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anatomy of thorax > Throax > Flashcards

Throax Flashcards

1
Q

X-ray colouring explained

A

White- dense so rays don’t pass through
Grey- some pass through, soft tissue
Black- all pass through, air/fat

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2
Q

Contrasting agents

A

Barium

Iodine

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3
Q

3 planes in imagery

A

Sagittal
Axial
Coronal

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4
Q

Difference between T1 and T2 MRI

A

T1 fluid is black

T2 fluid is white

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5
Q

Difference in CT and MRI

A

Fat is black in CT and white in MRI
Bone marrow is grey in CT
Cortical bone is white in CT and black in MRI

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6
Q

PET scan shows

A

Which tissues are metabolically active, useful for showing cancers

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7
Q

Describe rib formation with sternum

A

Rib 1 costal cartilage joins to manubrium
Rib 2 joins at sternal angle
Ribs 3-7 joins to the body With 7th on xiphoid-body joint
8-10 join costal cartilages above

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8
Q

Categories the ribs

A

Ribs 1-7 are true ribs
Ribs 8-10 are false ribs
Ribs 11 and 12 are floating ribs

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9
Q

What is located in thoracic inlet

A 
Subclavian arteries and veins
Internal jugular veins
Common carotid arteries
Oesophagus 
Trachea
Apex of lungs
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10
Q

External intercostal formation and direction

A

Form inferiorly and laterally from lower border of rib above

Run inferiorly and anteriorly from rib above in oblique direction

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11
Q

Internal intercostal formation and direction

A

Formations begin at lower border of rib above to the rib below
Are at 90degrees to external intercostal
Run inferiorly and posteriorly in oblique direction

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12
Q

Innermost Intercostal

A

Deepest and extend in same direction as internal intercostal

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13
Q

Intercostal nerve origins

A

Originate from ventral ramus of spinal nerve giving formation of lateral and anterior cutaneous branches

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14
Q

Intercostal bundles

A

Vein- most superior
Artery
Nerve

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15
Q

Intercostal artery origin

A

Posteriorly anastomoses with aorta

Anteriorly anatomoses with thoracic artery

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16
Q

Anterior branching of intercostal arteries

A

Spaces 1-6 have direct branches off of internal thoracic artery
7-9 have branches off the end branches
10-11 have no anterior branches

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17
Q

Mediastinum

A

Area between the two lungs in the thorax

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18
Q

Parts of the pectoralis major

A

Sternoclavicular head- originates from sternum and first 7 costal cartilage
Clavicular head- originates from anterior surface of medial half of clavicle
Join to humerus

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19
Q

Subclavius

A

Passes laterally from where rib 1 meets costal cartilage to middle third of clavicle
Contracts clavicle medially to stabilise joint

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20
Q

Pectoralis Minor

A

Passes from anterior surface of ribs 3-5 to carotids process of scapula

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21
Q

Trachea levels

A

From C6 to T4/5

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22
Q

Lobes and fissures of each lung

A

Right has inferior, middle and superior lobes
Oblique fissure separates superior from muddle and inferior and horizontal fissure separates middle and inferior
Left has an oblique fissure which separates superior and inferior

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23
Q

Spaces in pleural cavity

A

Costodiaphragmatic recess- inferior

Costomediastinal recess- medial

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24
Q

Margin of diaphragm

A

Attaches to xiphoid proces
Costal cartilage
Floating ribs
Lumbar vertebrae and median arcuate ligament

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25
Q

Breathing mechanics

A

Ribs are thrusted forward and upwards like a bucket handle
Increases transverse diameter of thoracic cavity
Contraction of diaphragm increases vertical diameter of thoracic cavity
Overall reduces pleural pressure and causes entry of air

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26
Q

Superior Mediastinum Outline

A

From thoracic inlet to line from sternal angle to between t4/5

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27
Q

Division of mediastinum

A

Above sternal angle is the superior

Below is inferior which is divided into anterior, middle(pericardial sac) and inferior

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28
Q

Azygous vein function and divisions

A

Drains posterior wall of thorax and abdomen arching over right lung root to sac
Provides veins for intercostal space
Produces hemiazygous and accessory hemiazygous (superior to hemiazygous)

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29
Q

Shunts that change at birth

A

Ductus arteriosis to ligamentus arterosis

Foreamen ovale to ovale fossa

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30
Q

Right Vagus Pathway

A

Lies beside trachea
Posterior to brachiocephalic vein and anterior to arteries
Crosses posterior to root of lung
Right recurrent laryngeal goes around right subclavian
Breaks up into batches on oesophagus

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31
Q

Left Vagus Pathway

A

Between left common carotid and subclavian artery
Crosses left side of aortic arch with recurrent laryngeal going underneath
Passes posterity to root of lung

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32
Q

Phrenic nerve functions

A 
Motor to diaphragm 
Sensory to tendon of diaphragm
Mediastinal pleura
Peritoneum of central diaphragm
Pericardium
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33
Q

Right phrenic nerve

A

Lies of right brachiocephalic vein and svc

and anteriorly to root of lung

34
Q

Left phrenic nerve

A

Lies on left brachiocephalic vein

and left side of pericardium and anterior to root of lung

35
Q

Borders of the heart

A

Right- RA
Inferior- mainly RV but some lV
Left- LV
Posterior- LA

36
Q

Pericardial Sinuses

A

Formed by reflection of serous pericardium onto the heart
Transverse-between superior and posterior reflections
Posterior to aorta and pulmonary trunk but anterior to SVC

Oblique-between pulmonary veins

Where pericardium sticks out creating sinus that goes inwards

37
Q

Drainage into right atrium

A

From SVC, IVC and coronary sinus

38
Q

Valves attachments

A

Valves attach to papillary muscles via chordae tendineae

39
Q

Parasympathetic Nerves

A 
Oculomotor CN3
Facial CN5
Glossopharygeal CN9
Vagus CN10
Sacral nerves 2-4 spinal nerves
40
Q

Autonomic afferent neurone

A

Travels up through the paraverterbral ganglia and white ramus communicans to the dorsal root

41
Q

Movement of lymph

A

Maintained by skeletal muscle and arteries pulsating

Have valves to ensure unidirectional

42
Q

Superficial Lymph drainage

A

Body is split into 4 quadrants divided at the midline and the umbilicus
Inguinal nodes are in the lower quadrants and axillary at upper
With cervical nodes that drain the head and neck
These then penetrate to deep adjacent nodes

43
Q

Thoracic Nodes

A

Parasternal adjacent to sternum
Intercostal on posterior
Diaphragmatic underneath xiphoid process

44
Q

Lymphatic drainage pathway form abdomen

A

Cisterna chyli drains the abdomen and the pelivs
Then forms thoracic duct at L2
Ascends between azygos and aorta
Then crosses over to left at T5 and empties into subclavian vein

45
Q

Lymphatics of heart

A

Vessels follow coronary arteries and drain into brachiocepahllic and tracheobronchial

46
Q

Lymphatics of posterior mediastinum

A

Pre and para aortic nodes drain the oesophagus, diaphragm and liver and go to the thoracic duct and posterior mediastinal

47
Q

Lymphatics of lung

A

Tracheobronchial nodes which unite with parasternal and brochiocephalic to form broncho-mediastinal trunks

48
Q

Lymphatic flow in thorax

A

Diaphragmatic go to parasternal and posterior mediastinal
Parasternal go to brachiocephalic which join with posterior intercostal and tracheobronchial to form broncho mediastinal trunks that drain into subclavian
Some posterior mediastinal drain into thoracic duct

49
Q

Breast anatomy

A

15-20 lactiferous ducts and glandular lobules (ductal lobular unit)
4-18 Areola glands (open onto nipple and areola)
Fat lies interspersed between ductal lobular unit
Organ divided by fibrous septa that radiate from the centre called suspensory/coopers ligaments

50
Q

Nervous innervation of the breast

A

Anterior and lateral branches of Intercostal nerves T2-6

51
Q

Breast ultrasound

A

Glandular tissue-white

Dense tissue -black

52
Q

Lymphatic drainage of breast

A

Medial- parasternal nodes
Lateral- axillary nodes- 75%

Relavent to metastases- brain, liver, bone, lungs

53
Q

Breast Blood supply

A

Laterally by branches of axillary - lateral thoracic

Medially by internal thoracic- t2-4

54
Q

4 Constrictions of oesophagus

A

Junction of pharynx
Crosses aortic arch
Compressed by left main bronchi
Oesophagus hiatus (enters diaphragm)

55
Q

Arteries of oesophagus

A

From thoracic aorta
Broncial arteries
Posterior intercostal arteries
Ascending branches of left epigastric

56
Q

Veins of oesophagus

A

Azygos
Hemiazygos
Accessory hemiazygos

57
Q

Splanchnic Nerves

A

Greater- T5-9/10 goes to coeliac ganglion
Lesser- T9-10 or T10-11 goes to aorticorenal ganglion
Least- T12- renal plexus

58
Q

Markings of pleura

A 
Apex- above middle third of clavicle
Medial- xiphoid process
MCL- 8th riv
MAL- 10th rib
Posterior- T12
59
Q

Markings of lungs

A 
Apex-Above middle third of clavicle 
Front- xiphoid
MCL- 6th
MAL- 8th
Post-T10
60
Q

Markings of the fissures

A

Oblique- Post- T3
MAL-6
Anterior- 6th costal cartilage

Horizontal- 4th costal cartilage to meet oblique in MAL

61
Q

Joints

A

Costovertebral- ribs and vertebrae
Costotransverse- transverse process
Sternocostal- synovial (rib 2 has 2 joints)
Interchondral- synovial- between costal cartilage
Manubrioxiphisternal-symphyses, moves in breathing
Manubriosternal- symphysis
Fibrocartilaginous joint- rib 1 and sternum

62
Q

Vessels and nerves peneratrating the diaphragm at points

A

IVC- T8
Vagus and oesophagus -T10
Aorta, azygous, thoracic duct- T12

63
Q

Muscle at anterior of thorax but posterior to sternum

A

Transversus thoracic muscles

Depresses costal cartilage

64
Q

Drainage of anterior of thorax

A

Internal thoracic vein

65
Q

Trachea level arise and end

A

C4-T4/5

66
Q

Lungs- anatomy

A

2 surfaces- mediastinal and costal

3 borders- inferior, anterior and posterior

67
Q

Phrenic nerve origination

A

C3, C4, C5

68
Q

Aorta and bronchi relativity

A

Aorta hooks over left main bronchi

69
Q

Aorta and SVC relativity

A

SVC is on the right of the aorta and the left brachiocephalic vein passes anteriorly to the aorta crossing it

70
Q

Splanchnic nerves

A

Greater splanchinic nerve- T5-9- celiac ganglion
Lesser splanchnic nerve -T10-12-aorticorenal ganglion
Least splanchnic nerve- T12-Renal Plexus
Pelvic Splanchnic nerve- S2-4- Parasympathetic

71
Q

Cardiac Tamponade

A

Fluid in parietal caitvity
Compresses heart
Difficulty pumping

72
Q

Pericardicitis

A

Inflammation. of sac

Similar symptoms to MI

73
Q

Right coronary branches

A

Sini-Atrial nodal branch
Marginal
Posterior intraventricualr

74
Q

Bundles in the heart

A

Bachmanns bundle in left atrium
Right and left bundle of HIs
Left posterior bundle branches off of left

75
Q

Cardiac Markings

A

Top right- 3rd CC, 1cm from sternal border
Bottom right- 6th CC 1 cm “”
Bottom left- 5th ICS at MC line
Top left - 2nd ICS- 2.5 cm form border

76
Q

Valve auscultation

A

Aortic-2nd ICS right of border
Pulmonary- 2nd ICS left of border
Tricupsid- 5th ICS left of border
Mitral- 5th ICS- 2.5 cm out

77
Q

Apex beat palpitation

A

5th ICS, palm and middle 3- middle in ICS

MAL-MCL

78
Q

Lymphatic drainage of quadrants

A

UR- right subclavian

UL, LR,LL- left subclavian

79
Q

Oesophagus levels

A

C7-T11

T7 deviates and goes anterior to aorta

80
Q

Vertebrae facets

A

Demifacet/ costal facet- head ribs
Transverse- tubercle of ribs
Articular facets on articular processes

81
Q

Breast innervation

A

Intercostal 2-6

Nipple 4th

anatomy of thorax (1 decks)

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