W01L03 Body Cavities and Serous Membranes Flashcards
Breast arterial supply
Axillary and internal thoracic arteries
Breast lymph drainage
Axillary and internal thoracic nodes
Breast lymph drainage levels
Pectoral to central to apical
Thoracic wall primary and secondary functions
Primary - respiratory movements
Secondary - protects major organs
Structures that pass between the thorax and the upper limb (anterior to posterior)
Subclavian vein (scalenus anterior)
(Scalene tubercle separates the subclavian vein and artery)
Subclavian artery
Inferior trunk of the brachial plexus
Aetiology of 45 year old man presented after a cross country ski holiday with a pulsatile right supraclavicular mass of 3-4 months duration. During a strenuous day of skiing, his right arm had become cold and numb with loss of power and pallor.
The aetiology is dysplastic first rib causing chronic trauma to the subclavian artery resulting in dissection and aneurysm. Acute trauma during active cross country skiing then caused embolisation to the forearm.
Recurrent laryngeal nerve
On both sides of the trachea
A branch of the vagus nerves
Vagus nerves
Cranial nerve 10 Parasympathetic innervation of the heart Lowers the heart rate Right vagus controls SA nodes Left vagus controls AV nodes
Rib elevation (pump handle)
Pushes the sternum up and forward to increase thoracic anterio-posterior diameter for inhalation
Rib eversion (bucket handle)
Elevation of later shaft of ribs to increase the lateral diameter of the lungs
Chest drain location
Done at upper edge of ribs due to neurovascular bundle at lower edge
What makes up the thoracic inlet?
T1
1st ribs + costal cartilages (hyaline)
Manubrium
Lung landmarks
Apex of lung extends to the level of T1 and neck of 1st rib (2-3 cm above ant. part of the 1st rib and clavicle)
Base of lung to rib 8 anteriorly, rib 10 posteriorly
Structures that passes between the thorax and the neck?
Vessels that supply and drain the head and neck
Trachea
Oesophagus
Right and left vagus and recurrent laryngeal nerves
Right and left phrenic nerves
What makes up the thoracic outlet?
T12 11th + 12th ribs Costal cartilage of 7-10 Xiphoid cartilage (Inverted upside down J shape)
Openings of the diaphragm
T8 caval opening
T10 oesophageal opening
T12 aortic hiatus (posterior)
T8 caval opening
Inferior vena cava
Right phrenic nerve
T10 oesophageal opening
Oesophagus
Left and right vagal trunks
Left gastric vessels
T12 aortic hiatus (posterior)
Aorta
Azygos vein
Thoracic duct
Thorax is lined by…
Lungs and chest wall lined by pleura
Heart surrounded by pericadium
Abdomen and pelvis lined by…
Lined by the peritoneum
Allows movement, expansion, contraction of organs
Typical pneumothorax on x-ray
Lung markings stop and lungs only fill about half of the thoracic cage
Superior mediastinum lies?
Lies between the inlet and the plane between the sternal angle and T4/5
Inferior mediastinum lies?
Lies inferior to the plane between the sternal angle and T4/5 and the thoracic outlet
Sternal Angle
2nd costal cartilage
T4/5
Contents of the superior mediastinum
Aorta (arch asc and desc) Bifurcation of pulmonary trunk Superior vena cava Vagus nerves Phrenic nerves Trachea and oesophagus
3 subdivisions of the inferior mediastinum
Anterior mediastinum
Middle mediastinum
Posterior mediastinum
(Refer to notes for images)
Contents of the anterior mediastinum
Thymus
Contents of the middle mediastinum
Contents of the pericardium (i.e. heart and great vessels)
Contents of the posterior mediastinum
Aorta
Oesophagus
Thoracic duct
Azygos veins
Thymus
Lies in the superior and anterior mediastinum
Active in children
Involved in immunological, programming T-lymphocytes
Atrophies with age - fatty remnant
