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LECOM anatomy > thorax-major slide powerpoint > Flashcards

thorax-major slide powerpoint Flashcards

1
Q

where is the thorax located

A

superior part of the trunk between the neck and abdomen

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2
Q

what is the floor of the thoracic cavity (diaphragm) deeply invaginated inferiorly by

A

viscera of the abdominal cavity

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3
Q

what does the central compartment of the thorax/mediastinum house

A

the conducting structures that make up the thoracic viscera (except the lungs)

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4
Q

what is the majority of the thoracic cavity occupied by

A

the lungs

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5
Q

how do nutrients/food traverse the thoracic cavity

A

via the esophagus

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6
Q

what is the most important symptoms of cardiac disease

A

chest pain

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7
Q

how do people who have had a heart attack usually describe the associated pain

A

as a severe sub-sternal pain (deep to the sternum) that does not disappear with rest

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8
Q

where do the mammary glands of the breast lie

A

within the subcutaneous tissue of the thoracic wall

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9
Q

where are intercostal spaces widest

A

anterolaterally

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10
Q

what can be injured if the first rib is broken

A

brachial plexus of nerves and subclavian vessels

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11
Q

which ribs are most commonly fractured

A

middle ribs

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12
Q

what do rib fractures usually result from

A

blows or from severe injures

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13
Q

what part of the rib is weakest

A

just anterior to its angle

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14
Q

what happens to then wall during flail chest

A

it moves paradoxically (inward on inspiration and outward on expiration)

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15
Q

define thoracotomy

A

the surgical creation of an opening through the thoracic wall to enter a pleural cavity

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16
Q

what is the most common location for a posterior thoracotomy incision

A

posterolateral aspects of the 5th-7th intercostal spaces

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17
Q

what do cervical ribs interfere with

A

neuromuscular structures exiting the superior thoracic aperture

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18
Q

what is the most accurate description for the type of bone of the manubrium

A

roughly trapezoidal bone

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19
Q

according to Dr ray what level does the xiphoid process lay

A

T10

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20
Q

what is the xiphoid process a marker for

A

midline marker for the superior limit of the liver, the central tendon of the diaphragm, and the inferior border of the heart

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21
Q

what type of fracture typically occurs when there is a fracture of the sternal body

A

comminuted fracture (the sternum is broken into several pieces)

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22
Q

where is the most common site of sternal fracture

A

sternal angle

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23
Q

what is the mortality rate associated with sternal fractures

A

24-45%

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24
Q

what is the superior thoracic aperture/anatomical thoracic inlet bounded by

A

posteriorly by vertebra T1, laterally by 1st pair of ribs and costal cartilage, and anteriorly by the manubrium

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25
Q

what structures pass through the superior thoracic aperture

A

trachea, esophagus, nerves and vessels that drain the head, neck and upper limbs

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26
Q

how does the superior thoracic aperture slope

A

anteroinferiorly

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27
Q

what is the inferior thoracic aperture/anatomical thoracic outlet bound by

A

12th thoracic vertebrae, 11th and 12 pairs of ribs, costal margins and xiphisternal joint

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28
Q

when are external intercostals most active

A

during inspiration (elevate ribs during forced inspiration0

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29
Q

what are the inferior internal intercostals continuous with

A

internal oblique muscles in anterolateral abdominal wall

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30
Q

when are internal intercostals most active

A

during expiration: maintain or increase bonus of intercostal space

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31
Q

what does the interosseous portion of the internal intercostals do during forced respiration

A

depress ribs

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32
Q

what does the interchondral portion of the internal intercostals duo during active inspiration

A

works with external intercostals to elevate the ribs

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33
Q

what costal cartilages do the transverse thoracic muscles attach to

A

2nd-6th costal cartilages

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34
Q

what are the transverse thoracic muscles continuous with inferiorly

A

transverse abdominal muscles in the anterolateral body wall

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35
Q

what is the main thing the transverse thoracic muscles do

A

provide proprioceptive information

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36
Q

what is the primary muscle of inspiration

A

diaphragm

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37
Q

what fascia covers the breasts

A

2/3 by pectoral fascia and the other third by fascia covering the serrates anterior

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38
Q

what is the space between the breast and the pectoral fascia called

A

retromammary space/bursa

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39
Q

where is the lactiferous sinus located

A

deep to the areola

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40
Q

what is the name for the creamy white to yellowish pre milk fluid that may secrete from the nipples during the last trimester of pregnancy and during initial episodes of nursing

A

colostrum

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41
Q

what is colostrum believed to be especially rich in

A

protein, immune agents, and a growth factor affecting the infant’s intestines

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42
Q

what is the arterial supply of the breast derived from

A

medial mammary branches of perforating branches , anterior intercostal branches of internal thoracic artery, lateral thoracic and thoracoacromial arteries, posterior intercostal arteries

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43
Q

what is the main venous drainage of the breast

A

axillary vein

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44
Q

describe the lymph passage of the breast

A

from nipple, areola and lobules of the gland to the subareolar lymphatic plexus

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45
Q

where does most lymph of the breast drain to

A

axillary lymph nodes (but initially to anterior or pectoral nodes)

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46
Q

where may the lymph of the inferior quadrants pass to

A

deeply to abdominal lymph nodes

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47
Q

where does lymph from the skin of the breast drain

A

ipsilateral axillary, inferior deep cervical and infraclavicular lymph nodes (and also into parasternal lymph nodes)

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48
Q

where does the lymph from the axillary nodes drain

A

into clavicular lymph nodes and from them into the subclavian lymphatic trunk

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49
Q

where does lymph from the parasternal nodes drain

A

the bronchomediastinal lymphatic trunk

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50
Q

what pleura directly surrounds the lungs

A

visceral pleura

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51
Q

where is the visceral pleura continuous with the parietal pleura

A

hilum of the lung

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52
Q

what are the 4 parts of the parietal pleura

A

costal part, mediastinal part, diaphragmatic part, cervical pleura

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53
Q

what does the costal part of the parietal pleura cover

A

the internal surfaces of the thoracic wall

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54
Q

how is the costal part of the parietal pleura separated from the internal surface of the thoracic wall

A

endothoracic fascia

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55
Q

what fascia connects the diaphragmatic pleura with the muscular fibers of the diaphragm

A

phrenicopleural fascia

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56
Q

what is the superior continuation of the costal and mediastinal parts of the parietal pleura

A

cervical pleura

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57
Q

what pleura covers the apex of the lungs

A

cervical pleura

58
Q

what is the fibrous extension of the endothoracic fascia that reinforces the cervical pleura

A

supra pleural membrane (sibson fascia)

59
Q

at what age is the cervical pleura especially vulnerable to injury

A

the first few years after birth (due to short necks at young age)

60
Q

when does hemothorax most commonly occur

A

from injury to a major intercostal or internal thoracic vessel (more than from laceration of a lung)

61
Q

what is acute pleuritic marked by

A

sharp, stabbing pain, especially on exertion, such as climbing stairs, when the rate and depth of respiration may be increased even slightly

62
Q

what separates the 2 lungs

A

mediastinum

63
Q

where is the pulmonary artery generally located

A

superior most on left (superior lobar bronchus may be superior most on right)

64
Q

which lung is longer

A

left

65
Q

which lung is heaver

A

right

66
Q

describe the anterior border of the right lung compared to left

A

right is relative straight and left as a deep cardiac notch

67
Q

is the mediastinal surface of the lung convex or concave?

A

concave

68
Q

which surface of the lung includes the hilum

A

mediastinal surface

69
Q

is the diaphragmatic surface of the lung concave or convex?

A

concave

70
Q

what color are the lungs of healthy non-smokers

A

pink

71
Q

lung cancer involving what nerve can result in paralysis of the hemidiaphragm

A

phrenic nerve

72
Q

what nerve may be involved in apical lung cancers due to its relationship with the apex of the lung

A

recurrent laryngeal nerves

73
Q

what nerve supplies all but one of the laryngeal muscles

A

recurrent laryngeal nerve

74
Q

what airway constitutes the tracheobronchial tree

A

sub-laryngeal airway

75
Q

where does the trachea bifurcate (at what level)

A

the level of the transverse thoracic plane (sternal angle)

76
Q

what does the right main bronchus pass direct to

A

hilum

77
Q

what is the passage of the left main bronchus to the hilum

A

passes inferolatearlly, inferior to the arch of the aorta and anterior to the esophagus and thoracic aorta to get to the hilum

78
Q

what is the arterial supply of the bronchopulmonary segments

A

supplied independently by a segmental bronchus and a tertiary branch of the pulmonary artery

79
Q

what is the basic structural unit of gas exchange in the lung

A

pulmonary alveolus

80
Q

where do the veins from the visceral pleura drain

A

pulmonary veins

81
Q

where do the veins of the parietal pleura drain

A

they join the systemic veins in adjacent parts of the thoracic wall

82
Q

where do the 2 left bronchial arteries usually arise from

A

directly from the thoracic aorta

83
Q

how does the right bronchial artery typically arise

A

indirectly either by the proximal part of one of the upper intercostal arteries (usually the 3rd posterior intercostal artery) or from a common trunk with the left superior bronchial artery

84
Q

where does the right bronchial vein drain

A

into azygos vein

85
Q

where does the left bronchial vein drain

A

into the accessory hemiazygos vein or the left superior intercostal vein

86
Q

what is the immediate result of pulmonary embolism

A

partial or complete obstruction of blood flow to the lung

87
Q

where is pain from the parietal pleura referred

A

to the cutaneous distribution of the intercostal nerves to the thoracic wall, or in the case of inferior nerves, to the anterior abdominal wall

88
Q

which lymph nodes commonly enlarge with bronchogenic carcinoma

A

supraclavicular lymph nodes

89
Q

what is another name for the supraclaviculr lymph nodes

A

sentinel lymph nodes

90
Q

what is the tough external layer of the pericardium (fibrous) continuous with

A

central tendon of diaphragm

91
Q

what is the serous pericardium mostly composed of

A

mesothelium

92
Q

what is the fibrous pericardium continuous with superiorly

A

tunica adventitia of the great vessels entering and leaving the heart and with the pre tracheal layer of deep cervical fascia

93
Q

what attaches the fibrous pericardium to the posterior surface of the sternum

A

sternopericardial ligaments

94
Q

what pericardium protects the heart against sudden overfilling

A

fibrous pericardium

95
Q

what is the main arterial supply of the pericardium

A

pericardiacophrenic artery (brach of internal thoracic)

96
Q

what is the nerve supply to the pericardium

A

phrenic nerve, vagus nerve sympathetic trunk

97
Q

why is the transverse pericardial sinus important to cardiac surgeons

A

inserting a clamp into this space can stop large artery blood flow during surgery

98
Q

define pericardial effusion

A

passage of fluid from pericardial capillaries into the pericardial cavity or an accumulation of pus

99
Q

what occurs when there is extensive pericardial effusion and the volume of the sac does not allow full expansion of the heart

A

cardiac tamponade

100
Q

what is a common way to reach the pericardiac sac

A

by entering the infrasternal angle and passing the needle superoposteriorly

101
Q

when does the lub sound of the heart occur

A

as the blood is transferred (sucked) from the atria into the ventricles

102
Q

when is the dub sound of the heart heard

A

as the ventricles expel blood from the heart

103
Q

what s the apex of the heart formed by

A

inferolatearl part of the left ventricle

104
Q

what intercostal space is the apex posterior to in adults

A

left 5th intercostal space

105
Q

where is the sound of mitral valve closure maximal

A

apex

106
Q

what mainly forms the base of the heart

A

left atrium

107
Q

what mainly forms the anterior (sternocostal) surface of the heart

A

right ventricle

108
Q

what mainly forms the diaphragmatic (inferior) surface of the heart

A

left ventricle and partly by the right ventricle; it is related mainly to the central tendon of the diaphragm

109
Q

what mainly forms the right pulmonary surface

A

right atrium

110
Q

what is the arterial continuation of the right ventricle

A

pulmonary trunk

111
Q

what disorder occurs when the apex of the heart is directly to the right

A

dextrocardia

112
Q

what is the ear-like conical muscular pouch that projects from the right atrium that increases the capacity of the atrium as it overlaps the ascending aorta

A

auricle

113
Q

what is the vertical ridge of the heart (internal)

A

crista terminalis

114
Q

what is the vertical groove/terminal groove of the heart (external)

A

sulcus terminalis

115
Q

at what level does the SVC open into the superior part of the right atrium

A

3rd costal cartilage

116
Q

what level does the IVC open into the inferior part of the right atrium

A

5th costal cartilage

117
Q

where is the coronary sinus

A

in between the right atrioventricular orifice and the IVC orifice

118
Q

what is the adult remnant of the foramen ovale

A

fossa ovalis

119
Q

what is the primordial atrium represented by in the adult

A

right auricle

120
Q

what is the coronary sinus a derivative of

A

venous sinus

121
Q

where is the SA node located

A

in the border between the primordial atrium and sinus venosus

122
Q

what separates the ridged muscular wall of the inflow part of the chamber from the smooth wall part of the conus arteriosus

A

supra ventricular crest

123
Q

what does the anterior papillary muscle arise from

A

anterior wall of right ventricle

124
Q

what does the posterior papillary muscle arise from

A

inferior wall of the right ventricle

125
Q

what does the septal papillary muscle arise from

A

inter ventricular septum

126
Q

what is the curved muscular bundle that traverses the right ventricular chamber from the inferior part of the IVC to the base of the anterior papillary muscle

A

septomarginal trabecula

127
Q

what is listed first for all cardiac defects

A

VSDs

128
Q

is arterial pressure higher in systemic or pulmonary circulation

A

systemic

129
Q

what level is the mitral valve at

A

4th costal cartilage

130
Q

what is the first branch of the aorta

A

coronary arteries

131
Q

what do the coronary arteries supply

A

myocardium and epicardium

132
Q

what is the main vein of the heart

A

coronary sinus

133
Q

what does the coronary sinus receive at his left end

A

great cardiac vein

134
Q

what does the coronary sinus receive at its right end

A

middle cardiac vein and small cardiac veins

135
Q

what does pulmonary valve incompetence ultimately lead to

A

backlash of blood under high pressure into the right ventricle during diastole

136
Q

what it the most frequent valve abnormality

A

aortic valve stenosis

137
Q

what is the most common site of coronary artery occlusion

A

anterior inter ventricular branch of the left coronary artery

138
Q

what is the most common cause of ischemic heart disease

A

coronary artery insufficiency resulting from atherosclerosis

139
Q

what is another way to describe pain that originate in the heart

A

angina pectoris

140
Q

what are pain receptors in muscles stimulated by

A

lactic acid

LECOM anatomy (20 decks)

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