Unit 1 Flashcards
Anterior upper thoracic aperture
Manubrium
Lateral upper thoracic aperature (inlet)
Medial margin of rib 1
Posterior upper thoracic aperture (inlet)
T1 vertebra
Membrane present at the thoracic inlet
Suprapleural membrane
Contents of the thoracic inlet (7) IMPORTANT TO KNOW
Apex of lungs Brachiocephalic artery and veins Subclavian arteries and veins Trachea Esophagus Vagus and phrenic nerves Sympathetic trunk
Lower thoracic outlet anteriorly, anterolaterally, posterlaterally, and posteriorly
Xiphoid process
Costal margin
End of rib 11 and rib 12
Body of t12
Thoracic outlet is closed by:
Diaphragm
Joints of the thoracic ribs IMPORTANT TO KNOW
Manubriosternal joint (symphysis/2ndary cartilaginous) Xiphisternal joint (2ndary cartilaginous/symphysis) Sternocostal (1st- primary cartilaginous/syncondrosis, 2nd-7th: synovial) Interchondral joints (7th to 10th: small synovial) Costovertebral joints (costocorporeal joint and costotransverse joint)
Which side of the diaphragm is higher? Why?
Right side- liver is pushing this up and heart on the left is pushing it down
Diaphragm domes support the ______.
Lungs
Fibrous portion of the pericardium intermingles with the ______ of the diaphragm
Central tendon
Sternal part of the diaphram:
Xiphoid process
Costal part of the diaphragm
Costal margin
Ends of ribs 11 and 12
Vertebral parts of the diaphragm
Lumbar vertebrae
Crura
Arcuate ligaments (medial and lateral)
Medial arcuate ligament overarcs the :
Psoas major
The lateral arcuate ligament overarcs the
Quadratics lumborum
Insertion of the diaphragm
Central tendon lies at the level of the xiphisternal joint
Pericardium blends with pericardial fibers
nerve supply to the diaphragm
Phrenic nerve (C3,4,5, runs down along the lateral side of the pericardium. Left side spreads across the diaphragm, right side passes through the diaphragm to innervate the other side)
C3 4 5 keeps your diaphragm alive
Functions of the diaphragm
Prime muscle of inspiration
Muscles of abdominal straining
Weight lifting
Thoracic-abdominal pump
Vena caval opening is found:
It contains:
T8, present in the central tendon
Inferior vena cava and right phrenic nerve branches
Esophageal opening is located:
It contains:
T10, present in the muscular part
Esophagus and right & left vagus nerves
Vagus nerve is typically more ____ than the phrenic nerve
Medial
When the hiatus is not keeping the stomach in place, causing it to slide:
Hiatal hernia
Hiatal hernia more common in:
Cause:
women, people overweight, people over 50
Cause: congenital, increased pressure
Types of hiatal hernias
Type 1- sliding hernia (most common)
Type 2, 3 and 4- paraesophogeal hernia
Aortic opening location
Contents:
T12- behind the posterior attachment of the diaphragm along the vertebral column
Contents:
Aorta and thoracic duct (starting with the Cysterna chyli)
Region that is external to the anterior thoracic wall. Anchors the upper limb to the trunk
Pectoral region
Pectoral region consists of what’s 2 compartments? List what is in the compartment
Superficial compartment (skin, superficial fascia and breast) Deep compartment (muscles and associates structures)
Nerve supply of the anterior thoracic wall:
Supraclavicular nerves
Intercostal nerves
Nerve supply of the posterior thoracic wall:
Posterior rami of thoracic spinal nerves
Supraclavicular nerves origin and branches (3)
Originate from C3 and C4 of the cervical plexus
Branches:
Medial infraclavicular region
(Intermediate) Pectoral and deltoid regions
(Lateral) Upper and posterior shoulder
Location of the breasts
Lies in superficial fascia anterior to pectoralis major
Extends vertically from ribs 2 to 6
Extends transversely from sternum to mid-axillary line
Innervation of breasts
Intercostal nerves 2-6
Mammary gland has _____ lobes. It contains: (3)
15-20 lobes
Contents:
Glandular tissue
Lactiferous ducts (opens onto the nipple)
Connective tissue
Suspensory ligaments run from ______ to ________
Dermis of the skin to deep fascia
Hormone responsible for milk production
Prolactin
Hormone responsible for milk ejection
Oxytocin
Lateral arterial supply of breast
2nd to 4th intercostal arteries
Intermediate arterial supply of the breast
Axillary arteries- Thoracoacromial artery and Lateral thoracic artery
Medial arterial breast supply
Internal thoracic artery- mammary branches
Lymphatic nodes of the breast
Anterior axillary nodes (receives 75% of lymph)
Internal thoracic nodes (parasternal)
Intercostal nodes
Muscles of the pectoral region
Pectoralis major
Pectoralis minor
Subclavius
Posterior thoracic all components
Twelve thoracic vertebrae
Intervertebral discs
Lateral thoracic wall
12 ribs
3 flat muscles (intercostal spaces)
Intercostal vein, artery and nerve
Anterior thoracic wall component
Sternum
Muscles of the thoracic wall
External intercostal Internal intercostal Innermost intercostal Subcostales Transversus thoracis
intercostal active during inspiration
External intercostal
Intercostal muscle active during expiration
Internal
Thoracic wall muscles that span multiple ribs
Subcostales
Thoracic wall muscles that secure internal thoracic vessels to the wall- anterior
Transversus thoracis
Actions of intercostal muscles
Support intercostal spaces during breathing
Pulls ribs nearer to one another
Contents of the intercostal spaces
External, internal, and innermost intercostal
Subcostales
Transverse thoracis
Intercostal vein, artery , and nerve (in that order)
Artery that enters rectus sheath and supplies rectus muscles to umbilicus
Superior epigastric artery
Artery that supplies diaphragm
Origin for lower anterior intercostal arteries
Musculophrenic artery
Arteries that connect with posterior intercostal arteries
Anterior intercostal arteries
Artery that accompanies phrenic nerve and supplies pericardium
Pericardiophrenic artery
Artery that supplies anterior mediastinum (thymus)
Mediastinal artery
What does the internal thoracic vein drain into?
brachiocephalic vein
Anterior intercostal arteries and their origin
Internal thoracic artery (origin for 1-6) Musculophrenic artery (origin for 7-10)
Posterior intercostal arteries
Subclavian artery (costocervical trunk and superior thoracic artery. Origin for superior 2 posterior IC arteries) Thoracic aorta (origin for lower 9 posterior IC arteries)
Anterior intercostal veins and where they drain
Musculophrenic vein and internal thoracic vein
-drain into brachiocephalic veins on both sides
Posterior intercostal veins and where they drain into
Azygos vein- right side, drains into superior vena cava
Hemiazygos vein- left side, drains into azygos vein
Left brachiocephalic vein
Branches of the intercostal nerves
Anterior cutaneous branch Lateral cutaneous branch Collateral branch Muscular branches Pleural sensory branches Peritoneal sensory branches Contribution to brachial plexus (T1) Lateral cutaneous branch of T2 (intercostobrachial nerve) Anterior rami of T1-T11 Anterior rami of T12 (subcostal nerve- inferior to rib)
Sternal angle
T4/T5
Sac that encloses the heart and the roots of the great vessels. Lies in the ____ ______.
Fibrous sac
Middle mediastinum
Pericardium attached to central tendon of diaphragm Fused to great vessel’ adventitious \_\_\_\_\_\_\_\_ ligament (fibers of the fibrous sac)
Fibrous pericardium
Sternopericardial ligament
Pericardium that is the parietal layer
Pericardial cavity
Visceral layer (epicardium)
Serous pericardium
Serous pericardium layers has _____(#) layer(s) of cells that are:
1
Simple squamous
Thickest side of the heart
Left
Nerve supply to the pericardium
Phrenic nerve
Sympathetic trunk
Vagus nerve
When fluid in the pericardial sac builds up and puts pressure on the heart
Cardiac Tamponade
Posterior nerve supply to the pericardium
Sympathetic
Medial nerve to pericardium
Vagus
Anterior nerve to the pericardium
Phrenic nerve
Anterior (sternocostal) surface
Right atrium
Right ventricle
Left ventricle
Right pulmonary surface of the heart
Right atrium
Left pulmonary surface of the heart
Left ventricle Left atrium (small part)
Diaphragmatic (inferior) surface
Left ventricle (mainly) Right ventricle Posterior intercentricular sulcus
Posterior surface of the heart (base)
Left atrium (mainly) Right atrium (small part) Proximal parts of great veins (SVC, IVC, Pulmonary veins)
Depression surfaces on the heart
External soul I
Sulcus that circles the heart. Separates atria from ventricles
Coronary sulcus
Sulcus present on the anterior surface, and on the diaphragmatic surface
Separates the left and right ventricles
Anterior and posterior interventricular sulcus
Upper limbs, head and necks, thoracic cage vein drains into
Superior vena cava
Smooth surface where the superior and inferior vena cava come together to
Sinus of vena Cavan
Internal ridge inside the right atrium.
Crusts terminalis
External groove where the crystal terminalis is located internally
Sulcus terminalis cordis
Properties of the right atrium
Atrium proper
Sinus of vena cavae
Sulcus terminalis cordis
Crystal terminalis
Space anterior to crystal terminalis
Derived from the embryonic primitive atrium
Musculophrenic pectinate (pectinate muscle)
Atrium proper
What will you find in the interatrial septum?
Fossa ovalis Annulus ovalis (limbus fossa ovalis)
Openings in the right atrium
Superior vena cava
Inferior vena cava
Right atrioventricular orifice (where right AV valve/tricuspid is)
Opening to the coronary sinus
Anterior cardiac vein (drain into right atrium as well)
In right ventricle
Muscular, irregular structures on the inflow portion
Papillary muscles, connected to the
Chordae tendineae, connected to the cusps
IMPORTANT
Trabeculae carneae
In right ventricle
Smooth walls of the outflow tract- to keep blood flow from being turbulent.
Derived from embryonic bulbus cordis
IMPORTANT
Infundibulum (conus arteriosus)
In right atrioventricular orifice
3 cusps
Apex of each cusp gives attachment to chordae tendineae
Tricupsid valve
3 semilunar valve
Pulmonary valve
Forms the base of the heart No sulcus terminalis cordis
No crista terminalis
Left atrium
Part of the left atrium that Has smooth walls
Receives pulmonary veins
Posterior part
Part of left atrium that contains musculi pectinati
Anterior part
What is present in the left ventricle
Trabeculae carneae, papillary muscles and chordae tendineae, and
Mitral (bicuspid) valve
Smooth outflow tract near the aorta
Derived from embryonic bulbus cordis
Aortic vestibule
What comes off of the ascending aorta?
Coronary arteries
Right comes off of the right cusp and left from the left cusp
Opening of the aorta
3 semilunar cusps
Aortic valve
Opening of the right and left coronary arteries
Coronary ostium.
Branches of right coronary artery
Atrial branch (goes to atrium at the SA node) Right marginal branch Posterior interventricular branch (posterior descending artery- PDA)
Branches of the left coronary artery
Anterior interventricular branch (left anterior descending artery- LAD)
Circumflex branch
Marginal branch runs:
Down the side of the heart, into the posterior interventricular sulcus
Biggest supply to the left ventricle
Left anterior descending artery
Coronary artery most commonly blocked, causing a heart attack
Left anterior descending artery- AKA Widow Maker
Venous drainage
Anterior cardiac veins
Coronary sinus
Veins of the coronary sinus
Study locations
Great cardiac vein
Small cardiac vein
Middle cardiac vein
Posterior cardiac vein
Posterior sulcus into coronary sinus vein
Small cardiac vein
Vein runs with posterior ventricular artery
Posterior cardiac vein
Cardiac conduction system
Sinoatrial node Atrioventricular node Atrioventricular bundle Right and left bundle branches Purkinje fibers
Node by superior vena cave and atrial border.
Has leaky sodium channels
No complete resting potential here.
Depolarizers atria
Sinoatrial node (SA node)- pacemaker of the heart
Look into atrial syncytium
Atrial syncytium
Cardiac skeleton
Insulation system of the nodes
AKA Bundle of His
AV Bundle
Ventricles should contract from:
Apex up
Pulmonary trunk
Carries blood into right and left artery
Remains of ductus arteriosum
Ligamentum arteriosum
Ascending aorta begins:
It ends:
Aortic valve
Sternal angle (T4/T5)
Branches of ascending aorta
Right and left coronary