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Cardiopulmonary 4
Thoracic Wall and Pleural Cavities
54
Medical
Graduate
12/08/2012

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Cards

Term
where is the thorax located?
Definition
between the neck and the abdomen
Term
how are the inlet and outlet of the thorax defined?
Definition
inlet is defined by the manubrium and first ribs
outlet is defined by the diaphragm
Term
breast tissue consists primarily of what?
Definition
fat, it is compartmentalized between glandular and connective tissue
Term
where do the suspensory ligaments of cooper run?
Definition
from the deep fascia all the way to the skin
Term
name the components of the female breast.
Definition
nipple, areola, lactiferous ducts, lactiferous sinuses, mammary glands, suspensory ligaments, fat
Term
what are areolar glands and what purpose do they serve?
Definition
sebaceous glands surrounding the nipple, help to lubricate the nipple during suckling
Term
true or false, the nipple and areola become more pigmented after first pregnancy?
Definition
true
Term
how is milk excreted by the mammary glands?
Definition
the nipple is supplied with smooth muscle that contracts upon stimulation
Term
what arteries supply the breast and where?
Definition
internal thoracic artery supplies the medial aspect
the lateral thoracic artery supplies the lateral aspect
Term
what lymph nodes drain the breast and where?
Definition
the majority of the breast (lateral portion) is drained by the axillary nodes, and the rest (medial portion) drain to the parasternal nodes, all eventually drain to subclavian lymph trunk
Term
what sections are the breast divided into and what region sees higher incidence of breast cancer?
Definition
superior lateral/medial and inferior lateral/medial, the superior lateral region (avoids spread to contralateral breast)
Term
true or false, the majority of breast lumps are cancerous?
Definition
false, only about 10%
Term
what makes up the majority of breast lumps?
Definition
fibrocystic changes (40%)
followed by no disease (30%)
Term
how does a breast tumor cause dimpling?
Definition
the tumor impinges on the suspensory ligaments, as the breast is compressed the ligament is unable to stretch producing a dimple (sign of aggressive tumor)
Term
true or false, a fibroadenoma is cancerous.
Definition
false, it is a benign tumor
Term
what are some signs of breast cancer?
Definition
dimpling, recruitment of blood vessels, amorphous region, edema, and orange peel skin
Term
what prevents large scarring in breast surgery?
Definition
utilization of langer lines
Term
what is involved in a mastectomy?
Definition
the removal of all breast tissue down to the pectoralis major, locating the long thoracic (seratus anterior) and thoracal dorsal (latissimus dorsi) nerves prior to removal
Term
what nerves innervate the seratus anterior and latissimus dorsi?
Definition
the long thoracic and the thoracal dorsal, respectively
Term
what is involved in a lumpectomy?
Definition
removal of only tumor and surrounding area, also axillary node dissection to detect metastasis
Term
describe lymph mapping?
Definition
injection of dye in an area to locate its draining lymph nodes
Term
what two surgical repair procedures are available after mastectomy and what do they involve?
Definition
tramp flap reconstruction - relocates the opposite rectus abdominal muscle to the affected breast, also uses skin graft from stomach to breast
latissimus dorsi flap reconstruction - relocating part of the lat dorsi around to the affected breast
Term
how is the relocated muscle kept viable during tram flap reconstruction?
Definition
only the insertion site is cut to maintain the blood supply to the muscle
Term
what surgical procedures are available for nipple reconstruction?
Definition
CV flap and double opposing tab
Term
what are the three main functions of the thorax?
Definition
protection of vital organs, breathing, and a conduit between structures of head and abdomen
Term
which ribs are true ribs and why?
Definition
ribs 1 through 7, they attach to the body of the sternum via their own costal cartilage
Term
which ribs are false ribs and why?
Definition
ribs 8 through 10, they attach to the costal cartilage of the rib superior to them
Term
which ribs are floating ribs and why?
Definition
ribs 11 and 12, they do not attach to the sternum only to the vertebral column
Term
what vertebra attach to the ribs?
Definition
T1 through T12
Term
which ribs are considered typical ribs and why?
Definition
ribs 3 through 10, because they have a normal rib shape
Term
which ribs are considered atypical and why?
Definition
ribs 1 and 2, they are very curved and shorter, and ribs 11 and 12, they are straighter and shorter
Term
what is involved in a thoracotomy and why is it performed?
Definition
cut through skin and underlying tissue, then cut through periosteum, cut out section of rib, and then cut through underlying periosteum; to gain access to the thoracic cavity
Term
what hazard does cartilagenous ribs pose to children?
Definition
the ribs can compress a lot possibly damaging underlying organs
Term
which ribs are the least/most likely to be broken and why?
Definition
rib 1 is least likely because of its shape and it is protected by the clavicle, ribs 2 through 7 are the most likely to be broken anterior to the angle (lateral portion)
Term
what is a flail chest?
Definition
caused by multiple rib fractures which causes an inward movement of the fractured rib during breathing
Term
what should be considered during chest x rays in the elderly?
Definition
ossification of the costal cartilage can resemble the appearance of a tumor
Term
what bone is commonly used for bone marrow extract due to its easy access?
Definition
sternum
Term
what bone fracture is associated with a 25-45% mortality rate and why?
Definition
the sternum, because it is anterior to the heart
Term
name the external muscles of the thoracic wall.
Definition
the pectoralis major, pectoralis minor, serratus anterior, posterior-superior serratus, trapezius, latissimus dorsi, levator scapulae, and major and minor rhomboids
Term
name the internal muscles of the thoracic wall.
Definition
external intercostals, internal intercostals, innermost intercostals, and the transversus thoracis
Term
what functions do the external, internal, and innermost intercostals and the transversus thoracis perform?
Definition
the externals and the innermost intercostals elevate the thorax during inspiration, and the internal intercostal and transversus thoracis depress the thorax during forced exhalation
Term
where do the vascular and nervous tissue run in the thoracic wall and how are they protected?
Definition
from the spinal column anteriorly between the internal and innermost intercostals, by the intercostal groove on the inferior side of the ribs
Term
what are the collaterals and where are they located?
Definition
they are the second set of arteries, veins, and nerves running through the intercostal space superior to the rib
Term
what three diameters are expanded during inspiration?
Definition
superior to inferior, anterior to posterior, and transverse
Term
define eupnea.
Definition
quiet inspiration
Term
what is the difference between deep and shallow breathing?
Definition
deep is also called diaphragmatic and shallow is called costal, refers to muscles used
Term
what type of breathing is increasingly used by pregnant women due to pressure on abdominal viscera?
Definition
costal (or shallow) because diaphragm is impeded
Term
define hypernea.
Definition
forced breathing, active inspiration and exhalation
Term
define agonal breathing.
Definition
utilizing every muscle possible for breathing, dying breathe
Term
what four regions make up the thorax and what land marks separate them?
Definition
superior, anterior inferior, middle inferior, and posterior inferior mediastinum; the sternal angle (angle of louis) to T5 divides superior to inferior, the pericardium divides anterior, middle, and posterior
Term
what surface feature resides at the 4th intercostal space?
Definition
the nipple
Term
what vertebra does the suprasternal notch align with?
Definition
T2/3
Term
what vertebra does the xiphisternal joint align with?
Definition
T9
Term
where can the apex beat of the heart be found?
Definition
5th intercostal space, mid clavicular line (under nipple)
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