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Thorax Somatic (Exam 1) Flashcards

1
Q

What are the 3 thoracic walls?

A

Anterior, lateral, and posterior thoracic wall

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2
Q

What are the 2 body cavities of the thorax?

A

Dorsal and ventral body cavity

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3
Q

What 2 cavities divide the dorsal body cavity of the thorax?

A

Cranial and vertebral cavity

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4
Q

What 2 cavities divide the ventral body cavity of the thorax?

A

Thoracic and abdominopelvic cavity

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5
Q

What are the 2 features of the thoracic cavity (within ventral body cavity)?

A

Pleural cavities and the mediastinum

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6
Q

What 2 cavities divide the mediastinum?

A

Superior and inferior mediastinal cavity

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7
Q

What are the 3 divisions of the inferior mediastinal cavity (of the thoracic cavity within ventral body cavity)?

A

Anterior, middle, and posterior

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8
Q

What 2 cavities make up the abdominopelvic cavity?

A

Abdominal and pelvic cavity

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9
Q

What do the pleural cavities contain?

A

-pleura (parietal and visceral)
-lungs

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10
Q

The superior mediastinum spans from the superior thoracic aperture to the…..

A

Transverse thoracic plane

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11
Q

The transverse thoracic plane separates the superior and inferior mediastinum. It is a plane at the level of the _________________ and the IVD of __________

A

Sternal angle, T4-T5

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12
Q

The inferior mediastinum spans from the transverse thoracic plane line to the…..

A

Diaphragm

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13
Q

The inferior mediastinum is subdivided into 3 regions, all relative to the _________________

A

Pericardium

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14
Q

Where is the anterior mediastinum?

A

In front of the pericardium

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15
Q

What does the inferior middle mediastinum contain?

Test q

A

-pericardium (parietal and visceral)
-heart

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16
Q

Where is the posterior mediastinum located?

A

Behind the pericardium

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17
Q

define membrane

A

thin layer of tissue covering a surface, lining a body cavity or dividing a space or organ

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18
Q

What does an epithelial membrane consist of?

A

epithelial cell layer and connective tissue layer

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19
Q

What is the cutaneous membrane?

A

skin

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20
Q

What does the mucous membrane produce?

A

mucous

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21
Q

Serous membranes produce serous fluid. What layers make up a serous membrane and where are they located?

Test q

A

parietal layer and visceral layer

parietal layer is located on the inner wall of cavity

visceral layer is located on the surface of organs contained in cavity

Serous membranes are given different names depending on their location. They can be represented by a fist pushing into a balloon. The outside of the balloon represents the parietal layer of serous membrane lining the body wall. The fist can represent any organ in a cavity. The inside of the balloon around the fist represents the visceral layer of the serous membrane

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22
Q

What do connective membranes consist of?

A

connective tissue layers

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23
Q

What do synovial membranes produce?

A

synovial fluid

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24
Q

What do the meningeal membranes protect?

A

brain and spinal cord

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25
Q

What does parietal mean in latin?

A

wall

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26
Q

What does visceral mean in latin?

A

organ

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27
Q

What is the function of serous fluid?

A

reduce friction between walls and organs thereby decreasing inflammation

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28
Q

There are 2 serous membranes of the thorax what are they?

Test q

A

1) pleura (parietal and visceral pleura)
2) pericardium (parietal and visceral pericardium)

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29
Q

What is the anterior boundary of the thoracic cavity?

A

sternum and costal cartilages

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30
Q

What is the lateral boundary of the thoracic cavity?

A

ribs and intercostal spaces

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30
Q

What is the posterior boundary of the thoracic cavity?

A

thoracic vertebrae and IVDs

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31
Q

What is the superior boundary of the thoracic cavity?

A

supra-pleural membrane

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32
Q

What is the inferior boundary of the thoracic cavity?

A

respiratory diaphragm

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33
Q

The supra-pleural membrane is a connective tissue layer located external to parietal pleura above tips of the lungs. It attaches to the internal border of the first rib and the TPs of vertebra ____

A

C7

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34
Q

What are the 2 thoracic apertures?

A

superior and inferior thoracic apertures

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35
Q

Which thoracic aperture is also known as the thoracic inlet?

A

superior thoracic aperture

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36
Q

Which thoracic aperture is a small superior opening of the thoracic cage?

A

superior thoracic aperture

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37
Q

Which thoracic aperture is a passageway between the thoracic cavity, neck, and upper limbs?

A

superior thoracic aperture

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38
Q

Which thoracic aperture is occupied by the supra-pleural membrane?

A

superior thoracic aperture

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39
Q

Which thoracic aperture is also known as the thoracic outlet?

A

inferior thoracic aperture

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40
Q

Which thoracic aperture is a large inferior opening of the thoracic cage?

A

inferior thoracic aperture

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41
Q

Which thoracic aperture is occupied by the respiratory diaphragm?

A

inferior thoracic aperture

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42
Q

Which thoracic aperture serves as a ring-like origin?

A

inferior thoracic aperture

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43
Q

Which angle is between the manubrium and the body of the sternum?

A

sternal angle/ angle of Louis

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44
Q

Which angle is formed by the right and left costal margins?

Test q

A

infrasternal angle/ subcostal angle

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45
Q

The costal margin/ costal arch is an arch formed by the medial margin of ribs _____. The margin is the articulation of costal cartilages

Test q

A

8-10

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46
Q

What makes up the skeletal framework of the thorax?

Test q

A

-thoracic vertebrae (12)
-ribs (12 pairs)
-associated costal cartilages
-sternum

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47
Q

What are the typical characteristics of thoracic vertebrae?

Test q

A

-bilateral costal facets (demifacets) on the superior and inferior parts of vertebral body
-costal facets on the TPs for rib tubercle
-long inferior slanting SPs

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48
Q

The intercostal space separates the…

A

ribs and costal cartilages

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49
Q

The subcostal space is below the 12th rib. What does it contain?

Test q

A

subcostal n. (T12 ventral rami of spinal nerve 12)

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50
Q

What are the classification of ribs?

A

-false or true ribs
-typical or atypical ribs

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51
Q

What are the true (vertebrosternal) ribs?

T/F test q

A

ribs 1-7

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52
Q

What are the false (vertebrocostal) ribs?

Test q

A

ribs 8-12

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53
Q

What are the floating (vertebral/ free) ribs?

Test q

A

ribs 11 and 12

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54
Q

What are the typical ribs?

Test q

A

ribs 3-9

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55
Q

What are the characteristics of ribs 3-9 (typical ribs)?

Test q

A

-head has 2 facets for articulation with corresponding vertebrae (superior and inferior facet and crest of head between the facets)
-neck
-tubercle that articulates with the corresponding TPs (articular part and non-articular part)
-body (costal angle is where the rib turns anterolaterally and the costal groove is where its parallel to the inferior border which is where blood vessels and nerves run)

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56
Q

What are the atypical ribs?

Test q

A

ribs 1, 2, 10, 11, 12

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57
Q

Which rib is the widest, shortest, and most curved with only 1 facet?

Test q

A

rib 1 (which articulates with T1)

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58
Q

Which rib has a tuberosity for the serratus anterior?

Test q

A

2nd rib

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59
Q

Which ribs have 1 facet besides rib 1?

Test q

A

ribs 10, 11, and 12

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60
Q

Which ribs are short with no neck or tubercle?

Test q

A

ribs 11 and 12

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61
Q

Which costal cartilages attach directly to sternum?

Test q

A

1-7

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62
Q

Which costal cartilages attach to the costal cartilage above?

Test q

A

8-10

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63
Q

Which costal cartilages form a cap at the end of the rib?

Test q

A

11 and 12

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64
Q

Where is the jugular (suprasternal) notch found?

Test q

A

manubrium

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65
Q

Where are the clavicular notches found?

Test q

A

manubrium

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66
Q

What part of the sternum is a synchondrosis of rib 1 with the costal cartilage attachment?

Test q

A

manubrium

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67
Q

What part of the sternum are the costal notches 2-7 found?

Test q

A

body of sternum

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68
Q

What part of sternum has 3 transverse ridges that are the fusion of growth centers?

Test q

A

body of sternum

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69
Q

What part of the sternum has the 7th costal notch?

Test q

A

xiphoid process

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70
Q

T/F: synchondrosis of the 1st rib is a costal cartilage attachment of 1st rib to the manubrium

A

true

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71
Q

Where is the 2nd costal notch found and what does it articulate with?

Test q

A

-found at the junction between the manubrium and the body of the sternum
-articulation with 2nd costal cartilage

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72
Q

Where is the 7th costal notch found and what does it articulate with?

Test q

A

-found between the junction of the body of sternum and the xyphoid process
-articulation with 7th costal cartilage

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73
Q

Breasts are an organ containing mammary glands. Mammary glands are _________ glands that produce milk

A

Exocrine

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74
Q

The ________ has openings of lactiferous ducts arranged radially on tip from which milk is released during lactation

A

Nipple

75
Q

What is areola in Latin?

A

Small space/area or interstice (small intervening space)

76
Q

The _________ of the breast has sebaceous oil glands to reduce friction and chapping

A

Areola

77
Q

What is the glandular tissue of breast called?

A

Lobes

78
Q

How many lobes are there per breast?

A

15-20 lobes

79
Q

What are the lobes of the breast separated by?

A

Suspensory ligaments

80
Q

What are the mammary milk glands called?

A

Lobules

81
Q

How many lobules are there per breast lobe?

A

20-40 lobules per lobe of breast

82
Q

Alveolus has cells and hollow cavities they surround. How many alveoli are there per lobule in breast?

A

10-100 alveoli

83
Q

What are the 2 cells within the alveolus of the breast?

A

1) cuboidal cells
2) myoepithelial cells

84
Q

What are cuboidal cells?

A

Cells that produce milk that is secreted into the cavity they surround of the alveolus of breast

85
Q

What are myoepithelial cells?

A

-they surround each alveolus
-contraction stimulated by oxytocin (posterior pituitary hormone) causes milk ejection into lactiferous ducts

86
Q

What are lactiferous ducts?

A

Ducts that carry milk from each lobule to nipple of breast

87
Q

Lactiferous ducts from each lobule unite within the lobe to form a….

A

Lactiferous sinus

88
Q

Where is prolactin (PRL) secreted from?

A

Anterior pituitary gland

89
Q

What does prolactin (PRL) do?

A

Stimulates breast development and milk production during pregnancy

90
Q

Where is oxytocin secreted from?

A

Posterior pituitary gland

91
Q

Which hormone is secreted in response to suckling infant and is responsible for milk ejection reflex?

A

Oxytocin

92
Q

What nerves innervate the breast?

A

Anterior and lateral cutaneous branches of the 4th-6th intercostal nerves

93
Q

What arteries are found in the breast?

A

1) internal thoracic artery (branch of subclavian artery)
2) lateral thoracic artery (branch of axillary artery)

94
Q

What veins are found within the breast?

A

1) internal thoracic vein -> brachiocephalic vein
2) axillary vein

95
Q

Where do 75% of lymph drainage of the lateral breast quadrants go?

hint: think in a sequence

Test q

A

subareolar lymphatic plexus> axillary lymph nodes> subclavian trunk> R lymphatic duct and L thoracic duct > subclavian veins

note: the L thoracic duct and R lymphatic duct drain into the subclavian vein on their side

96
Q

Where does 25% of the lymph drainage of the medial breast quadrant go?

Hint: think in a sequence

Test q

A

subareolar lymphatic plexus> parasternal lymph nodes> bronchomediastinal trunk> R lymphatic duct and L thoracic duct> subclavian veins

note: the L thoracic duct and R lymphatic duct drain into the subclavian vein on their side

97
Q

What are the 3 types of muscles of the thoracic wall?

A

1) axio-appendicular (muscles that extend from axial to appendicular skeleton)
2) true muscles of thoracic wall
3) diaphragm

98
Q

What 5 structures make up the diaphragm?

A

1) central tendon
2) muscular part
3) hiati (apertures, openings) with contents
4) arcuate ligaments
5) crus

99
Q

The diaphragm has 3 hiati (apertures/openings) with contents. What is the landmark for the caval hiatus and what goes through it?

Test q

A

T8

IVC and R phrenic n./its branches

100
Q

The diaphragm has 3 hiati (apertures/openings) with contents. What is the landmark for the esophageal hiatus and what goes through it?

Test q

A

T10

-esophagus
-anterior and posterior vagal trunks (to esophagus and stomach) of CN X
-esophageal a. (branch of L gastric a.)

101
Q

The esophageal a. is a branch of…..

A

the L gastric a.

102
Q

The diaphragm has 3 hiati (apertures/openings) with contents. What is the landmark for the aortic hiatus and what goes through it?

Test q

A

T12

-aorta
-aortic plexus of CN X
-R azygous v.
-L hemiazygous v.
-thoracic duct

103
Q

What are the arcuate ligaments attached to besides the diaphragm?

A

-lateral quadratus lumborum
-medial psoas major
-median union of crus anterior to aorta

104
Q

The crus of diaphragm refers to tendinous structures that extends below the diaphragm to the vertebral column. There is a right crus and a left crus, which together form a tether for muscular contraction. How long is the one on right side? Left?

A

Right= upper 3 lumbar long

Left= upper 2 lumbar long

105
Q

The diaphragm has efferent (motor) and afferent (sensory) nerves. What are they?

Test q

A

phrenic nerve from C3-C5 is both efferent/afferent

lower 6 intercostal nerves are afferent

*remember that phrenic n. C3-C5 keep the diaphragm alive

106
Q

What are the arteries of the diaphragm?

A

1) Internal thoracic a. branches into:
1a) pericardiophrenic a.
1b) musculophrenic a branches into anterior intercostal branches

2) thoracic aorta branches into:
2a) posterior intercostal branches
2b) superior phrenic a.

3) abdominal aorta branches into inferior phrenic a.

107
Q

The internal thoracic a. branches into….

A

1) pericardiophrenic a.
2) musculophrenic a. branches into
2a) anterior intercostal branches

108
Q

The thoracic aorta branches into….

A

1) posterior intercostal branches
2) superior phrenic a.

109
Q

The abdominal aorta branches into….

A

inferior phrenic a.

110
Q

What are the veins of the diaphragm?

A

posterior intercostal veins drain into the azygous system

anterior intercostal veins drain into musculophrenic veins

111
Q

Posterior intercostal veins drain into the….

A

azygous system

112
Q

Anterior intercostal veins drain into….

A

musculophrenic veins

113
Q

When inspiratory muscles contract, what happens to the diaphragm and ribcage?

Test q

A

diaphragm goes down, rib cage goes up

114
Q

When does the thoracic cavity volume increase?

Test q

A

during inspiration

115
Q

When does intrapulmonary (lung) volume increase (lungs stretch)?

Test q

A

during inspiration

116
Q

When does intrapulmonary (lung) pressure decrease?

Test q

A

during inspiration

117
Q

During inspiration, air flows into the lungs ________ the pressure gradient. During expiration, air flows out of lungs ________ pressure gradient

Test q

A

down, down

118
Q

When inspiratory muscles relax, what happens to the diaphragm and rib cage?

Test q

A

diaphragm goes up, rib cage goes down

119
Q

When does the thoracic cavity volume decrease?

Test q

A

during expiration

120
Q

When does intrapulmonary (lung) volume decrease/ lungs recoil?

Test q

A

during expiration

121
Q

When does intrapulmonary (lung) pressure increase?

Test q

A

during expiration

122
Q

Boyle’s law= pressure of gas is inversely proportional to the volume at constant temp

is this in relation to inspiration or expiration?

Test q

A

expiration

123
Q

What is a pressure gradient?

Test q

A

air flows from high pressure to low pressure

124
Q

What are the nerves of the thoracic wall?

A

1) intercostal nerves
2) subcostal nerve
3) intercostobrachial nerve
4) thoracoabdominal nerves
5) phrenic nerve

125
Q

Intercostal nerves are _________ rami

A

ventral

126
Q

What nerves are found between T1-T11?

A

intercostal nerves

127
Q

What nerve is found at T12?

A

subcostal nerve

128
Q

What nerves are found between T3-T6?

A

typical intercostal nerves with lateral and anterior cutaneous branches

129
Q

All spinal nerve plexi (cervical, brachial, lumbosacral, and coccygeal) are formed from interlacing of ventral rami of spinal nerves. Where there are no spinal nerve plexi, like the thorax, then the ventral rami of spinal nerves are….

A

intercostal nerves

130
Q

Typical intercostal nerves are from _________ and have lateral cutaneous branches (which in turn have anterior and posterior branches), and anterior cutaneous branches (which in turn have medial and lateral branches)

A

T3-T6

131
Q

Which nerve is this?
-its a lateral cutaneous branch of the 2nd intercostal nerve
-it does not divide like the typical intercostal nerves into anterior and posterior branches
-it is sensory cutaneous to the axilla (armpit)

A

intercostaobrachial nerve

132
Q

Which nerves run from T7-11 and have lateral cutaneous branches that innervate anterolateral abdominal muscles?

A

thoracoabdominal nerves

133
Q

The phrenic nerve is derived from C3-C5 of the cervical plexus and courses with what artery and vein?

A

pericardiophrenic artery and vein

134
Q

The pericardiophrenic artery and vein are branches of the….

A

internal thoracic artery and vein

135
Q

Within the posterior thoracic wall, there are 11 pairs of posterior intercostal arteries and 1 pair of subcostal arteries. The first 2 pairs of posterior intercostal arteries branch from the ___________________________. All the others branch from the __________

A

supreme intercostal (branch of thyrocervical trunk), aorta

136
Q

Within the anterior thoracic wall, there are 11 pairs of anterior intercostal arteries and NO subcostal arteries. The first 6 pairs of anterior intercostal arteries branch from the ____________________. The remaining 5 branch from the ______________________

A

internal thoracic arteries, musculophrenic arteries

137
Q

The internal thoracic a. is the 1st descending branch of the _______________

A

subclavian a.

138
Q

The internal thoracic a. divides into the __________________ and ________________ arteries at the 7th rib

A

superior epigastric, musculophrenic

139
Q

The first 6 anterior intercostal veins drain into the ________________ and the remainder into ___________________

A

internal thoracic veins, musculophrenic veins

140
Q

Where do the RIGHT posterior intercostal veins drain into?

Test q

A

-brachiocephalic v.
-superior intercostal v.
-azygous v.

141
Q

Where do the LEFT posterior intercostal veins drain into?

Test q

A

-brachiocephalic v.
-superior intercostal v.
-acessory hemiazygous v.
-hemiazygous v.

142
Q

The intercostal artery, vein, and nerve in order from superior to inferior is VAN and lies between the ____________________________

Test q

A

internal and innermost intercostal muscles

143
Q

Collateral branches of intercostal nerves, arteries, and veins emerge at the _______________ of the rib and lie between the internal and innermost intercostal muscles just above the rib below. Collateral branches of each go from nerve, artery, vein from superior to inferior (NAV)

Test q

A

costal angle

144
Q

The posterior intercostal vessels and their posterior collateral branches anastomose with their anterior counterparts of the same side at the ______________ reference line

Test q

A

anterior axillary

145
Q

The ________________________ rejoins the intercostal n. from which it was a branch

A

collateral intercostal n.

146
Q

What are the true muscles of the thoracic wall?

A

1) serratus posterior superior and inferior
2) levator costorum
3) external intercostal, internal intercostal, innermost intercostal muscles
4) subcostal (on posterior wall)
5) transversus thoracic (on anterior wall)

147
Q

What is the origin of the serratus posterior superior?

Test q

A

C7-T3 SPs

148
Q

What is the insertion of the serratus posterior superior?

Test q

A

ribs 2-5

149
Q

What are the actions of the serratus posterior superior?

Test q

A

elevate ribs

150
Q

What innervates the serratus posterior superior?

Test q

A

intercostal nerves T2-T5

151
Q

What is the origin of the serratus posterior inferior?

Test q

A

T11-L2 SPs

152
Q

What is the insertion of the serratus posterior inferior?

Test q

A

ribs 9-12

153
Q

What are the actions of the serratus posterior inferior?

Test q

A

depress ribs

154
Q

What innervates the serratus posterior inferior?

Test q

A

intercostal nerves T9-T11

155
Q

What is the origin of the levator costorum?

Test q

A

C7-T11 TPs

156
Q

What is the insertion of the levator costorum?

Test q

A

one (brevis) or 2 ribs (longus) below

157
Q

What are the actions of the levator costorum?

Test q

A

elevate ribs

158
Q

What innervates the levator costorum?

Test q

A

dorsal rami locally

159
Q

What is the origin of the intercostal muscles?

Test q

A

inferior border of ribs

160
Q

What is the insertion of the intercostal muscles?

Test q

A

superior border of ribs

161
Q

What are the actions of the intercostal muscles and subcostal?

Test q

A

elevate ribs (interchondral part of internal and innermost muscles, whereas interosseous part depresses)

162
Q

What innervates the intercostal muscles?

Test q

A

intercostal nerves locally

163
Q

What is the origin of the subcostal?

Test q

A

internal surface of ribs near angle

164
Q

What is the insertion of the subcostal?

Test q

A

superior borders of 2nd and 3rd rib below

165
Q

What innervates the subcostal?

Test q

A

intercostal nerve

166
Q

What is the origin of the transversis thoracis?

Test q

A

posterior surface of lower sternum

167
Q

What is the insertion of the transversus thoracis?

Test q

A

internal surface of costal cartilages of ribs 2-6

168
Q

What are the actions of the transversus thoracis?

Test q

A

depress ribs

169
Q

What innervates the transversus thoracis?

Test q

A

intercostal n.

170
Q

Who is the “star player” artery in the anterior thoracic wall?

Test q

A

Internal thoracic a.

171
Q

Intercostal nerves and spinal nerve plexi are derived from ________ rami of spinal nerves

Test q

A

ventral

172
Q

What are the typical intercostal nerves? Why are they typical?

Test q

A

T3-T6
-they have lateral and anterior sensory cutaneous branches

173
Q

Why is T1 intercostal n. atypical?

Test q

A

It’s a part of the brachial plexus

174
Q

Why is T2 intercostal n. atypical?

Test q

A

Also known as intercostobrachial n.

It only has 1 branch- which is the lateral sensory cutaneous branch sensory to armpit

175
Q

Why are T7-T11 intercostal nerves atypical?

Test q

A

Also known as thoracoabdominal nerves bc they go to anterior abdominal muscles

Atypical bc they only have 1 one branch- which is the lateral cutaneous branch

176
Q

Why is T12 intercostal n. atypical?

Test q

A

Also known as subcostal n. and it goes to abdominal muscles

It is atypical bc it only has 1 branch- which is the lateral sensory cutaneous branch

177
Q

________ = sympathetic outflow. Each have white rami that communicates (preganglionic) from ventral rami to their own level sympathetic ganglia

Test q

A

T1-L2

178
Q

What nerve innervates the organs of the thorax?

Test q

A

CN X (vagus n.)

179
Q

The phrenic n. is derived from….

Test q

A

C3-C5 ventral rami

180
Q

Which nerve courses with the pericardiophrenic artery and vein?

Test q

A

Phrenic nerve

181
Q

Which nerve innervates the diaphragm?

Test q

A

Phrenic nerve

182
Q

The internal thoracic artery is the 1st descending branch of the…..

Test q

A

Subclavian a.

183
Q

The internal thoracic artery divides into the superior epigastric and musculophrenic arteries at the….

Test q

A

7th rib

184
Q

Collateral branches of anterior intercostal arteries and veins emerge midway of….

Test q

A

costal cartilage

tapp (11 decks)

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