Witwer Thorax & Respiratory Flashcards
The sternal angle is also called ____. Being an important landmark the 2nd ____ insterts here at the thoracic level of __-__.
Manubriosternal, rib, T4-T5
What landmark is at the top of the manubrium? This is at level __-__?
suprasternal notch, T2-3
The superior and inferior mediastinum is separated transversely by?
Plane of the sternal angle
The sternal angle is very important landmark as it also notes the?
- Superior limit of pericardium
- Beginning of aortic arch
- superior vena cava enters right atrium
- tracheal bifurcation
- superior limit of pulmonary trunk
Where is central venous pressure determined?
Where superior vena cava enters atrium at level of sternal angle
What are the contents of the anterior mediastinum?
thymus, internal mammary vessels, lymph nodes, loose connective tissue
What gland is located behind the manubrium
Thymus
What are the contents of the middle mediastinum?
Pericardia (fibrous and serous), heart, great vessels (aorta, SVC, IVC, pulmonary aa vv), nerves (vagus, sympathetics, phrenics), trachea
What are the contents of the posterior mediastinum?
descending aorta, esophagus, intercostal aa/vv, thoracic duct, azygos and hemiazygos vv
What are the contents of the superior mediastinum?
Thymus, brachiocephalic vv, SVC, aortic arch and branches (R brachiocephalic, L common carotid and L sublcavian), trachea, esophagus, phrenic and vagus nn, L recurrent laryngeal n, thoracic duct
The phrenic nerve follows ____ through the ____ ____.
vasculature, middle mediastinum
Right phrenic n. follows ____ (three of them).
Veins = SVC, IVC, RA
Left phrenic n. follows ____ ____ (two of them).
arterial vessels = pulmonary artery (PA) and left ventricle (LV)
The vagus n. follows the ____ route through the _____ mediastinum, and the ____ route through the ____ mediastinum.
arterial, superior, food, posterior
The right vagus n. takes the ____ route through the ____ mediastinum then the ____ route through the ____ mediastinum.
air (next to trachea), superior, food, posterior
superior intercostal aa branches off to form the ____ and ____ ____ ____ aa
1st and 2nd posterior intercostal
The descending aorta branches off lower 9 ___ ___ aa
posterior intercostal
The 6th rib is a landmark sigifiying?
Internal mammary aa bifurcation
The internal mammary vv anastomose w/ which two veins?
lateral thoracic vv and superior epigastric vv
What causes caput medusae?
portal HTN distends superior and inferior epigastric vv and this extends into the thoraco-epigastric anastomosis (collateral) «_space;are these the lateral thoracic and superior epigastric???
For a refresher, the vagus n. causes ____ of bronchioles while the sympathetic trunk ____.
constricts, dilates
The R&L parasternal lymphatics serves as a site of?
Metastasis
The thoracic lymphatic duct descends anterior to the vertebral column, passing behind the diaphragm and dilates into a larger collecting duct called?
Cisterna chyli (Witty loves these crazy anatomy names)
what are the primary muscles of inspiration?
Diaphragm (75% of baseline inspiration), external intercostals (externals Elevate) moving ribs up and out (T1-11), Interchondral portion of the intercostals (T1-11)
What are the accessory muscles of breathing (i.e. forced breathing of exercise or pathology)
-Sternocleidomastoids (C
N XI)
-A/P/M scalenes (C3-8)