Thorax: Wall, Pleura, and Diaphragm Flashcards

1
Q

Describe what makes up the throacic wall poterior, laterally, anteriorly

A
  • Posteriorly= 12 thoracic vertebrae
  • Laterally= 12 ribs on each side + 3 layers of flat muscle
  • Anterior= sternum (manubrium, body, xiphoid process
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

approximately the same horizontal plane as the intervertebral disc between vertebrae TII and TIII.

superior aspects of the pleural cavities, which surround the lungs, lie on either side of the entrance to the mediastinum

A

Superior Thoracic Aperature

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Lower opening into throax. Closed by the diaphram.
* T12 vertebrae
* Xyphoid process anteriorly

A

inferior thoracic aperture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

seals the inferior thoracic aperture domed

A

Diaphram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

thick midline partition that extends from the sternum anteriorly to the thoracic vertebrae posteriorly, and from the superior thoracic aperture to the inferior thoracic aperture.

A

Mediastinum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

The inferior mediastinum is further divided by the ___ this is called the ___ mediastinum

A

Pericardium which encloses the heart; middle mediastinum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What does this do?

Horizontal line passing through the sternal angle and the intervertebral disc between vertebrae TIV (4) and TV (5)

A

separates the mediastinum into superior and inferior parts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

The ____ mediastinum lies between the sternum and the pericardium

In front of heart, behind sternum

A

Anterior mediastinum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

The ____ mediastinum lies between the pericardium and thoracic vertebrae.

Contains blood vessels, esophagus, in front of verterbral bodies.

Vertebral bodies

A

posterior mediastinum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Situated on either side of the mediastinum, holds the lungs.

Right and Left

A

pleural cavitys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Location of the heart

A

Middle Mediastinum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

The mediastinum the region bewteen the lungs:

Anterior:
Posterior:
Superior:
Inferior:

A

Anterior: Sternum
Posterior: Vertebral bodies
Superior: thoracic apeture
Inferior: diaphram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the 3 Major landmarks used to divide the mediastinum

A

Sternal Angel, Pericardium, Mediastinal Pleura

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

WHat are the 3 functions of the thorax?

A
  1. Breathing (inspire/expire)
  2. Protection to vital organs (lungs/heart/vessles)
  3. Conduit (lots of structures in and out of it)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

A vertical line starting mid clavical down to Rib 8 and on

A

Midclavicular Line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Vertical line running from the center of the axilla down!

A

Midaxillary Line

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Simple squamous epitherlium; serous membrane

A

Pleura

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Wall of pleural cavity

touches outside of body

A

Pareietal Pleura

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Surface of the lung

on top of lungs

A

Visceral Pleura

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Potential Space

A

Pleural Cavity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Serous fluid in pleural space

Lubricates lungs and tissues

A

Pleural Fluid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Seperates the superior and middle lobes at the level of the 4th innercostal space

Only right lung

A

Horizontal Fissure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Seperates middle and inferior lobe at the level of the levels of the **5th innercostal **space and contours rib #6

A

Oblique Fissure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

When a doctor meausures breathing with a stethascope, where does it have to be placed?

A

Above the oblique fissure above rib #6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

The lungs have what lobes and which lung has an extra lobe?

A

Both have a superior and inferior lobe, right lung has a middle lobe

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the base of the lungs?

A

The diaphram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Where is the apex of the lungs?

A

Above rib #1 and root of the neck

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Where is the root of the lungs?
Covered by what?

A

short attachment connecting lung to mediastinal structures
covered by mediastinal pleura

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the hilum of the lungs?

A

medial surface of lung where structures enter and leave

Pulmonary artery, veins, & bronchus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Contents within the hilum

1 within each hilum, recieve deoxygenated blood

Superior at hilum

A

Pulmonary arterys

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Content of the hilum

2 within each hilum, push out oxygenated blood out of lung.

Inferior at hilum

A

Pulmonary Veins

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Content of hilum

1 in each bronchis, branch out into primary, secondary, tertiary,

Posterior at hilum

A

Bronchus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What are the 6 contents of the hillum?

A

▪ a pulmonary artery,
▪ two pulmonary veins,
▪ a main bronchus,
▪ bronchial vessels,
▪ nerves, and
▪ lymphatics.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What two vessels pass over the superior lobes of the lungs?

A

Right & Left subclavian artery & vein

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Form the apex of the throax, root of the neck.

A LOT of important veins, arterys, nerves run through here.

A

Thoracic Inlet

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What are the 5 great vessles that exit the throacic inlet?

A
  1. Left common carotid artery
  2. Left sublavian (up and over) artery
  3. RIght Brachiocephalic trunk
  4. RIght Brachiocephalic vein
  5. Left brachiocephalic vein (transiton into Left subclavian)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is posterior to the trachea and also exits out of the throacic inlet?

A

The esophagus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Next to apicies of the lungs, anterior to the esophagus, posterior to the manubrium of the sternum

A

Trachea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Nerves that exits out of the thoracic inlet next to the brachiocephalic artery and left common carotid artery

A

Vagus Nerve; C10

main nerve of your parasympathetic nervous system (rest)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Nerve that innervates the diapharam (motor movement) , damage to this nerve can results in loss of inspiration and expiration functionality of the diaphram .

Exits Thoracic inlet bilaterally, posterior to the R & L brachiocephalic veins

A

Phrenic Nerve (C3, C4, C5)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Skeletal Muscle that forms inferior margin of the thorax.

Domed shaped

A

Diaphram

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the significance of the dome shape of the diaphram when it comes to trauma?

A

It works with inhilation and exhailation; trauma to the diaphram can result in lossing the ability to break

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

The skeletal muscle of the diaphram (on periphery) inserts into a what?

All muscles attached

A

Central tendon

44
Q

What are the 3 orgins of the diaphram skeletal muscle?

A
  1. Sternum; styloid process
  2. Costal; cartilage & bones of rib 7-12
  3. Lumbar
45
Q

Region of the Diaphram

Over the top of the psoas muscle and quadratus lumborum, that attach to te vertebrae L2

A

Medial Acurate Ligmanet

46
Q

Region of the Diaphram

Ligament that is betwen ribs 11 and 12 on both sides.

Over Quadratus Lumborun

A

Lateral Acurate Ligament

47
Q

Region of the Diaphram

Part of th arucate ligament that travels up and extends up above aortic hiatus, looping and coming back do to attached to the body of the L3.

A

Right Crus

48
Q

Region of the Diaphram

Part of the arucate ligament that that attached to the vertebral body of L2

A

Left Crus

49
Q

Region of the Diaphram

Arch shape band of tissue that forms the opening of the aoritic hiatus

A

Median Acurate Ligament

50
Q

What nerve innervates the diaphram?

A

Phrenic nerve C3,C4,C5

keeps you alive!

51
Q

Where is the acurate Ligament?

A

Between ribs 11 & 12

52
Q

Thick fiborus band that goes between ribs 11 and 12

A

Arcuate ligament

53
Q

The **Arcuate ligament **crosses over which deep back muscles?

A
  • Quadratus lumborum
  • Psoas
54
Q

Bilateral Ligament on the diaphram that is Anterior to the psoas

A

Medial arcuate Ligament

55
Q

What region of the diaphram forms the esophogeal hiatus?

A

The right Crus

56
Q

What ligament froms the aortic hiatus?

A

Median arcuate ligament

57
Q

What part of the arcuate ligament goes over the quadratus lumborum?

A

Lateral Arcuate Ligament

58
Q

What part of the arcuate ligament goes over the Psoas?

A

Medial Arcuate Ligament

59
Q

What is the path of the phrenic nerve down to the diaphram?

A
  • Down bilateraly through superior thoracic inlet (next to r & l brachiocephalic veins)
  • Pass next to pericardium
  • Come down and peice the Diaphram; inneravating the underside.
60
Q

How does the right phrenic nerve enter the diaphram?

A

Through the Caval opening; next to inferior vena cava

61
Q

How does the Left phrenic nerve enter the diaphram?

A

Just pierces the diaphram.

62
Q

What diaphram opening?

Opening at T8
* Inferior vena cava
* Right Phrenic Nerve

A

Caval Hiatus

63
Q

What diaphram opening?

Opening at T10
* Esophagus
* Vagal trunks (from vagus nerve 10)
* Esophageal branches of left gastric arterty

A

Esophageal Hiatus

64
Q

What diaphram opening?

Opening at T12
* Aorta runs through
* Thoraci Duct
* Azygous vein (drains throax)

A

Aortic Hiatus

65
Q

Sypathetic trunks ** run close the vertebral body and posterior to which ligament** in the diaphram?

A

Medial Arcuate Ligament

66
Q

What Vertebrae is each hiatus at?

Caval?
Esophageal?
Aortic?

A
  1. Caval= T8
  2. Esophageal= T10
  3. Aortic= T12
67
Q

What pierces the right and left crus?

A

Splanchic Nerves

68
Q

a collection of gas or air within the pleural cavity;

Tissue elasticity causes lung to collapse!

A

Pneumothorax

69
Q

the gas within the pleural cavity may accumulate to such an extent that the mediastinum is “pushed” to the opposite side, compromising the other lung

urgent tx

A

tension pneumothorax

70
Q

Can occur spontaneously or due to trauma, inflammation, smoking and other underlying pulomary diseases

A

Causes of pneumothoraces

71
Q

Certain pulmonary metastases, such as in patients with osteosarcoma, may cause ____ ____ especially **After chemotherapy. ** the occurrence of this interferes with cancer treatment and increases mortality.

A

Spontaneous Pnenumothorax

72
Q

Symptoms of pneumothorax?

A
  • Pain, shortness of breath, and cardiorespiatory collapse if severe.
73
Q

Ribs 1-7 attach directly from vertebrae to the sternum

A

True Ribs (1-7)

74
Q

a noninflammatory collection of serous fluid within the pleural cavities. The effusion is clear and straw colored. unilateral or bilateral. The most common cause is cardiac failure

A

Hydrothroax

75
Q

a collection of blood in the space between the chest wall and the lung (the pleural cavity)

A

Hemothorax

76
Q

Ribs 8-10 joined anteriorly via costal cartilage, attached posteriorly to respectve vertebrae.

A

False Ribs (8-10)

77
Q

RIbs 11 & 12, attached to respective vertebrae, free ventral end.

A

Floating Ribs (11-12)

78
Q

What part of sternum?

articulates with clavicle & costal cartilage of 1st rib

A

Manubrium

79
Q

What part of sternum?

Articulates with ribs 2-7 via costal cartilage

A

Body

80
Q

What part of sternum?

Tip, articulates with rib 7

A

Xyphoid Process

81
Q

What runs throught the costal groove of each rib?

A
  1. Innercostal vein, artery, nerve
82
Q

What part of the rib attaches to the dens facet for articulation on each vertebrae?

A

Head of rib

83
Q

What part of ribs ____ attach to transveres proces of thoracic vertbrae?

A

Tubercle

84
Q

The space between each ribs

A

Innercostal Space

85
Q

Spinal nerve that comes off and runs in the costal groove of ribs, with sevreral branches

Can be anterior or posterior

A

Innercostal nerve

86
Q

Posterior branch of innercostal nerve will give off what branch?

A

Lateral Cutaneous Branch

87
Q

Anterior branch of the innercostal nerve will give off what branch?

A

Anterior cutaneous branch

88
Q

Hold together and are involved with movement of the ribs, i

Innervated by innercostal nevres T1-T11

A

Intercostal muscles

88
Q
  • Inferior medial orientation (hands in pockets)
  • Most active in inspiration, move ribs superiorly.
A

External intercostal muscles (most superficial)

89
Q

Opposite orientation to external intercostal, inbetween

Pull ribs down for exhalation

A

Internal Innercostal Muscles

90
Q

Run on posterior aspcect of costal groove, run same orientation as internal

Most active during expiration, moves ribs inferior

A

Innermost Intercostal Muscles

91
Q

Between internal and innermost intercostal muscles this is where what runs?

A

Intercostal Vein, Artery, Nerve (top to bottom)

VAN

92
Q

What kind of repsiratory movment?

Superior and** anteior** movement of the sternum when you inhale.

A

Pump Handle

93
Q

What respiratory movement?

**Lateral **upwards movement of the shaft of the ribs
when inhaling

A

Bucket handle moment

94
Q

Posterior Innercostal arterys from ribs 3-12 come off what?

A

Aorta

95
Q

anterior branches of arterys come off where?

A

Anterior Innercostal arterys

96
Q

The anteior and posterior innercostal arterys join in a ?

Lots of blood when bleeding

A

Anastamosis

97
Q

What is the significane of an anastamosis ?

A

Allow for flow from one or more sources, helps compensates with obstruction.

Alternative pathways of blood

98
Q

Narrowing of an artery

A

Stenosis

99
Q

Series of highly variable viens that dump into the throax into the =

A

Azygous System

100
Q

Right vein, main vein that dumps blood from the right innercostal veins, into the SVC returning blood to the heart.

A

Azygous vein

101
Q

2 main veins on left side of thorax where all left innercostal veins return blood too.

A
  • Hemiazygous vein
  • Acessory hemiazygous vein
102
Q

Both the and Hemiazygous vein
and acesory hemiazygous vein dump into what?

A

The azygous vein

103
Q

What dermatome?

Nipples

A

T4

104
Q

What dermatome?

Xiphoid Process

A

T6

105
Q

What dermatome?

Umbilicus

A

T10