Thorax, Snell Flashcards

1
Q

3 parts of sternum

A

1) Manubrium
2) Body
3) Xiphoid process

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2
Q

Manubrium articulates with

A

1) Body of sternum
2) Clavicles
3) First costal cartilage
4) Upper part of 2nd costal cartilage

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3
Q

Landmark formed by articulation of manubrium with body of sternum

A

Sternal angle of Louis

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4
Q

5 structures at the level of sternal angle of Louis

A

1) 2nd costal cartilage
2) Junction of superior and inferior mediastinum
3) Bifurcation of trachea
4) Junction of ascending aorta and aortic arch and aortic arch and descending aorta
5) IV disc between T4 and T5

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5
Q

Body of sternum articulates with on each side with

A

2nd to 7th costal cartilages

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6
Q

T/F Xiphoid process is ossified at birth

A

No, plate of cartilage that becomes ossified at proximal end during adult life

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7
Q

T/F No ribs or costal cartilages are attached to the xiphoid process

A

T

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8
Q

T/F Sternum possesses red hemopoietic marrow throughout life

A

T

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9
Q

Ribs, #

A

12

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10
Q

Categories of ribs

A

1) True
2) False
3) Floating

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11
Q

True ribs

A

Attached to the sternum by their costal cartilages (1st-7th)

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12
Q

False ribs

A

Attached anteriorly to each other and to the 7th rib by their costal cartilages and small synovial joints (8th-10th)

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13
Q

Floating ribs

A

No anterior attachment (11th-12th)

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14
Q

Atypical rib

A

1st rib

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15
Q

Superior vs inferior: Costal groove

A

Inferior

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16
Q

Costal groove accomodates

A

Intercostal vessels and nerves

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17
Q

Typical rib: Parts

A

1) Head
2) Neck
3) Tubercle
4) Shaft
5) Angle

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18
Q

Head of rib: How many facets

A

2

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19
Q

Head of rib: Superior facet articulates with

A

Vertebra immediately above it

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20
Q

Head of rib: Inferior facet articulates with

A

Numerically corresponding vertebral body

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21
Q

Tubercle of rib: How many facets

A

1

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22
Q

Tubercle of rib: Facet articulates with

A

Transverse process of the numerically corresponding vertebra

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23
Q

Part of rib where the shaft bends forward sharply

A

Angle

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24
Q

Important structures related to the first rib (2)

A

1) Brachial plexus

2) Subclavian artery and vein

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25
Q

T/F The first rib is flattened anteroposteriorly

A

F, superoinferiorly

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26
Q

First rib: Muscle attached to its upper surface and inner border

A

Scalenus anterior

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27
Q

Crosses first rib anterior to the scalenus anterior

A

Subclavian vein

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28
Q

Lie in contact with 1st rib posterior to the scalenus anterior attachment

A

1) Subclavian artery

2) Brachial plexus

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29
Q

A cervical rib occurs in ~ ___% of persons

A

0.5

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30
Q

Cervical rib: Arises from

A

Transverse process of C7

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31
Q

Cervical rib: Possible anterior attachments

A

1) Free
2) Connected to first rib by fibrous band
3) Articulate with 1st rib

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32
Q

Thoracic outlet syndrome is brought about by compression of what structures by the cervical rib

A

1) Brachial plexus

2) Subclavian artery

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33
Q

T/F Costal cartilages of eighth, ninth, and tenth ribs connect to the cartilage immediately above them

A

T

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34
Q

T/F 11th and 12th ribs do not have costal cartilages

A

F, cartilages of the eleventh and twelfth ribs end in the abdominal musculature

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35
Q

Rib #s: Head articulates by a synovial joint with the corresponding vertebral body and that of the vertebra above it

A

2nd-9th

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36
Q

Rib #s: Heads have a simple synovial joint with the corresponding vertebral body

A

1st, 10th-12th

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37
Q

Type of joint: Manubriosternal joint

A

Cartilaginous

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38
Q

Type of joint: Xiphisternal joint

A

Cartilaginous

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39
Q

Type of joint: Costovertebral joint

A

Synovial

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40
Q

Articulation of rib tubercle with transverse process of corresponding vertebra is absent in which ribs

A

11th-12th

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41
Q

Type of joint: Costochondral

A

Cartilaginous

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42
Q

Movement in the costochondral joint

A

NONE

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43
Q

Type of joint: Articulation of first costal cartilage with manubrium

A

Cartilaginous

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44
Q

Articulation of first costal cartilage with manubrium: Movement

A

NONE

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45
Q

Type of joint: Articulation of second to the seventh costal cartilages articulate with the lateral border of the sternum

A

Synovial joints

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46
Q

Type of joint: Articulation of sixth, seventh, eighth, ninth, and tenth costal cartilages with one another

A

Small synovial joints

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47
Q

Movement that rotates the neck of rib around its own axis

A

Respiration

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48
Q

Brachial plexus, subclavian artery, and subclavian vein can be compressed between which bones

A

1) First rib

2) Clavicle

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49
Q

Muscles of respiration within intercostal spaces

A

1) External intercostal
2) Internal intercostal
3) Innermost intercostal

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50
Q

Thoracic muscles are lined internally by

A

Endothoracic fascia and parietal pleura

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51
Q

Intercostal nerves and blood vessels run between what muscles

A

1) Internal intercostal muscles

2) Innermost intercostal muscles

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52
Q

Intercostal nerves and blood vessels: Arrangement from superior to inferior

A

VAN
Intercostal vein
Intercostal artery
Intercostal nerve

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53
Q

Needle thoracostomy: Indications

A

1) Tension pneumothorax

2) Large hemothorax

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54
Q

Most important muscle of respiration

A

Diaphragm

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55
Q

Diaphragm: Insertion

A

Central tendon

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56
Q

Diaphragm: Nerve supply

A

Phrenic

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57
Q

Raise ribs during inspiration and lower ribs during expiration

A

External intercostals

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58
Q

Thoracic muscle: Elevate ribs

A

1) Levatores costarum

2) Serratus posterior superior

59
Q

Thoracic muscle: Lowers ribs

A

Serratus posterior inferior

60
Q

Diaphragm: Origins

A

1) Sternal
2) Costal
3) Vertebral

61
Q

Diaphragm: Sternal part arises from

A

Posterior surface of xiphoid

62
Q

Diaphragm: Costal part arises from

A

Deep surfaces of lower 6 ribs and their costal cartilages

63
Q

Diaphragm: Vertebral part arises from

A

Crura and arcuate ligaments

64
Q

Diaphragm: Encloses the esophagus

A

Right crus

65
Q

Diaphragm: Right crus arises from

A

Bodies and IV discs of L1-3

66
Q

Diaphragm: Left crus arises from

A

Sides and IV discs of L1-2

67
Q

Diaphragm: Supports the heart

A

Central tendon

68
Q

Weight-lifting muscle

A

Diaphragm

69
Q

Thoracoabdominal pump

A

Diaphragm

70
Q

As the thoracoabdominal pump, the diaphragm helps in

A

1) Return of blood to right atrium

2) Passage of lymph through thoracic duct

71
Q

Diaphragm: Aortic opening, level

A

T12

72
Q

Diaphragm: Aortic opening, transmits

A

1) Aorta
2) Azygos vein
3) Thoracic duct

73
Q

Diaphragm: Esophageal opening, level

A

T10

74
Q

Diaphragm: Esophageal opening, transmits

A

1) Esophagus
2) Right and left vagus
3) Esophageal branches of left gastric vessels
4) Lymphatic vessels from lower 3rd of esophagus

75
Q

Diaphragm: Caval opening, level

A

T8

76
Q

Diaphragm: Caval opening, through what part of diaphragm

A

Central tendon

77
Q

Diaphragm: Caval opening, transmits

A

1) IVC

2) Terminal branches of right phrenic

78
Q

Diaphragm: Sympathetic trunk passes posterior to

A

Medial arcuate ligament on each side

79
Q

T/F Any penetrating wound to the chest below the level of the nipples should be suspected of causing damage to the diaphragm until proved otherwise

A

T

80
Q

Diaphragm: Arching domes of diaphragm can reach level of ___ rib

A

5th, right dome can reach a higher level

81
Q

Intercostal arteries per intercostal space, #: Posterior intercostal

A

1 large

82
Q

Intercostal arteries per intercostal space, #: Anterior intercostal

A

2 small

83
Q

Intercostal veins: Posterior drain into

A

Azygos or hemiazygos

84
Q

Intercostal veins: Anterior drain into

A

Internal thoracic and musculophrenic veins

85
Q

Posterior intercostal arteries: First 2 are branches of

A

Superior intercostal artery from costocervical trunk of subclavian artery

86
Q

Posterior intercostal arteries: Lower 9 are branches of

A

Thoracic aorta

87
Q

Anterior intercostal arteries: First 6 are branches of

A

Internal thoracic

88
Q

Anterior intercostal arteries: Lower 3 are branches of

A

Musculophrenic from internal thoracic

89
Q

Internal thoracic artery arises from

A

1st part of subclavian

90
Q

Internal thoracic artery: Descends directly behind

A

1st 6 costal cartilages

91
Q

Internal thoracic artery: ___ cm lateral to sternum

A

About a fingerbreadth

92
Q

Internal thoracic artery: Terminates in the

A

6th ICS

93
Q

Internal thoracic artery: Divides into

A

1) Superior epigastric

2) Musculophrenic

94
Q

Trachea: Continuation of

A

Larynx

95
Q

Trachea: Begins at

A

Lower border of cricoid, C6

96
Q

Trachea: Divides into right and left main bronchi at level of

A

Sternal angle of Louis

97
Q

Trachea: Length

A

~ 13cm

98
Q

Trachea: Diameter in adults

A

2.5 cm

99
Q

Trachea: Shape of supporting cartilage

A

U

100
Q

Trachea: Posterior relations

A

1) Esophagus

2) Left recurrent laryngeal nerve

101
Q

Levels of the airway

A

1) Trachea
2) Main bronchi
3) Lobar bronchi
4) Segmental bronchi
5) Terminal bronchiole
6) Respiratory bronchiole
7) Alveolar duct
8) Alveolar sac
9) Alveolus

102
Q

Trachea, relations: Right

A

1) Azygos
2) Right vagus
3) Pleura

103
Q

Trachea, relations: Left

A

1) Left vagus
2) Left phrenic
3) Pleura
4) Arch of aorta
5) Left common carotid
6) Left subclavian

104
Q

Right vs left main bronchus: Wider, shorter, more vertical

A

Right

105
Q

Right main bronchus: Branch given off before entering the hilum of right lung

A

Superior lobar bronchus

106
Q

Right main bronchus: Branches given off upon entering the hilum of right lung

A

Middle and inferior lobar bronchi

107
Q

Left main bronchus: Related structures

A

1) Aortic arch above

2) Esophagus behind

108
Q

Left main bronchus: Branches given off on entering the hilum of left lung

A

Superior and inferior lobar bronchi

109
Q

Foreign bodies that lodge into the right main bronchus usually pass into

A

Middle or lower lobar bronchus

110
Q

2 parts of the pleura

A

1) Parietal

2) Visceral

111
Q

Lowest area of the pleural cavity

A

Costodiaphragmatic recess

112
Q

Parietal vs visceral pleura: Sensitive to pain, temperature, touch and pressure

A

Parietal pleura

113
Q

Parietal pleura: Costal parietal pleura is supplied y

A

Intercostal nerves

114
Q

Parietal pleura: Mediastinal parietal pleura is supplied by

A

Phrenic nerve

115
Q

Parietal pleura: Diaphragmatic parietal pleura is supplied by

A

Phrenic nerve

116
Q

Visceral pleura: Nerve supply

A

Autonomic from pulmonary plexus

117
Q

Visceral pleura: Sensitive only to

A

Stretch

118
Q

Thin layer of loose connective tissue that separates the parietal pleura from thoracic wall

A

Endothoracic fascia

119
Q

Lower margins of pleural reflections

A

1) 8th rib MCL
2) 10th rib MAL
3) 12th rib paravertebral

120
Q

Lower margins of lungs

A

1) 6th rib MCL
2) 8th rib MAL
3) 10th rib paravertebral

121
Q

Intrapleural pressure

A

-4 mmHg

122
Q

Visceral pleura is derived from

A

Visceral mesoderm

123
Q

Parietal pleura is derived from

A

Somatic mesoderm

124
Q

Lungs: Main function

A

Oxygenation of blood

125
Q

of lobes: Right lung

A

3

126
Q

of lobes: Left lung

A

2

127
Q

Fissure/s: Right lung

A

Horizontal and oblique

128
Q

Fissure/s: Left lung

A

Oblique

129
Q

Right vs left lung: Larger and heavier

A

Right

130
Q

Right vs left lung: Shorter and wider

A

Right

131
Q

Lung: Apex extends ___ cm above ___

A

2.5 cm, clavicle

132
Q

Where parietal and visceral pleura meet

A

Root of lung

133
Q

Root of lung: Contents

A

1) Bronchi
2) Pulmonary artery and vein
3) Bronchial vessels
4) Lymph vessels

134
Q

Right vs left lung: Hyparterial and eparterial bronchi

A

Right

135
Q

Left lung: Hyparterial vs eparterial

A

Hyparterial

136
Q

Largest subdivision of a lung lobe

A

Bronchopulmonary segment

137
Q

Bronchopulmonary segment: Shape

A

Pyramidal

138
Q

Bronchopulmonary segment: Apex directed towards

A

Lung root

139
Q

Bronchopulmonary segment: Named according to

A

Segmental bronchus supplying it

140
Q

Bronchopulmonary segment: Separated from adjacent segments by

A

Connective tissue

141
Q

Bronchopulmonary segment: Has its own

A

1) Bronchus
2) Arterial supply
3) Venous drainage
4) Lymphatic drainage

142
Q

Anatomic and surgical unit of the lung

A

Bronchopulmonary segment

143
Q

Bronchopulmonary segment: Right lung

A

10
1) Superior lobe: Apical, anterior, posterior
2) Middle lobe: Lateral, medial
3) Inferior lobe: Superior, anterior basal, lateral basal, medial basal, posterior basal
IMAGE at DOWNLOADS

144
Q

Bronchopulmonary segment: Left lung

A

10

1) Superior lobe: Apico-posterior, anterior, superior lingular, inferior lingular
2) Inferior lobe: Superior, anterior basal, lateral basal, medial basal, posterior basal