots of the phrenic nerve and what does it supply?

A

Nerve roots: C3,4,5

Supplies: Diaphragm, sensation central diaphragm and pericardium

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2
Q

What is the path of the phrenic nerve as it enters the thorax and how does it differ on the left from the right?

A

Phrenic nerve passes with the IJV across Scalenus Anterior.

  • Left: crosses anterior to the 1st part of Subclavian artery
  • Right: crosses anterior to the 2nd part of the subclavian artery

Both sides, the nerve runs posterior to the subclavian vein and Internal Thoracic artery as it enters the thorax

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3
Q

What path does the left phrenic nerve take as it travels down the thorax?

A
  • Passes lateral to the Left Subclavian Artery and Aortic Arch
  • Then passes Anterior to the Root of the lung
  • Pierces the Diaphragm
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4
Q

What path does the RIGHT phrenic nerve take in the mediastinum?

A

Travels Anterior to the Right VAGUS nerve and lateral to the SVC

Passes over the right ATRIUM and exits diaphragm at T8

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5
Q

What are the roots and origins of the Long Thoracic Nerve?

A

Derived from the Ventral Rami of C5,C6 and C7

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6
Q

What muscle does the Long Thoracic nerve innervate and what clinical sign is associated with damage to this nerve?

A

Innervates the Serratus Anterior muscle

  • damage causes Winged Scapula
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7
Q

What is the nerve supply of the Breast?

A

Branches of intercostal nerves T4 - T6

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8
Q

What is the blood supply of the breast?

A

Internal mammary artery (branch of subclavian)
External mammary artery (supplies lateral)

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9
Q

What is the structure that suspends the spinal cord in the dural sheath?

A

Denticulate ligaments

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10
Q

What is the name of the fascia that overlies the apices of both lungs?

A

Sibson’s fascia

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11
Q

At what vertebral level does the aorta, oesophagus and vena cava traverse the diaphragm?

A

Aorta - T12
Oesophagus - T10
Vena cava - T8

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12
Q

What structure separates the subclavian artery from the vein?

A

Anterior scalene muscle

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13
Q

At what level does the trachea bifurcate?

A

T5

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14
Q

What nerve is commonly injured in axillary node clearances and what would a patient present with?

A

Thoracodorsal nerve

Innervates the latissumus dorsi.

Pt would present with quick fatigue of the arm of the affected side

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15
Q

What is the nerve supply of the oesophagus?

A

Upper half: Recurrent Laryngeal nerve

Lower half: Oesophageal plexus (vagus)

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16
Q

What are the arterial supplies of the oesophagus and it’s venous drainage?

A

Upper third:
- inferior thyroid artery
- inferior thyroid vein
- deep cervical lymph

Middle third:
- Aortic branches
- azygos veins
- mediastinal nodes

Lower third:
- Left gastric artery
- left gastric vein
- gastric lymph nodes

17
Q

What are the 4 constrictions of the oesophagus?

A

1- Cricoid cartilage (15cm)
2- Arch of the aorta (22.5cm)
3- Left principal bronchus (27cm)
4- Diaphragmatic hiatus (40cm)

18
Q

What are the relations of the oesophagus in the thorax?

A

Anteriorly:
Trachea (T4) / Recurrent laryngeal nerve / Left bronchus / Diaphragm

Posteriorly:
Thoracic duct to the left (T5) / Descending aorta

Left:
Thoracic duct / Left subclavian artery

Right: Azygos vein

19
Q

What are the borders of the safety triangle (chest drain insertion)?

A

Mid axillary line in 5th intercostal space

  • Anterior edge of Latissimus dorsi
  • Lateral border of Pectoralis major
  • Line superior to horizontal level of nipple
  • Apex below axilla
20
Q

What is the investigation of choice for upper airway compression?

A

Flow volume loop

21
Q

What is contained within the superior mediastinum?

A
  • SVC
  • Arch of the aorta
  • Trachea
  • Oesophagus
  • CN X
  • Phrenic nerve
  • Left recurrent laryngeal nerve
  • Thoracic duct
  • Brachiocephalic veins
22
Q

What is contained within the middle mediastinum?

A
  • Pericardium
  • Heart
  • Aortic root
  • Arch of azygos vein
  • Main bronchi
23
Q

What is contained within the posterior mediastinum?

A
  • Oesophagus
  • Thoracic aorta
  • Azygos vein
  • Thoracic duct
  • Vagus nerve
  • Sympathetic nerve trunks
  • Splanchnic nerves
24
Q

What separates the subclavian artery from the subclavian vein and where does this structure insert?

A

Scalenus anterior

Runs from transverse processes of C3,4,5,6 and inserts onto Scalene tubercle of the 1st rib

25
Q

What are the branches of the subclavian artery before it becomes the Axillary artery?

A

Vertebral artery
Int. thoracic artery
Thyrocervical artery
Costocervical artery
Dorsal scapular artery

26
Q

Where does the trachea start and end and what is it’s arterial supply?

A

Starts at C6 to the upper border of T5

Supplied by the inferior thyroid arteries

MRCS part A (9 decks)

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