VHD Relationships Thorax Flashcards
What articulates at the sternocostal joints?
the sternum and ribs
What articulates at the costovertebral joints?
the ribs and thoracic vertebrae
What type of joints are the sternocostal and costovertebral joints?
plane (gliding)
What does the thorax include?
chest wall, pleural cavities, lungs, mediastinum, heart, pericardium, diaphragm
What muscles are in the chest wall?
intercostal and transversus thoracis muscles
Where do the external intercostal muscles pass?
rib to rib, oriented superior-lateral to inferior medial
Where do the internal intercostal muscles pass?
rib to rib; oriented superior-medial to inferior-lateral
Where do the transverse thoracis muscles pass?
posterior sternum to costal cartilages
What are the functions of the muscles of the chest wall?
elevate and depress ribs during respiration (intercostals and transverse thoracis)
Where does the diaphragm pass?
xiphoid process of sternum, lower ribs, lower ribs and costal cartilages, medial and lateral arcuate ligaments and lumbar vertebrae to the central tendon
What is the fascia covering the chest wall and diaphragm?
endothoracic fascia
What is the visceral pleura?
serous membrane applied to the lung surface and its interlobar fissures
What is the parietal pleura?
lines the chest wall, vertebral bodies and lateral mediastinal structures
What defines the line between the superior and inferior divisions of the medistinum?
imaginary line from sternal angle to T4-5 intervertebral disc
What vascular structures does the superior mediastinum contain?
aortic arch, brachipcephalic, left common carotid, left subclavian, and internal thoracic arteries brachiocephalic and internal thoracic veins
What visceral structures does the superior mediastinum contain?
esophagus, trachea, thoracic duct, thymic remnant, and lymph nodes
What nervous structures does the superior medistinum contain?
left recurrent laryngeal, vagus and phrenic nerves
What are the divisions of the inferior mediastinum?
anterior, middle and posterior
Where is the anterior mediastinum and what does it contain?
between the sternal body and pericardium; remnants of the thymus and lymph nodes
What organ does the middle mediastimum contain?
heart
What vascular structures does the middle mediastinum contain?
ascending aorta, pulmonary trunk and pulmonary arteries, superior vena cava and pulmonary veins
What visceral structures does the middle mediastinum contain?
tracheal bifurcation, main bronchi and lymph nodes
What nervous structures does the middle mediastinum contain?
left recurrent laryngeal, vagus and phrenic nerves
Where is the posterior mediastinum positioned?
between the tracheal bifurcation and pericardium and the vertebral column
What vascular structures does the posterior mediastinum contain?
descending aorta, azygos and hemizygos veins
What visceral structures does the posterior mediastinum contain?
esophagus, thoracic duct, and lymph nodes
What nervous structures does the posterior mediastinum contain?
vagus and splanchnic nerves
this separates the superior and inferior lobes of the lungs
oblique fissure
this separates the superior and middle lobes of the right lung
horizontal fissure
What is a bronchopulmonary segment?
a subdivision of the lobes of the lungs that has a segmental bronchus and an adjacent segmental branch of the pulmonary artery
What is the path of blood flow in the heart?
deoxygenated blood–> superior or inferior vena cava –>right atrium –> right atrioventricular (tricuspid) valve –> reight ventricle –> pulmonary valve and pulmonary trunk –> (oxygenated blood) –> pulmonary veins –> left atrium –> atrioventricular (mitral or bicuspid) valve –> left ventricle –> aortic valve –> ascending aorta
What separates the atria from ventricles?
coronary sulcus
What are the muscles on the inside of the right atrium?
pectinate muscles
What are the muscles in the right and left ventricles?
trabeculae carnae and papillary muscles (and chordae associated with the cusps of the tri and bi- cuspid valves)
What innervates the intercostal muscles?
intercostal nerves (motor and sensory)
What innervates the diaphragm and parietal pleura?
phrenic nerves (motor and sensory)
What innervates the thoracic viscera?
vagus (sensory and parasympathetic) and cardiopulmonary splanchnic (sensory and sympathetic) nerves
The intercostal nerves, arteries and veins are positioned _______ to the internal intercostal muscles.
deep
The intercostal nerves, arteries and veins are positioned deep to the ________ intercostal muscles.
internal
The ______ nerves, arteries and veins are positioned deep to the internal intercostal muscles.
intercostal
What are the four divisions of the parietal pleura?
costal, cupola, diaphragmatic and mediastinal
Where is the costal pleura?
lines the ribs (a division of the parietal pleura)
Where is the cupola?
overlies the apex of the lung (a division of the parietal pleura)
What does the diaphragmatic pleura line?
the diaphragm
What does the mediastinal pleura line?
the mediastinum (compartment between the two pleural cavities)
What is the costodiaphragmatic recess?
space associated with the costal pleura to the diaphragmatic pleura
The pulmonary ligament extends _____ from the root of the lung.
inferior
The phrenic nerve passes _______ to the root of the lung.
anterior
The ________ is positioned posterior (deep) to the first six costal cartilages.
internal thoracic artery
The internal thoracic artery is positioned _______ to the first six costal cartilages.
posterior (deep)
The internal thoracic artery is positioned posterior (deep) to the ___________.
first six costal cartilages
The left phrenic nerve passes ______ to the root of the left lung.
anterior
The ______ nerve passes anterior to the root of the left lung.
left phrenic
The left phrenic nerve passes anterior to the root of the ______.
left lung
The left phrenic nerve is positioned ______ to the pericardial sac.
lateral
The ______ nerve is positioned lateral to the pericardial sac.
left phrenic
The left phrenic nerve is positioned lateral to the ________.
pericardial sac
The left phrenic nerve passes _____ to the ascending aorta.
lateral
The ______ nerve passes lateral to the ascending aorta.
left phrenic
The left phrenic nerve passes lateral to the _______.
ascending aorta
The right phrenic nerve is positioned ______ to the superior vena cava.
lateral
The ________ nerve is positioned lateral to the superior vena cava.
right phrenic
The right phrenic nerve is positioned lateral to the _____________.
superior vena cava
The right phrenic nerve is positioned _________ to the pericardial sac.
lateral
The ________ nerve is positioned lateral to the pericardial sac.
right phrenic
The right phrenic nerve is positioned lateral to the _______.
pericardial sac
The right phrenic nerve passes ______ to the root of the right lung.
anterior
The _______ nerve passes anterior to the root of the right lung.
right phrenic
The right phrenic nerve passes anterior to the root of the ______.
right lung
The arch of the aorta passes _______ to the pulmonary trunk.
superior
The ________ passes superior to the pulmonary trunk.
arch of aorta
The arch of the aorta passes superior to the ________.
pulmonary trunk
The left vagus nerve passes directly _____ to the arch of the aorta.
lateral
The _______ nerve passes directly lateral to the arch of the aorta.
left vagus
The left vagus nerve passes directly lateral to the _________.
arch of the aorta
The left recurrent laryngeal nerve passes _______ to the ligamentum arteriosum.
posterior
The ______ nerve passes posterior to the ligamentum arteriosum.
left recurrent laryngeal
The left recurrent laryngeal nerve passes posterior to the _______.
ligamentum arteriosum
The left recurrent laryngeal nerve passes directly _____ to the arch of the aorta.
inferior
The _______ nerve passes directly inferior to the arch of the aorta.
left recurrent laryngeal
The left recurrent laryngeal nerve passes directly inferior to the ______.
arch of the aorta
The left vagus nerve passes ______ to the left main bronchus.
posterior
The ______ nerve passes posterior to the left main bronchus.
left vagus
The left vagus nerve passes posterior to the _______.
left main bronchus
The right vagus nerve is positioned ______ to the trachea.
lateral
The _______ nerve is positioned lateral to the trachea.
right vagus
The right vagus nerve is positioned lateral to the ________.
trachea
The right vagus nerve passes _______ to the arch of the azygos vein and ______ to the right main bronchus.
medial, posterior
The ________ nerve passes medial to the arch of the azygos vein and posterior to the right main bronchus.
right vagus
The right vagus nerve passes medial to the arch of the _______ and posterior to the ________.
azygos vein, right main bronchus
The _____ is positioned lateral (right) to the ascending aorta.
superior vena cava
The superior vena cava is positioned _____ to the ascending aorta.
lateral (right)
The superior vena cava is positioned lateral (right) to the _____.
ascending aorta
The _________ passes superior to the right main bronchus.
azygos vein (arch)
The azygos vein (arch) passes ______ to the right main bronchus.
superior
The azygos vein (arch) passes superior to the _____.
right main bronchus
Do the external intercostal muscles extend all the way to the sternum?
No
How can you identify the bronchus from the arteries/veins?
it is cartilagenous
The pulmonary artery is ________ to the bronchus in the left lung.
superior
The pulmonary artery is _______ to the bronchus in the right lung.
inferior
The phrenic nerves are located between the ______ and the ________.
mediastinal pleura and pericardium
The arch of the aorta is on the ____ side of the ________ mediastinum.
left, superior
The ligamentum arteriosum is a remnant of the _________.
ductus arteriosum
The _____________ is a remnant of the ductus arteriosum.
ligamentum arteriosum
The transverse pericardial sinus is positioned ________ to the ascending aorta and the pulmonary trunk.
posterior
The _________ is positioned posterior to the ascending aorta and the pulmonary trunk.
transverse pericardial sinus
The transverse pericardial sinus is positioned posterior to the ______________ and the ________.
ascending aorta, pulmonary trunk
The left recurrent laryngeal nerve is a branch of the _______ nerve.
vagus
The azygos vein drains directly into the ______.
Superior vena cava
The middle cardiac vein drains into the _______.
coronary sinus
The _______ drains into the coronary sinus.
middle cardiac vein
The left posterior ventricular vein drains into the origin of the _________ .
coronary sinus
What is the crista terminalis?
ridge of tissue where the rough and smooth walled portions of the right atrium meet
The SA node is positioned where the ________ meets the base of the SVC.
crista terminalis
The _______ is positioned where the crista terminalis meets the base of the SVC.
SA node
The SA node is positioned where the crista terminalis meets the base of the ______.
SVC
The A-V node is located in the _______ immediately superior to the opening of the coronary sinus.
interarterial wall
The ________ is located in the interatrial wall immediately superior to the opening of the coronary sinus.
AV node
The A-V node is located in the interatrial wall immediately superior to the opening of the _________.
coronary sinus
The ________ extends between the base of the anterior papillary muscle and the interventricular septum.
septomarginal trabecula
The septomarginal trabecula extends between the base of the ______________ muscle and the ________ septum.
anterior papillary, interventricular septum
The fatty tissue posterior to the manubrium of the sternum is most likely the remnant of the ________ .
Thymus
The_______ passes anterior to the subclavian artery and then posterior to the right main bronchus.
right vagus nerve
The right vagus nerve passes anterior to the subclavian artery and then posterior to the ________________.
right main bronchus
The right vagus nerve passes _______ to the subclavian artery and then ___________ to the right main bronchus..
anterior, posterior
The ________ is positioned posterior to the trachea.
esophagus
The esophagus is positioned ___________ to the trachea.
posterior
The esophagus is positioned posterior to the _______.
traches
The _______ passes posterior to the left main bronchus.
esophagus
The esophagus passes posterior to the _______________________.
Left main bronchis
The esophagus passes ________ to the left main bronchus.
posterior
The descending (thoracic) aorta passes posterior to the ____________.
Left main bronchus
The _____________a passes posterior to the left main bronchus.
descending thoracic artery
The descending (thoracic) aorta passes ___________ to the left main bronchus.
posterior
At the hilum of the left lung, the ________ is positioned superior to the main bronchus.
pulmonary artery
At the _______, the pulmonary artery is positioned superior to the main bronchus.
hilum of the left ling
At the hilum of the left lung, the pulmonary artery is positioned _______ to the main bronchus.
superior
At the hilum of the left lung, the pulmonary artery is positioned superior to the ____________.
main bronchus
At the ________, the pulmonary veins are positioned anterior and inferior to the main bronchus.
hilum of the left lung
At the hilum of the left lung, the ___________ are positioned anterior and inferior to the main bronchus.
pulmonary veins
At the hilum of the left lung, the pulmonary veins are positioned ______ and __________ to the main bronchus.
anterior and inferior
At the hilum of the left lung, the pulmonary veins are positioned anterior and inferior to the __________.
At the hilum of the left lung, the pulmonary veins are positioned anterior and inferior to the main bronchus.
At the hilum of the right lung, the__________ is positioned anterior to the main bronchus.
pulmonary artery
At the hilum of the right lung, the pulmonary artery is positioned _______to the main bronchus.
anterior
At the hilum of the right lung, the pulmonary artery is positioned anterior to the main bronchus.
main bronchus
At the hilum of the ________, the pulmonary veins are positioned anterior to the main bronchus.
right lung
At the hilum of the right lung, the pulmonary veins are positioned anterior to the _______.
main bronchus
At the hilum of the right lung, the ____________ are positioned anterior to the main bronchus.
pulmonary veins
At the hilum of the right lung, the pulmonary veins are positioned _____ to the main bronchus.
anterior
At the hilum of the right lung, the ___________ are positioned anterior and inferior to the pulmonary arteries.
pulmonary veins
At the hilum of the right lung, the pulmonary veins are positioned anterior and inferior to the __________________.
pulmonary arteries
At the hilum of the right lung, the pulmonary veins are positioned ________ and _______to the pulmonary arteries.
anterior and inferior
The right posterior intercostal arteries pass anterior to the _______________.
vertebral bodies
The ________ pass anterior to the vertebral bodies.
right posterior intercostal arteries
The right posterior intercostal arteries pass _____ to the vertebral bodies.
anterior
The intercostal veins, arteries, and nerves are all positioned directly ________ to the ribs.
inferior
The intercostal _______, _______, and _______ are all positioned directly inferior to the ribs.
veins, arteries and nerves
The intercostal veins, arteries, and nerves are all positioned directly inferior to the ____.
ribs
The sympathetic chain is positioned lateral to the _________.
thoracic vertebral bodies
The sympathetic chain is positioned ________ to the thoracic vertebral bodies.
lateral
The ________ is positioned lateral to the thoracic vertebral bodies.
sympathetic chain
The right superior intercostal vein drains into the _______.
azygos vein
The thoracic duct is to the _______ of the descending aorta, ________ to the azygos vein and ______ to the esophagus.
right, left, posterior
The ________ is to the right of the descending aorta, left of the azygos vein and posterior to the esophagus.
thoracic duct
The descending (thoracic) aorta is positioned __________ to the pericardial sac.
posterior
The descending (thoracic) aorta is positioned posterior to the _______________.
pericardial sac
The _____________ is positioned posterior to the pericardial sac.
descending (thoracic aorta)
The ___________ is positioned to the left (lateral) of the vertebral bodies.
descending (thoracic) aorta
The descending (thoracic) aorta is positioned to the left (lateral) of the _________.
vertebral bodies
The descending (thoracic) aorta is positioned to the ________ of the vertebral bodies.
left (lateral)
The ___________ is positioned to the right of the descending aorta.
inferior vena cava
The inferior vena cava is positioned to the ________ of the descending aorta.
right
The inferior vena cava is positioned to the right of the ___________.
descending aorta
The ____________ is positioned anterior - medial to the sympathetic chain.
greater splanchnic nerve
The greater splanchnic nerve is positioned _________ to the sympathetic chain.
anterior - medial
The greater splanchnic nerve is positioned anterior - medial to the ___________.
sympathetic chain
The ________ is positioned posterior to the pericardial sac.
esophagus
The esophagus is positioned ________to the pericardial sac.
posterior
The esophagus is positioned posterior to the ___________.
pericardial sac
Near the ________, the esophagus is positioned anterior to the thoracic aorta.
diaphragm
Near the diaphragm, the esophagus is positioned anterior to the ___________.
thoracic aorta
Near the diaphragm, the __________ is positioned anterior to the thoracic aorta.
esophagus
The thoracic duct is positioned directly anterior to the ___________.
thoracic vertebral bodies
The _________is positioned directly anterior to the thoracic vertebral bodies.
thoracic duct
The thoracic duct is positioned directly ______to the thoracic vertebral bodies.
anterior
Near the diaphragm, the esophagus is positioned ___________ to the thoracic aorta.
anterior
