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Medical Physiology > Thorax, Plueri, And Lungs > Flashcards

Thorax, Plueri, And Lungs Flashcards

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USMLE® Step 1 flashcards
1
Q

What are the two apertures in the thorax, and which one is more clinically significant?

A
  1. Superior thoracic aperture (Inlet) - Clinical outlet

2. Inferior Thoracic Aperture

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2
Q

What are the contents of the thoracic inlet?

A
  • Trachea
  • Esophagus
  • Vagus and phrenic nerve
  • Apex Of lungs
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3
Q

What does the angle of Louie?

A
  • notch from manubrium to sternum

- at 2nd costal cartilage

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4
Q

Which rib is longest? Shortest? Which are your typical ribs?

A
  • 7 is longest
  • 12 is shortest
  • 3-9 are typical
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5
Q

What are the contents of the costal groove superior to inferior?

A

VAN

Vein
Artery
Nerve

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6
Q

What are the Openings of the diaphragm and the associated structures and spinal level?

A

Caval Opening (T8)

  • Inf Vena Cava
  • Phrenic Nerve
  • Lymphatics

Esophageal opening (T10)

  • Esophagus
  • Vagus Nerves
  • Esophageal branch of left gastric artery and vein

Aortic opening (T12)

  • Thoracic Aorta
  • Thoracic Duct
  • Greater Splanchnic Nerves
  • Azygos Vein
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7
Q

Which intercostal spaces have Anterior intercostal arteries, and what are the supply?

A
  • ICS 1-6 come from anterior intercostal arteries f/m Internal thoracic artery
  • ICS 7-9 come from musculophrenic arteries from internal thoracic artery

*ICS 10-11 have no anterior intercostal arteries

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8
Q

What is the blood supply of the posterior aspect of the thoracic wall?

A
  • ICS 1: Costocervical trunk of subclavian
  • ICS 2-11: Posterior intercostal arteries by the thoracic aorta
  • ICS 12: Subcostal artery via thoracic aorta
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9
Q

What is the venous drainage of the anterior aspect of the thorax?

A

Internal thoracic vein of the BrachioCephalic vein

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10
Q

What is the venous drainage of the posterior aspect of the thorax?

A

Azygos vein system

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11
Q

What is the venous drainage of the right side of the thorax?

A

ICS1 —> BrachioCephalic vein

ICS 2/3 —> higher intercostal to Azygos

ICS 4-11 —> Azygos

12th (subcostal) —> Azygos

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12
Q

What is the venous drainage of the left side of the thorax?

A

ICS 1 —> BrachioCephalic

ICS 2-4 —> Accessory hemiazygos

ICS 5-12 —> Hemiazygous

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13
Q

What prevents the parietal pleura from rubbing against the innermost intercostal muscles?

A

Endothoracic fascia

AKA SIBSON’s Fascia

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14
Q

What is the weakest point of the rib that is most fractured in adults?

A

Angle of the rib

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15
Q

What is Flail chest?

A

multiple rib fractures leading to paradoxical chest movement (i.e. inward with inspiration and outward with expiration); it impairs ventilation.

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16
Q

Differentiate Rib dislocation and separation?

A

Rib dislocation: displacement of the costal cartilage from the sternum (2-7); contact sports

Rib Separation: dislocation of the costochondral joint between the rib and its costal cartilage.

17
Q

What is Pectus Excavatum

A

“Funnel Chest”

Body of sternum projects inferiorly and posteriorly pressing in the heart which widens it making it look large on AP radiograph

18
Q

What is Pectus Carinatum?

A

“Pigeon Chest”

Sternum projects anteriorly

19
Q

At which levels are Thoracentesis and Thoracostomy done?

A

ICS 4 to 5

20
Q

What is the Cupula?

A

The area of parietal pleura reflected over the apex of the lung (Cervical pleura)

21
Q

What are the three pleural recesses?

A
  1. Costodiaphragmatic: Junction of costal and diaphragmatic parietal pleura; lowest area of pleural cavity during inspiration
  2. Costomediastinal: Lie along anterior margin of pleura
  3. Costovertebral
22
Q

How low does the costal parietal pleura extend?

A

Anteriorly: ICS 8

Mid-axillary: ICS 9

Posteriorly: ICS 10

23
Q

What is a pneumothorax? What are the two types?

A

When the pleural cavity is breached.

Open:
- Air can enter and leaves to oppose inspiration and expiration

Tension:

  • Tessie forms a flap that covers wound which prevents air from escaping during expiration
  • ** life threatening
24
Q

What are the blood supply for the pleura?

A

Parietal -> Intercostal and internal thoracic arteries

Visceral -> Bronchial arteries

25
Q

Differentiate pain innervation in the pleura

A

Parietal -> Very sensitive to pain

Visceral -> Insensitive to pain

26
Q

What attaches lungs to pericardium?

A

Pulmonary ligaments

27
Q

What forms the anterior border of the left lung?

A

Cardiac notch

28
Q

What are the two fissures of the lugs and what costal level are they at?

A

Oblique fissure runs inferior and ends at CC 6

Horizontal fissure is at CC4

29
Q

Differentiate anatomical features of left/right lungs.

A

Right: superior, middle, and inferior lobes

Left: Superior and inferior lobes, lingula

30
Q

Where does the trachea begin? How does it run inferiorly?

A
  • A continuation of the larynx at lower border of cricoid cartilage (C6)
  • Descends anterior to esophagus and deviating right of midline at angle of Louis
  • Ends in thorax by deciding into right and left bronchi at T4/T5 vertebrae
31
Q

What is the carina?

A

The bifurcation of the trachea at the sternal angle (T4/T5) into primary bronchi

32
Q

What is the blood supply to the trachea?

A
  • Superior thyroid artery
  • INf thyroid artery
  • Bronchial arteries
  • Internal thoracic artery
33
Q

What is significant regarding the passage of the left primary bronchus?

A
  • Passes to the left below the arch of aorta and in front of esophagus
34
Q

What is the blood supply to the primary bronchi?

A

Brachial arteries:

  • Two on the left from the thoracic aorta
  • One of the right from 3rd posterior intercostal artery
35
Q

What are Bronchopulmonary segments? How many are there?

A

Anatomic, functional, and surgical units of the lung

Right - 10 segments

Left - 8 segments

36
Q

What is Pleuritis?

A

Inflammation of pleura - “Pleural rub” heard

37
Q

What is Atelectasis?

A

Lung collapse

Medical Physiology (43 decks)

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