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Anatomy > Thorax (Test III) > Flashcards

Thorax (Test III) Flashcards

0
Q

What are the three compartments of the thoracic cavity?

A

The mediastinum and left and right pulmonary cavities.

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1
Q

What makes up the thoracic cage?

A

Ribs and costal cartilages, sternum, thoracic vertebrae, and the diaphragm (as the floor).

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2
Q

What is the vertebrae levels of the sternum?

A

T5-T9

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3
Q

What is the level of the sternal angle (the angle of Lewis)?

A

T4-T5

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4
Q

What is the level of the xiphoid process?

A

T10

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5
Q

How many true ribs are there?

A

Ribs #1-7

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6
Q

What are the false ribs?

A

Ribs #8-10.

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7
Q

What are the floating ribs?

A

Ribs #11-12

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8
Q

What is the thoracic inlet bounded by?

A

(Anteriorly) superior border of the manubrium
(Laterally) 1st ribs and their cartilages
(Posteriorly) T1 vertebrae

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9
Q

What is the thoracic outlet bounded by?

A

(Anteriorly) costal cartilages of ribs #7-10 and the xiphsternal joint
(Posterior-Laterally) 11th and 12th ribs
(Posteriorly) T12 vertebrae

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10
Q

What travels into the thoracic inlet?

A

Trachea
Esophagus,
Nerves, and
Blood Vessels

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11
Q

What travels through the thoracic outlet?

A

Diaphragm,
Esophagus,
Aorta, and
Inferior vena cava

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12
Q

What level is the jugular notch at?

A

T2-T3.

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13
Q

What are the levels of the scapula (include those for the superior angle, base of the spine and the inferior angle?

A

Superior angle= T2-T3 and the 2nd posterior intercostal space
Base of spine= T4-T5 and the 4th posterior intercostal space
Inferior angle= T7-T8 and the 7th posterior intercostal space

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14
Q

Name the structures of a rib running posterior to anterior.

A

Head (with two articular facets for demi facets of vertebrae)
Neck
Tubercle (with articular facets for transverse processes of vertebrae)
Angle (where rib changes direction)
Body

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15
Q

What is the subcostal groove?

A

A groove running on the inferior aspect of a rib. It is for the subcostal vein, artery, and nerve to run.

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16
Q

How are ribs orientated? What does this allow for?

A

Inferiorly to superiorly. This allows for the pump-handle movement during deep respiration.

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17
Q

Does the external intercostal muscle end anteriorly or posteriorly as the external intercostal membrane?

A

Anteriorly

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18
Q

How does the internal intercostal muscle end?

A

Posteriorly as the internal and innermost intercostal membrane.

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19
Q

What artery runs on both sides of the sternum?

A

Internal thoracic (mammillary) artery.

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20
Q

What does the internal thoracic (mammillary) artery give off?

A

The anterior intercostal artery for spaces #1-6 and the pericardioacophrenic artery.

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21
Q

What does the pericardioacophrenic artery run with?

A

The phrenic nerve.

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22
Q

When does the internal thoracic (mammillary) artery divide? What does it divide into?

A

At the 6th intercostal space;

Superior epigastric artery and musculophrenic artery.

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23
Q

What does the superior epigastric artery (medial portion) supply?

A

Abdominal muscles

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24
Q

Where do the anterior intercostal arteries for spaces #7-10 come off?

A

The musculophrenic artery (what the internal thoracic artery divides into at the level of the 6th intercostal space).

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25
Q

Where do the intercostal neves arise from?

A

The ventral primary rami of the thoracic levels.

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26
Q

Where do the posterior intercostal arteries of spaces 3-11 come from?

A

Off the descending aorta.

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27
Q

Where do the posterior intercostal arteries of spaces 1-2 come from?

A

Off the supreme intercostal artery (comes from the costocervical trunk)

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28
Q

What comes off the sympathetic trunk?

A

Gray and white communicans.

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29
Q

Of the gray and white communicans, which is more medial and which is more lateral? Which one is pre-ganglionic fibers and which is post-ganglionic fibers?

A 
Gray= more medial and post-ganglionic fibers
White= more lateral and pre-ganglionic fibers
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30
Q

During inspiration, what happens to the interthoracic and interpulmonary pressures?

A

Decease

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31
Q

What are the muscles of inspiration?

A

Diaphragm and external intercostal.

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32
Q

What innervates the diaphragm?

A

The phrenic nerve (C3-C5)

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33
Q

What are the muscles of forced inspiration? (X5)

A

Sternocleidomastoid, levator costarum, anterior/middle/posterior scalene, pectoralis major, and serratus posterior superior.

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34
Q

What are the muscles of expiration?

A

Relaxation of the diaphragm

Internal intercostal

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35
Q

What are the muscles of forced expiration?

A

Abdominals, transverse thoracis, and the serratus posterior inferior.

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36
Q

What happens to the intrathoracic and intrapulmonary pressure during expiration?

A

Increases

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37
Q

What does the intercostal vein, artery, and nerve run between?

A

Between the innermost and internal intercostal muscles.

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38
Q

How does the innermost intercostal muscle end?

A

Anteriorly as the innermost intercostal membrane.

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39
Q

True or false:

The diameter of the throrax increases with inspiration.

A

True. The thorax expands during inspiration.

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40
Q

The superior/inferior axis of the thorax increases during quiet breathing because of the:

A

Diaphragm

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41
Q

The anterior/posterior axis of the thorax increases during breathing because of:

A

The intercostals and scalene muscle

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42
Q

What creates the “pump-handle” movement during breathing?

A

The ribs rotating around a transverse axis at the costovertebral and costotransverse joints. This occurs mainly at the upper ribs)

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43
Q

What creates the “bucket-handle” movement during breathing?

A

The ribs rotating one degree around an anterior/posterior axis at the sternocostal joints. This happens mainly at the middle ribs.

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44
Q

Where does the apical portion if the lungs lie?

A

Above the clavicle and 1st rib

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45
Q

What separates the superior and middle lobes of the lungs?

A

Horizontal fissure

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46
Q

What separates the middle lobe from the inferior lobe of the right lung and the superior lobe from the middle lobe of the left lung?

A

Oblique fissure

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47
Q

Where will blood acculumate in the event of a hemothorax?

A

The costodiaphragmatic recess. (It’s where there is no lung tissue in he pleural cavity).

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48
Q

True of false:

The dome of the diaphragm sits higher on the left side.

A

False. It sits higher on the right because of the liver.

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49
Q

What helps to adhere the parietal pleura to different structures such as the rib cage and mediastinum?

A

Endothoracic fascia.

50
Q

What do the lung buds develop into?

A

The pleura (a serous membrane that is one cell layer thick).

51
Q

What occurs when air gets into the pleural cavity? When blood gets in?

A

Pneumothorax; hemothorax.

52
Q

What is the pulmonary ligament?

A

A vertical fold of the mediastinum pleura extending from the hilus of the lung to the diaphragm.

53
Q

What are the parts of the parietal pleura?

A

Cervical (cupola) pleura
Mediastinal parietal pleura
Costal parietal pleura
Diaphragmatic parietal pleura

54
Q

What is the esophageal ligament?

A

A double fold of the mediastinal pleura behind the esophagus.

55
Q

How many pulmonary arteries come off the pulmonary trunk of the heart? What is unique about them?

A

2- a right and left pulmonary artery. They are the only arteries in the body that carry deoxygenated blood.

56
Q

How many pulmonary veins are the returning blood to the heart from the lungs? What is unique about them?

A

4– a left, right, superior, and inferior. They are the only veins in the body that carry oxygenated blood.

57
Q

True or false:

The arch of the aorta is superior to the left primary bronchi.

A

True.

58
Q

What is interesting about the orientation of the right primary bronchus?

A

It has a wider diameter and is more vertical, allowing of the possibility of food to fall down into it.

59
Q

How many lobes are there in the right lung? The left lung?

A

3 in the right–superior, middle, and inferior lobes.

2 in the left–superior and inferior.

60
Q

Which border of the lung is sharp and which is rounded?

A

Sharp is the anterior border and rounded is the posterior border.

61
Q

Describe the bronchi branching sequence of the right lung.

A

Primary bronchi-> superior lobar -> apical segmental (S1), posterior segmental (S2), and anterior segmental (S3)

                     - > middle lobar -> medial segmental (S4) and lateral segmental (S5) 
                     - > inferior lobar -> superior segmental (S6), medial basilar (S7), anterior basilar (S8), lateral basilar (S9), posterior basilar (S10)
62
Q

Describe the branching sequence of the bronchi of the left lung.

A

Primary bronchi-> superior lobar -> apical/posterior segmental (S1/2), anterior segmental (S3), lingular superior (S4), and lingular inferior (S5)
-> inferior lobar -> superior basilar (S6), anterior/medial basilar (S7/8), lateral basilar (S9), posterior basilar (S10)

63
Q

What is found in the hillus of the lung?

A

Pulmonary artery, primary bronchus, and two pulmonary veins.

64
Q

True or false:

In the hilus of the lung, the pulmonary artery is superior to the primary bronchus.

A

True.

65
Q

Grooves for what vessels are found on the left lung?

A

Descending aorta, aortic arch, and cardiac impression.

66
Q

Grooves for what vessels are found on the right lung?

A

Superior vena cava, esophagus, trachea, and brachiocephalic vein

67
Q

True or false:

The pulmonary artery sits more anterior than the primary bronchus.

A

True

68
Q

What is the smooth muscle of the bronchial tree innervated by during vasodilation?

A

The sympathetic nervous system.

69
Q

What is the smooth muscle of the bronchial tree innervated by during constriction?

A

Parasympathetic nervous system.

70
Q

How far down does the smooth muscle of the bronchial tree extend?

A

To the level of the alveoli

71
Q

Where do the bronchioles begin in the bronchial tree?

A

Where the hyaline cartilage ends.

72
Q

Where does respiration begins?

A

In the terminal branches (also with the alveoli for gas exchange)

73
Q

What do the terminal branches of the bronchial tree give rise to? What occurs here?

A

Respiratory bronchioles. This is where CO2 and O2 is exchanged.

74
Q

What is the branching sequence of the lungs? (Bronchial tree)

A

Trachea- primary bronchi- secondary (lobar) bronchi- tertiary (segmental bronchi)- bronchioles- terminal branches- respiratory branches and acinus.

75
Q

What makes up the acinus?

A

The alveolar ducts, sacs, and alveoli.

77
Q

What mediates the exchange of gas in the lungs?

A

The partial pressure of CO2 (PCO2).

78
Q

Where are the chemoreceptors that monitor PCO2 levels?

A

In the carotid body (located in the carotid sinus).

79
Q

Of the respiratory reflex, what is the afferent limb mediated by?

A

Glossopharyngeal N (CN XI)

80
Q

Of the respiratory reflex, what is the efferent limb mediated by?

A

(Sympathetic) GVE fibers

(Parasympathetic) Vagus Nerve

81
Q

How many bronchial arteries supply the lung? Where do they come from?

A

Three–2 left bronchial arteries off the descending thoracic aorts and one right bronchial artery off the 3rd right posterior intercostal artery

82
Q

When do the bronchial arteries become bronchiole arteries? What do they supply?

A

After the bronchi tree–they supply the lobar and teritary segements.

83
Q

What supplies esophagus?

A

The esophogeal arteries

84
Q

What feeds into the esophogeal arteries that supply the esophagus?

A

The descending aorta and bronchial arteries.

85
Q

Lymphatic vessels drain the bronchial tree. What do the pulmonary vessels drain into?

A

The pulmonary and bronchopulmonary lymph nodes.

86
Q

What do the pulmonary and bronchopulmonary lymph nodes drain into?

A

The traceobronchial and paratracheal lymph nodes.

87
Q

What do the trachobronchial and paratracheal lymph nodes drain into?

A

The thoracic duct or bronchomediastinal lymphatic duct.

88
Q

Describe the lymphatic system of the lungs.

A

Pulmonary vessels-> pulmonary and bronchopulmonary lymph nodes -> tracheobronchial and paratracheal nodes -> thoracic duct or bronchomediastinal lymphatic duct.

89
Q

What is the mediastinum?

A

A midline “wall of structures” between the two pleural cavities.

90
Q

What is the mediastinum bounded laterally by?

A

The medistinal parietal pleura.

91
Q

What constitues the superior mediastinum?

A

The plane connecting the sternal angle to the level of T4-T5 vertebre.

92
Q

What are the major structures of the superior mediastinum?(x10)

A

Superior vena cava, brachiochephalic vein, aortic arch, trachea, esophagus, remnents of the thymus gland, phrenic nerve, vagus nerve, left recurrent laryngeal nerve, and the thoracic duct.

93
Q

What are the three divisions of the inferior mediastinum?

A

Anterior, middle, and posterior.

94
Q

What constitutes the area of the anterior mediastinum?

A

Anterior to the heart

95
Q

What constitutes the area of the middle mediastinum?

A

The pericardium and heart–it is bounded laterally by the parietal pleura.

96
Q

What are the major strucutues of the anterior mediastinum?

A

Remnants of the thymus gland, parasternal lymph nodes, and superficial fat and connective tissue.

97
Q

What structures can be seen in the right lateral view of the posterior mediastinum? (x6)

A

Esophagus, azygos vein, right vagus nerve, sympathetic trunk, thoracic splanchnic nerves, and the thoracic duct.

98
Q

What structures can be seen in the left lateral view of the posterior mediastinum? (x6)

A

Thoracic aorta, accessory hemaxygos vein, left vagus nerve, sympathetic trunk, throacic splanchnic nerves, and the thoracic duct.

99
Q

At what cord level is the foramen of the IVC found in the diaphragm?

A

T8

100
Q

Where in the diaphragm does the IVC pass through? What also runs with the IVC through this?

A

Foramen of the IVC (level of T8) in the central tendon of the diaphgram. It runs with the right phrenic nerve.

101
Q

At what cord level is the esophageal hiatus? Where is this found?

A

T10; muscular right crus

102
Q

What passes through the esophageal hiatus?

A

Esophagus, and the anterior and posterior vagal trunks.

103
Q

Where is the aortic hiatus located?

A

Between the right and left crus

104
Q

What passes through the aortic hiatus? (x4)

A

Aorta, thoracic duct, greater thoracic splanchnic nerve, and azygos vein.

105
Q

What are the three diaphramatic foramen?

A

IVC, esophageal hiatus, and the aortic hiatus.

106
Q

At what level is the aortic hiatus?

A

T12

107
Q

What is the sympathetic nervous system distribution?

A

Thoracolumbar outflow (T1-L2)

108
Q

What innervates the heart and lungs?

A

The pulmonary and cardiac plexuses. (and the cervical–cardiopulmonary) splanchnic nerves)

109
Q

What innervates the foregut?

A

Greater splancnic nerve

110
Q

What levels is the greater thoracic splancnic nerve?

A

T5-T9

111
Q

What innervates the midgut?

A

Lesser thoracic splancnic nerve

112
Q

What levels is the lesser thoracic splancnic nerve?

A

T10-T11

113
Q

What innervates the hindgut?

A

Least thoracic splancnnic nerve and the lumbar splancnic nerve

114
Q

What level is the least thoracic splancnic nerve?

A

T12

115
Q

What innervates the pelvis and perineum?

A

Sacral splancnic nerve

116
Q

What constitues the area of the posterior mediastinum?

A

The area posterior to the heat–it is bounded posteriorly by the vertebrae.

117
Q

What is included in the middle medistinum?

A

Heart, pericardium, primary bronchi, bases of SVC, IVC, aorta, pulmonary arteries and veins, phrenic nerve, and the azygos vein.

118
Q

What is included in the posterior mediastinum?

A

Esophagus, descending aorta, azygos system, vagus nerve, thoracic splanchnic nerves, sympathetic trunk, and thoracic duct.

119
Q

What does the phrenic nerve innervate? What are it’s cord levels?

A

Diaphragm–C3, C4, C5

120
Q

True or false:

The phrenic nerve passes posterior to the root of the lung.

A

False–it passes anterior as it runs with the pericardiophrenic artery.

121
Q

True or false: the vagus nerve passes posterior to the root of the lung`

A

True–it passes posterior to the root of the lung and the heart.

122
Q

What is the level of the vagus nerve? What does it innervate?

A

Cranial nerve 10–it innervates the heart, lungs, and the esophagus and provides parasympathetic innervation to the thoracic organs.

123
Q

What does the left recurrent laryngeal nerve come off of? Where is it? What does it do?

A

It comes off the vagus nerve around the ligamentum arteriosus –it give parasympthetic innervation going back to the neck.

124
Q

What does the right recurrent laryngealnerve come off of? Where is it?

A

The vagus nerve–it goes around the base of the right subclavian where the brachiocephalic trunk divides into the subclavian and the carotid.

Anatomy (24 decks)

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