Term
What are the anterior, posterior, inferior, lateral and superior boundaries of the Thorax? |
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Definition
| sternum, vertebral column, diaphragm, Ribcage, no superior boundary-the superior thoracic aperture is open, allowing continuity with the neck |
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Term
| What are the Subdivisions of the thoracic cavity |
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Definition
Subdivided into three major compartments: - a left and a right pleural cavity, each surrounding a lung;
- mediastinum.
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Term
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Definition
| The mediastinum is a thick, flexible soft tissue partition oriented longitudinally in a median sagittal position. It contains the heart, esophagus, trachea, major nerves, and major systemic blood vessels | |
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Term
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Definition
Completely separated from each other by the mediastinum.
abnormal events in one pleural cavity do not necessarily affect the other cavity. the mediastinum can be entered surgically without opening the pleural cavities. they extend above the level of rib I.
The apex of each lung actually extends into the root of the neck.
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Term
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Definition
- Breathing-Up&down movements of the diaphragm and changes in the lateral and anterior dimensions of the thoracic wall,alter the volume of the thoracic cavity
- Protection of vital organs-houses and protects the heart, lungs, and great vessels and because of the domed shape of the diaphragm, the thoracic wall also offers protection to some important abdominal viscera eg.Liver,stomach and spleen.
- Conduit- mediastinum acts as a conduit for structures that pass completely through the thorax from one body region to another and for structures that connect organs in the thorax to other body regions eg. esophagus, vagus nerves, and thoracic duct course between the abdomen and neck,phrenic nerves, which originate in the neck, penetrate and supply the diaphragm and the trachea, thoracic aorta, and superior vena cava course within the mediastinum en route to and from major visceral organs in the thorax
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Term
What are the componenets of the Thorax? |
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Definition
- Thoracic Wall
- Superior Thoracic Cavity
- Inferior thoracic aperature
- Diaphram
- Mediastinum
- Pleural Cavities
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Term
| What are the posterior, anterior and lateral boundaries of the thoracic wall? |
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Definition
The thoracic wall consists of skeletal elements and muscles: - posteriorly, it is made up of twelve thoracic vertebrae and their intervening intervertebral discs;
- laterally, the wall is formed by ribs (twelve on each side) and three layers of flat muscles, which span the intercostal spaces between adjacent ribs, move the ribs and provide support for the intercostal spaces;
- anteriorly, the sternum, which consists of the manubrium of sternum, body of sternum, and xiphoid process
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Term
| What are the posterior, anterior and lateral boundaries of the superior thoracic aperature? |
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Definition
- Posteriorly-Body of T1 vertebra
- Laterally-Medial margin of Rib 1 and its costal cartilage.Since the first ribs slope inferiorly from their posterior articulation with vertebra TI to their anterior attachment to the manubrium,the plane of the superior thoracic aperture is at an oblique angle, facing somewhat anteriorly.
- Anterior-Superior margin of the Manubrium which is in approximately the same horizontal plane as the intervertebral disc between vertebrae TII and TIII
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Term
| What closes the Inferior thoracic aperature? |
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Definition
| The inferior thoracic aperture is closed by the diaphragm, and structures passing between the abdomen and thorax pierce or pass posteriorly to the diaphragm |
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Term
| What are the skeletal elements of the inferior thoracic aperature? |
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Definition
- Posteriorly - the body of vertebra TXII ;
- Posterolaterally - rib XII and the distal end of rib XI ;
- Anterolaterally- the distal cartilaginous ends of ribs VII to X, which unite to form the costal margin ;
- Anteriorly - the xiphoid process
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Term
| Describe the anatomy of the Diaphram? |
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Definition
- The diaphragm seals the inferior thoracic aperture
- Muscle fibers of the diaphragm arise radially, from the margins of the inferior thoracic aperture, and converge into a large central tendon.
- Because of the oblique angle of the inferior thoracic aperture, the posterior attachment of the diaphragm is inferior to the anterior attachment.
- The diaphram 'balloons' superiorly, on both the right and left sides, to form domes. The right dome is higher than the left, reaching as far as rib V.Upon contraction the height of the domes decreases and the volume of the thorax increases.
- The esophagus and inferior vena cava penetrate the diaphragm; the aorta passes posterior to the diaphragm.
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Term
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Definition
It is the central compartment of the thoracic cavity. |
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Term
| What are the anterior, posterior, inferior, lateral and superior boundaries of the mediastinum? |
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Definition
| sternum, vertebral column, diaphragm, medial border or boundaries of the lungs, no superior boundary |
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Term
| What are the four lesser spaces of the mediastinum |
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Definition
| superior, anterior, posterior, and middle |
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Term
| Which of the four lesser spaces of the mediastinum does the heart occupy |
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Definition
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Term
Where does the anterior and posterior mediastinum lie? |
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Definition
between the sternum and the pericardium between the pericardium and thoracic vertebrae |
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Term
| Where does the pleural cavity lie and what lines this cavity? |
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Definition
The two pleural cavities are situated on either side of the mediastinum and each pleural cavity is completely lined by a mesothelial membrane called the pleura. |
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Term
| What are the right and left pleural cavities |
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Definition
| the space between the visceral and parietal pleura |
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Term
| What is the visceral pleura and what does it surround? |
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Definition
| a serous epithelial membrane that lines the lungs |
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Term
| What is the parietal pleura and what does it line |
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Definition
| a serous epithelial membrane that lines the internal aspect of the thoracic wall and the superior aspect of the diaphragm |
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Term
| What is the space between two pleura called |
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Definition
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Term
| T/F: the diaphragmatic pleura is a visceral pleura |
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Definition
| false, it is a parietal pleura |
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Term
| A pleural cavity is the... |
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Definition
| space between the two lungs |
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Term
| Does the costal pleura go all the way accross the top of the chest? |
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Definition
| no, it goes to bidline and attaches to the pericardial sac so there are two separate pleural cavities |
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Term
| T/F: Parietal pleura is continuous with itself and visceral pleura at the root of the lung |
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Definition
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Term
| T/F: The serous membrane is continuous with itself |
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Definition
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Term
| T/F: The serous membrane contains fluid |
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Definition
| true, the fluid acts as a lubricant produce a minimized frictionless system |
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Term
| How does the Thorax relate to the Neck? |
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Definition
- superior thoracic aperture opens directly into the root of the neck
- superior aspect of each pleural cavity extends approximately 2-3 cm above rib I and the costal cartilage into the neck
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Term
| How does the Thorax relate to the Upper limbs? |
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Definition
An axillary inlet, or gateway to the upper limb, lies on each side of the superior thoracic aperture. These two axillary inlets and the superior thoracic aperture communicate superiorly with the root of the neck |
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Term
| What forms the Axillary inlet? |
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Definition
- Posteriorly the superior margin of the scapula ;
- Anteriorly the clavicle ;
- Medially the lateral margin of rib I
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Term
| What is the path of large blood vessels from the axillary inlet to the Thorax? |
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Definition
Large blood vessels passing between the axillary inlet and superior thoracic aperture do so by passing over rib I. |
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Term
| What are and how do structures pass from the thorax and into the abdomen? |
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Definition
The diaphragm separates the thorax from the abdomen.Structures that pass between the thorax and abdomen either penetrate the diaphragm or pass posteriorly to it. - the inferior vena cava pierces the central tendon of the diaphragm to enter the right side of the mediastinum near vertebral level TVIII;
- the esophagus penetrates the muscular part of the diaphragm to leave the mediastinum and enter the abdomen just to the left of the midline at vertebral level TX;
- the aorta passes posteriorly to the diaphragm at the midline at vertebral level TXII;
- numerous other structures that pass between the thorax and abdomen pass through or posterior to the diaphragm
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Term
| How does the breast relate to the thoracic cavity? |
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Definition
- They are in the pectoral region on each side of the anterior thoracic wall
- Branches from the internal thoracic arteries and veins perforate the anterior chest wall on each side of the sternum to supply anterior aspects of the thoracic wall. Those branches associated mainly with the second to fourth intercostal spaces also supply the anteromedial parts of each breast.
- Lymphatic vessels from the medial part of the breast accompany the perforating arteries and drain into the parasternal nodes on the deep surface of the thoracic wall
- Vessels and lymphatics associated with lateral parts of the breast emerge from or drain into the axillary region of the upper limb
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Term
| Describe the Lymphatic drainage if the Breast? |
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Definition
- vessels and lymphatics associated with lateral parts of the breast emerge from or drain into the axillary region of the upper limb;
- lateral and anterior branches of the fourth to sixth intercostal nerves carry general sensation from the skin of the breast.
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Term
| What nerves carry the general sensation from the skin of the Breast? |
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Definition
| Lateral and anterior branches of the fourth to sixth intercostal nerves carry general sensation from the skin of the breast. |
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Term
| What is the sternal angle and what are the characteristics of the transverse plane that passes through it? |
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Definition
Is the junction between the manubrium and the body of the sternum.
A horizontal passing through the disc that separates thoracic vertebrae TIV and TV plane and the sternal angle marks the position of the anterior articulation of the costal cartilage of rib II with the sternum.
This plane also serves to: 1.separates the superior mediastinum from the inferior mediastinum and marks the position of the superior limit of the pericardium; 2.marks where the arch of the aorta begins and ends; 3.passes through the site where the superior vena cava penetrates the pericardium to enter the heart; 4.is the level at which the trachea bifurcates into right and left main bronchi; 5.marks the superior limit of the pulmonary trunk. |
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Term
| What are the components of the Pectoral region? |
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Definition
- a superficial compartment containing skin, superficial fascia, and breasts; and
- a deep compartment containing muscles and associated structures.
Note that : | Nerves, vessels, and lymphatics in the superficial compartment emerge from the thoracic wall, the axilla, and the neck | |
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Term
| What are the components if the Breast? |
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Definition
| mammary glands and associated skin and connective tissues |
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Term
| What are the mammary glands? |
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Definition
- The mammary glands are modified sweat glands in the superficial fascia anterior to the pectoral muscles and the anterior thoracic wall
- The mammary glands consist of a series of ducts and associated secretory lobules which converge to form 15 to 20 lactiferous ducts,that open independently onto the nipple.
- The nipple is surrounded by a circular pigmented area of skin termed the areola.
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Term
| What surrounds the ducts and lobules of the mammary glands? |
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Definition
- a well-developed, connective tissue stroma.
- In certain regions, this stroma condenses to form well-defined ligaments, the suspensory ligaments of breast, which are continuous with the dermis of the skin and support the breast
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Term
| Where is the breast located? |
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Definition
- lies on deep fascia related to the pectoralis major muscle and other surrounding muscles.2/3 lies on the fasia of the pectoralis major whereas the other 1/3 rest on the fascia covering the serratus anterior.
- A layer of loose connective tissue (the retromammary space) separates the breast from the deep fascia and provides some degree of movement over underlying structures.
- base, or attached surface, of each breast extends vertically from ribs II to VI, and transversely from the sternum to as far laterally as the midaxillary line.
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Term
| What is the arterial supply to the breast? |
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Definition
Occurs via multiple routes: - laterally, vessels from the axillary artery-superior thoracic, thoracoacromial, lateral thoracic, and subscapular arteries;
- medially, branches from the internal thoracic artery originating from the subclavian vein;
- the second to fourth intercostal arteries via branches that perforate the thoracic wall and overlying muscle
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Term
| What is the venous drainage of the breast? |
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Definition
The Venous drainage of the breast is mainly to ihe axillary vein , but there is some drainage to the internal thoracic vein and intercostal veins |
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Term
| What is the innervation of the breast? |
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Definition
- anterior and lateral cutaneous branches of the second to sixth intercostal nerves.
- The nipple is innervated by the fourth intercostal nerve
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Term
| What is the lymphatic drainage of the breast? |
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Definition
Lymphatic drainage of the breast is as follows: - approximately 75% is via lymphatic vessels that drain laterally and superiorly into axillary nodes
- most of the remaining drainage is into parasternal nodes deep to the anterior thoracic wall and associated with the internal thoracic artery;
- some drainage may occur via lymphatic vessels that follow the lateral branches of posterior intercostal arteries and connect with intercostal nodes situated near the heads and necks of ribs
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Term
| Where does the axillay node,parasternal node and intercotal node drain into? |
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Definition
Axillary nodes - subclavian trunks Parasternal nodes - bronchomediastinal trunks Intercostal nodes - thoracic duct or into the bronchomediastinal trunks |
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Term
| What is the clavipectoral fascia? |
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Definition
| A continuous layer of deep fascia, that encloses subclavius and pectoralis minor and attaches to the clavicle above and to the floor of the axilla below. | |
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Term
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Definition
ORIGIN:Rib I at junction between rib and costal cartilage INSERTION:Groove on inferior surface of middle third of clavicle ACTION:Pulls clavicle medially to stabilize sternoclavicular joint NERVES: Nerve to the subclavius |
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Term
| What are the limits of extension of the Thoracic wall? |
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Definition
It extends between: - the superior thoracic aperture bordered by vertebra TI, rib I, and the manubrium of sternum; and
- the inferior thoracic aperture bordered by vertebra TXII, rib XII, the end of rib XI, the costal margin, and the xiphoid process of sternum
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Term
| What are the sites for articulation of the thoracic vertebra with the ribs? |
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Definition
A typical thoracic vertebra has three sites on each side for articulation with ribs: - two demifacets (i.e. partial facets) are located on the superior and inferior aspects of the body for articulation with corresponding sites on the heads of adjacent ribs. The superior costal facet articulates with part of the head of its own rib, and the inferior costal facet articulates with part of the head of the rib below;
- an oval facet (transverse costal facet) at the end of the transverse process articulates with the tubercle of its own rib
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Term
| What thoracic vertebraes are exception to the rules of articulation? |
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Definition
TI-the superior costal facets on the body of vertebra are complete and articulate with a single facet on the head of its own rib-in other words, the head of rib I does not articulate with vertebra CVII; TX (and often TIX) - articulates only with its own ribs and therefore lacks inferior demifacets on the body; TXI and TXII- articulate only with the heads of their own ribs-they lack transverse costal facets and have only a single complete facet on each side of their bodies. |
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Term
| What are the parts of the typical ribs? |
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Definition
- Typical ribs are ribs 3 through 9, each of which has a head, neck, tubercle, and body (shaft).
- The head is wedged shaped with two articular surfaces separated by a crest. The smaller superior surface articulates with the inferior costal facet on the body of the vertebra above, while the larger inferior facet articulates with the superior costal facet of its own vertebra
- The neck is a short flat region of bone that separates the head from the tubercle.
- The tubercle occuring at the junction of head and shaft,has two regions, an articular part for articulation with a corresponding transverse process of the associated vertebra and non-articular part for attachment of costo-transverse ligament.
- Shaft that is thin and curved most markedly at the costal angle where the rib rums amerolaterally; the concave internal surface has a costal groove thai protects the intercostal nerve and vessels.
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Term
| What are the different types of ribs? |
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Definition
True Ribs Are the first seven ribs (ribs 1 to 7), which are attached to the sternum by their costal cartilages. False Ribs Are the lower five ribs (ribs 8 to 12); ribs 8 to 10 are connected to the costal cartilages immediately above them to form the anterior costal margin. Floating Ribs
Are the last two ribs (ribs 11 and 12), which are connected only to the vertebrae. |
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Term
| What are the distincitive features of Rib 1 |
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Definition
- Flat in the horizontal plane and has broad superior and inferior surfaces
- Broadest and shortest of the true ribs
- Has a single articular facet on its head, which articulates with the first thoracic vertebra.
- Has a scalene tubercle for the insertion of the anterior scalene muscle and two grooves for the subclavian artery and vein.
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Term
| What are the distincitive features of Rib 2 |
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Definition
- Has two articular facets on its head, which articulate with the bodies of the first and second thoracic vertebrae.
- Is about twice as long as the first rib.
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Term
| What are the distincitive features of Rib 10 |
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Definition
- Has a single articular facet on its head, which articulates with the tenth thoracic vertebra.
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Term
| What are the distincitive features of Rib 11 and 12 |
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Definition
- Have a single articular facet on their heads.
- Have no neck or tubercle
- Both ribs are short, have little curve, and are pointed anteriorly
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Term
| What are the parts of the sternum? |
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Definition
Consist of 3 parts: - Manubrium
- Body
- Xiphoid process
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Term
Describe the Manubrium? What is found on its superior margin,on each of its sides and on itslower end? |
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Definition
- Has a superior margin, the jugular notch, which can be readily palpated at the root of the neck.
- Has a clavicular notch on each side for articulation with the clavicle.
- Also articulates with the cartilage of the first rib, the upper half of the second rib, and the body of the sternum at the manubriosternal joint, or sternal angle.
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Term
Describe the body of the Sternum? What costal cartilages does it articulate with? What are its other poinst of articulation? |
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Definition
Articulates with the second to seventh costal cartilages. Also articulates with the xiphoid process at the xiphisternal joint, which is level with the ninth thoracic vertebra.
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Term
Describe the xiphoid process? |
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Definition
- smallest part of the sternum.
- Variable shape is variable: it may be wide, thin, pointed, bifid, curved, or perforated.
- Cartilaginous structure at birth, which becomes ossified in the adult.
- On each side of its upper lateral margin is a demifacet for articulation with the inferior end of the seventh costal cartilage.
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Term
| List the joins found in the Thorax? |
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Definition
- Costovertebral joints
- Costotransverse joints
- Sternocostal joints
- Interchondral joints
- Manubriosternal and xiphisternal joints
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Term
| Describe the Costovertebral joint? |
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Definition
Subdivides into two separate joints with regards to the articulation of the ribs with the vertebra.They are: the bodies of adjacent vertebrae, forming a joint with the head of the rib; the transverse process of its related vertebra, forming a costotransverse joint
The costovertebral joints and related ligaments allow the necks of the ribs either to rotate around their longitudinal axes, which occurs mainly in the upper ribs, or to ascend and descend relative to the vertebral column, which occurs mainly in the lower ribs.Essential for breathing. |
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Term
| Costovertebral joint-Describe the costotransverse joint? |
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Definition
- synovial joints between the tubercle of a rib and the transverse process of the related vertebra.
- The capsule surrounding each joint is thin.
- Slight gliding movements occur in this joint.
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Term
| Costovertebral joint-Describe the joint with head of the rib? |
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Definition
- The two facets on the head of the rib articulate with the superior facet on the body of its own vertebra and with the inferior facet on the body of the vertebra above
- Joint is divided into two synovial compartments by an intra-articular ligament, which attaches the crest to the adjacent intervertebral disc.
- The two synovial compartments and the intervening ligament are surrounded by a single joint capsule attached to the outer margins of the combined articular surfaces of the head and vertebral column
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Term
| How is the costotransverse joint stabilized? |
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Definition
stabilized by two strong extracapsular ligaments from the transverse process to the rib on the medial and lateral sides of the joint: - the costotransverse ligament is medial to the joint and attaches the neck of the rib to the transverse process
- the lateral costotransverse ligament is lateral to the joint and attaches the tip of the transverse process to the roughened nonarticular part of the tubercle of the rib
A third ligament, the superior costotransverse ligament, attaches the superior surface of the neck of the rib to the transverse process of the vertebra above |
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Term
| Describe the Sternocostal joints? |
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Definition
- Are synchondroses in which the sternum articulates with the first seven costal cartilages.
- The joint between rib I and the manubrium is a fibrocartilaginous connection between the manubrium and the costal cartilage. The 2nd to 7th joints are synovial and have thin capsules reinforced by surrounding sternocostal ligaments.
- joint between the 2nd costal cartilage and the sternum is divided into two compartments by an intra-articular ligament which attaches the 2nd costal cartilage to the junction of the manubrium and the body of the sternum.
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Term
| What type of joins are found in the sternocostal joints? |
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Definition
The joints between rib 1 and the manubrium is fibrocartilaginous whereas the remaining 2nd-7th ate synovial. |
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Term
Where are the Interchondral joints found? What purpose do they serve? What type of joints are they? |
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Definition
- Occur between the costal cartilages of adjacent ribs, mainly between the costal cartilages of ribs VII to X, but may also involve the costal cartilages of ribs V and VI.
- Provide indirect anchorage to the sternum and contribute to the formation of a smooth inferior costal margin
- Synovial
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Term
| Describe the arrangement of vessels and nerves in the costal groove? |
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Definition
From superior to inferior- Vein,Artery,Nerve - The vein is the most superior structure and is therefore highest in the costal groove.
- The artery is inferior to the vein, and the nerve is inferior to the artery and often not protected by the groove.
- Small collateral branches of the major intercostal nerves and vessels are often present superior to the inferior rib below.
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Term
| What structures bring milk and other lubricants from the mammary glandular tissue to the surface of the nipple? |
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Definition
| Lactiferous ducts that empty into lactiferous sinuses. |
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Term
| What surrounds and applies to the pectoralis minor mm.? The pectoralis major mm.? The subclavius mm.? |
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Definition
1. clavipectoral fascia 2. pectoral fascia 3. clavipectoral fascia |
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Term
External intercostal -Superior attachment -Inferior attachment -Innervation -Function |
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Definition
Superior attachment:Inferior margin of rib above Inferior attachment:Superior surface of rib below Innervation:Intercostal nerves; T1-T11 Function:Most active during inspiration; supports intercostal space; moves ribs superiorly |
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Term
Internalintercostal -Superior attachment -Inferior attachment -Innervation -Function |
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Definition
Superior attachment:Lateral edge of costal groove of rib above Inferior attachment:Superior surface of rib below deep to the attachment of the related external intercostals Innervation:Intercostal nerves; T1-T11 Function:Most active during exspiration; supports intercostal space; moves ribs inferiorly |
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Term
Subcostales -Superior attachment -Inferior attachment -Innervation -Function |
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Definition
Superior attachment:Internal surface (near angle) of lower ribs Inferior attachment:Internal surface of second or third rib below Innervation:Related Intercostal nerves Function:May depress ribs. |
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Term
Transversus thoracis -Superior attachment -Inferior attachment -Innervation -Function |
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Definition
Superior attachment:Lower margins and internal surfaces of cocostal cartilages of second to sixth ribs. Inferior attachment:Inferior aspect of deep surface of body of sternum, xiphoid process and costal cartilages ribs IV-VII Innervation:Related Intercostal nerves Function:Depresses costal cartilages |
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Term
Innermost intercostal -Superior attachment -Inferior attachment -Innervation -Function |
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Definition
Superior attachment:Medial edge of costal groove of rib above. Inferior attachment:Internal aspect of superior surface of rib below Innervation:Intercostal nerves; T1-T11 Function: Acts with internal intercostals muscles |
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Term
How many external Intercostals are there? How are the muscles positioned? When is it most active? |
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Definition
- Eleven pairs
- Obliquely anteroinferiorly,when thoracic wall is viewed from a lateral position
- Inspiration
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Term
| What is the external intercostal membrane? |
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Definition
| a thin connective tissue aponeurosis that serves as the continuation of the extarnal intercostal |
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Term
How many internal Intercostals are there? How are the muscles positioned? When is it most active? |
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Definition
- Eleven pairs
- The muscle fibers pass in the opposite direction to those of the external intercostal muscles.When the thoracic wall is viewed from a lateral position, the muscle fibers pass obliquely posteroinferiorly.
- Expiration.
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Term
How are Innermost internal Intercostals muscles positioned? Where are they found? |
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Definition
- fibers have the same orientation as the internal intercostals
- most evident in the lateral thoracic wall
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Term
How are Subcostales positioned? How are there fibers postioned? Where are they found?
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Definition
- Subcostales are in the same plane as the innermost intercostals.They extend from the internal surfaces of one rib to the internal surface of the second or third rib below.
- fibers parallel the course of the internal intercostal muscles and extend from the angle of the ribs to more medial positions on the ribs below.
- span multiple ribs and are more numerous in lower regions of the posterior thoracic wall.
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Term
What is the arterial supply of the thoracic wall? Where are they found? Where does it originate from? |
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Definition
- posterior and anterior intercostal arteries
- pass around the wall between adjacent ribs in intercostal spaces
- originate from the aorta and internal thoracic arteries.
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Term
Where does the Internal thoracic artery arise from? Where is it found? |
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Definition
- First part of the subclavian artery
- Descends directly behind the first six costal cartilages, just lateral to the sternum.
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Term
How many arteries supply the intercostal space? What are these arteries? |
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Definition
3 A large posterior intercostal artery (and its collateral branch) and a small pair of anterior intercostal arteries: - one passes below the margin of the upper rib;
- the other passes above the margin of the lower rib and meets a collateral branch of the posterior intercostal artery
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Term
How many posterior intercostal arteries are there? Where do they originate from? What is their course? What is their distribution? |
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Definition
9 pairs Origin:Superior intetcostal artery (intercostal spaces 1 and 2) and thoracic aorta (Remaining intercostal spaces) Course:Pass between internal and innermost intercostal muscles.It also has branches that accompany lateral cutaneous branches of the intercostal nerves to superficial regions. Distribution:lntercostal muscles and overlying kin, parietal pleura |
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Term
How many anterior intercostal arteries are there? Where do they originate from? What is their course? What is their distribution? |
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Definition
12 small arteries, 2 in each of the upper six intercostal spaces that run laterally, 1 each at the upper and lower borders of each space. The upper artery in each intercostal space anastomoses with the posterior intercostal artery, and the lower one joins the collateral branch of the posterior intercostal artery. ORIGIN:Intenal thoracic (intercostal spaces 1-6) and musculophrenic arteries (intercostal
spaces 7-9) COURSE: DISTRIBUTION: |
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Term
What is the path of venous drianage of the Thoracic Cavity? Describe its course? Centrally? Upper posterior intercostal V (R&L sides)? |
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Definition
PATH:Parallels the pattern of arterial supply COURSE: 1.Centrally, intercostal veins --> the azygos system of veins or into internal thoracic veins ----> the brachiocephalic veins in the neck. 2.Upper posterior intercostal veins ( left side) join to create left superior intercostal vein -----> left brachiocephalic vein. 3.Upper posterior intercostal veins (right side) join to create right superior intercostal vein,---> azygos vein
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Term
| Describe the outline for lymphatic drainage of the thoracic wall and provide an outline of its path |
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Definition
- Lymph nodes associated with the internal thoracic arteries (parasternal nodes), with the heads and necks of ribs (intercostal nodes), and with the diaphragm (diaphragmatic nodes)
- Parasternal nodes --> bronchomediastinal trunks.
- Intercostal nodes (Upper thorax) -->bronchomediastinal trunks,
- Intercostal nodes (lower thorax) --> thoracic duct.
- Diaphragmatic nodes interconnect with parasternal, prevertebral, juxta-esophageal nodes, brachiocephalic and lateral aortic (in the abdomen) nodes
- Superficial regions of wall ---> axillary lymph nodes in the axilla or parasternal nodes.
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Term
| List the peripheral attachments of the diaphram? |
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Definition
- the xiphoid process of the sternum;
- the costal margin of the thoracic wall;
- the ends of ribs XI and XII;
- ligaments that span across structures of the posterior abdominal wall; and
- vertebrae of the lumbar region.
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Term
| T/F :The pericardium is not attached to the diaphram? |
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Definition
False pericardium is attached to the middle part of the central tendon |
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Term
| List the structures that pass through or around the diaphram form the thorax into the abdomen? |
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Definition
- the inferior vena cava passes through the central tendon at approximately vertebral level TVIII;
- the esophagus passes through the muscular part of the diaphragm, just to the left of midline, approximately at vertebral level TX;
- the vagus nerves pass through the diaphragm with the esophagus;
- the aorta passes behind the posterior attachment of the diaphragm at vertebral level TXII;
- the thoracic duct passes behind the diaphragm with the aorta;
- the azygos and hemiazygos veins may also pass through the aortic hiatus or through the crura of the diaphragm
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Term
| What is the arterial supply of the diaphram and list these vessels. |
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Definition
- from vessels that arise superiorly and inferiorly to it
- Superiorly the pericardiacophrenic and musculophrenic arteries which are branches of the internal thorarcic supply the diaphragm.
- Superior phrenic arteries, which arise directly from lower parts of the thoracic aorta, and small branches from intercostal arteries contribute to the supply
- Inferiorly it is supplied by the inferior phrenic arteries, which branch directly from the abdominal aorta.
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Term
| What do the veins of the diaphram drain into? |
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Definition
- the brachiocephalic veins in the neck;
- the azygos system of veins; or
- abdominal veins (left suprarenal vein and inferior vena cava)
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Term
| What are the superior,inferior and medial walls of the pleural cavity? |
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Definition
- superiorly, they extend above rib I into the root of the neck;
- inferiorly, they extend to a level just above the costal margin;
- Medially,the medial wall of each pleural cavity is the mediastinum
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Term
| What are the different names of the Parietal Pleura? |
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Definition
- pleura related to the ribs and intercostal spaces is termed the costal part;
- pleura covering the diaphragm is the diaphragmatic part;
- pleura covering the mediastinum is the mediastinal part;
- the dome-shaped layer of parietal pleura lining the cervical extension of the pleural cavity is cervical pleura (dome of pleura or pleural cupola).
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Term
| What is the root of the Lung? |
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Definition
| mediastinal pleura which reflects off the mediastinum as a tubular, sleeve-like covering for structures (i.e. airway, vessels, nerves, lymphatics), that pass between the lung and mediastinum |
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Term
| T/F : The diaphram is innervated by the intercostal nerves? |
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Definition
| F:The diaphram is innervated by the phrenic nerves (C3 to C5) at the abdominal surface |
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Term
| T/F :The Costal Pleura is separated from the internal surface of the thoracic wall (Ribs, sternum,costal cartilages,intercostal muscles,and sides of the thoracic vertebrae) by the endothoracic fascia? |
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Definition
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Term
What are the lines of pleural reflection? List the lines of pleural refection? |
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Definition
- relatively abrupt lines along which the parietal pleura changes direction from one wall of the pleural cavity to another.
- Sternal line of pleural reflection -where the costal pleura becomes the mediastinal pleura.
- Costal line of pleural reflection- where the costal pleura becomes the diaphragmatic pleura.
- Vertebral line of pleural reflection- where the costal pleura becomes the mediastinal pleura posteriorly.
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Term
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Definition
- The pleural recesses are potential spaces within the thoracic cavity where, particularly in expiration, the visceral and parietal pleura are relatively opposed.
- the recesses provides potential spaces in which fluids can collect and from which fluids can be aspirated.
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Term
| List the different types of pleural recess and describe them? |
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Definition
- Costomediastinal recess occurs on each side where costal pleura is opposed to mediastinal pleura.
- Costodiaphragmatic recesses, which occur in each pleural cavity between the costal pleura and diaphragmatic pleura.It is the largest and clinically most important recesses and also the deepest after forced expiration and shallowest after forced inspiration.
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Term
| How many lobes does each lung have? |
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Definition
Right Lung - 3 Left Lung - 2 |
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Term
What are the base, apex,surfaces and borders of the Lung? |
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Definition
- The base sits on the diaphragm.
- The apex projects above rib I and into the root of the neck.
- The two surfaces-the costal surface lies immediately adjacent to the ribs and intercostal spaces of the thoracic wall. The mediastinal surface lies against the mediastinum anteriorly and the vertebral column posteriorly and contains the comma-shaped hilum of the lung through which structures enter and leave.
- The three borders-the inferior border of the lung is sharp and separates the base from the costal surface. The anterior and posterior borders separate the costal surface from the medial surface. Unlike the anterior and inferior borders, which are sharp, the posterior border is smooth and rounded.
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Term
| What is the hilum of the Lung? |
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Definition
| where the structures which form the root of the lung enter and leave the viscus.It is outlined by mediastinal pleura. |
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Term
| What structures are located in each root and hilum of the Lung? |
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Definition
- a pulmonary artery;
- two pulmonary veins;
- a main bronchus;
- bronchial vessels;
- nerves; and
- lymphatics.
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Term
| How many fissures does the right Lung have? |
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Definition
- oblique fissure separates the inferior lobe (lower lobe) from the superior lobe and the middle lobe of the right lung;
- horizontal fissure separates the superior lobe (upper lobe) from the middle lobe
Is divided into upper, middle, and lower lobes by the oblique and horizontal (accessory) fissures |
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Term
What structures lie on the medial surface of the Right lung? What structures lie on the superior lobe of the Right lung? |
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Definition
- the heart,
- inferior vena cava,
- superior vena cava,
- azygos vein,
- esophagus
The right subclavian artery and vein arch over and are related to the superior lobe of the right lung as they pass over the dome of cervical pleura and into the axilla |
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Term
How may fissures does the left lung have? What structures lie adjacent to the medial structures of the left Lung? What structures lie on the superior lobe of the Right lung? |
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Definition
1- oblique fissure - the heart,
- aortic arch,
- thoracic aorta,
- esophagus.
The left subclavian artery and vein arch over and are related to the superior lobe of the left lung |
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Term
| Describe the path of the Trachea form the geginning to its bifurcation including a description of its characteristics. |
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Definition
- Begins at the inferior border of the cricoid cartilage (C6) as a continuation of the larynx and ends by bifurcating into the right and left main stem bronchi at the level of the sternal angle (junction of T4 and T5).
- Is about 9 to 15 cm in length and has 16 to 20 incomplete hyaline cartilaginous rings that open posteriorly toward the esophagus and prevent the trachea from collapsing.
- the carina, a downward and backward projection of the last tracheal cartilage, which lies at the level of the sternal angle and forms a keel-like ridge separating the openings of the right and left main bronchi
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Term
| T/F:The left main bronchus is wider and takes a more vertical course through the root and hilum than the right main bronchus |
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Definition
False: -The right main bronchus is wider and takes a more vertical course through the root and hilum than the left main bronchus inhaled foreign bodies tend to lodge more frequently on the right side than on the left |
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Term
| Describe the branching of the Bronchus? |
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Definition
- Main bronchus--->lobar bronchi (secondary bronchi) (each of which supplies a lobe)
Note: On the right side, the lobar bronchus to the superior lobe originates within the root of the lung. - lobar bronchi ---> segmental bronchi (tertiary bronchi)----> bronchopulmonary segments---> multiple generations of divisions ---->bronchioles
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Term
| What is the smallest functionally independent region of a lung and what are its constituents? |
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Definition
| Bronchopulmonary segment is the smallest functionally independent region of a lung and it is the area of lung supplied by a segmental bronchus and its accompanying pulmonary artery branch |
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Term
| How many Lobar and segmental Bronchi are found in each lung |
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Definition
Right lung has 3 lobar and 10 segmental bronchi Left lung has 2 lobar and 8 (or possibly 9 or 10) segmental bronchi. |
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Term
How many pulnonary arteries are there and describe the path of it? |
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Definition
2- Right and left R. Pulmonary (enters the root of the lung and gives off a large branch to the superior Artery lobe of the lung. The main vessel continues through the hilum of the lung, gives off a second (recurrent) branch to the superior lobe, and then divides to supply the middle and inferior lobes) Pulmonary Thrunk L. Pulmonary (shorter and narrower than the right pulmonary artery, and arches over the left \ Artery primary bronchus)
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Term
| What is the path of the Pulmonary Vein? |
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Definition
Leave the lung as five pulmonary veins, one from each lobe of the lungs. However, the right upper and middle veins usually join so that only four veins enter the left atrium as the superior pulmonary vein and an inferior pulmonary vein. |
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Term
Where does the Bronchial artery arise from? What functions do they serve? |
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Definition
thoracic aorta; usually there is one artery for the right lung and two for the left lung. Supply oxygenated blood to the nonrespiratory conducting tissues of the lungs and the visceral pleura. Anastomoses occur between the capillaries of the bronchial and pulmonary systems. |
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Term
| Where does the bronchial vein drain into? |
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Definition
- either the pulmonary veins or the left atrium; and
- into the azygos vein on the right or into the superior intercostal vein or hemiazygos vein on the left.
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Term
| Show the pathway of lymph drainage of the lung? |
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Definition
Superficial, or subpleural, and deep lymphatics of the lung ----> tracheobronchial nodes (roots of lobar and main bronchi and along the sides of the trachea)---->unite with similar vessels from parasternal nodes and brachiocephalic nodes ---->right and left bronchomediastinal trunks ---->deep veins at the base of the neck, or may drain into the right lymphatic trunk or thoracic duct. ---->- drains to |
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Term
| What organs are found within the mediastinum? |
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Definition
- thymus gland
- the pericardial sac
- the heart
- the trachea
- major arteries and veins
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Term
| What are the divisions of the mediastinum and hoiw are these divisions obtained? |
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Definition
A transverse plane extending from the sternal angle to the IV disc between vertebrae TIV and TV separates the mediastinum into: - superior mediastinum; and
- inferior mediastinum, which is further partitioned into the anterior, middle, and posterior mediastinum by the pericardial sac
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Term
| What are the boarders of the anterior,middle and the posterior mediastinum? |
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Definition
- Anterior mediastinum-area anterior to the pericardial sac and posterior to the body of the sternum
- Posterior mediastinum - area anterior to the pericardial sac and posterior to the body of the sternum
- Middle mediastinum - area in the middle, which includes the pericardial sac and its contents
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Term
| What organs are found within the Middle mediastinum? |
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Definition
- pericardium
- heart
- origins of the great vessels
- various nerves
- smaller vessels
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Term
What is the pericardium? What are the components of the pericardium? |
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Definition
Pericardium is a fibroserous sac surrounding the heart and the roots of the great vessels. It consists of two components : The fibrous pericardium and the serous pericardium |
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Term
What is the fibrous pericardium? What feature of the mediastium does it define? What are its attachemnts? |
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Definition
- Fibrous pericardium is a tough connective tissue outer layer
- Defines the boundaries of the middle mediastinum
- Blends with the adventitia of the roots of the great vessels and the central tendon of the diaphragm and anteriorly, it is attached to the posterior surface of the sternum by sternopericardial ligaments
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Term
| What are the parts of the serous pericardium? |
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Definition
- parietal layer lines the inner surface of the fibrous;
- visceral layer (epicardium) of serous pericardium adheres to the heart and forms its outer coverin (epicardium) and roots of the great vessels.
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Term
| T/F:The parietal layer of serous pericardium is not continuous with the visceral layers of serous pericardium? |
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Definition
False Parietal layer of serous pericardium is continuous with the visceral layers of serous pericardium around the roots of the great vessels and these reflections of serous pericardium occur in two location: - one superiorly, surrounding the arteries, the aorta and pulmonary trunk;
- the second more posteriorly, surrounding the veins, the superior and inferior vena cava and the pulmonary veins (oblique pericardial sinus)
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Term
| What is the purpose of the Transverse pericardial sinus? |
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Definition
Separates the arteries from the veins. Transverse pericardial sinus -Is a subdivision of the pericardial sac, lying posterior to the ascending aorta and pulmonary trunk, anterior to the SVC, and superior to the left atrium and the pulmonary veins |
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Term
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Definition
| b/w the parietal and visceral layers, slitlike cavity which contains a film of serous fluid to lubricate heart during beating |
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Term
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Definition
-functional blood supply of the heart, shortest circulation in the body -the arterial supply of the heart is provided by the right and left coronary arteries, arising from the aorta -left coronary artery runs to the left side of the heart divides into: the anterior interventricular artery (supplies blood to the interventricular sulcus, septum and anterior walls of the ventricles; and the circumflex artery:
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Term
| pathway of blood through the heart |
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Definition
pulmonary circulation
-o2 poor, co2 rich blood returns from body
-enters right atrium to right ventricle
-rt. v pumps to lungs via pulmonary trunk -blood unloads co2/picks up o2 in lungs -o2 blood carried up by pulmonary veins systemic circulation -back to left atrium, into left ventricle -pumped into aorta -transported via smaller systemic arteries to body tissues -gases & nutrients exhanged across capillary walls -blood now co2 rich/o2 poor goes thru systemic veins -enters right side of heart through venae cavae
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Term
| True or False- LV pumps more blood than RV? |
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Definition
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Term
| What is the difference between tricuspid valve and mitral valve? |
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Definition
| TV has three leaflets, MV has two leaflets. |
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Term
| What is the most superior valve of the heart? |
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Definition
| Pulmonic valve.It is also the most anterior. |
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Term
| What chamber has the thickest walls and why? |
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Definition
| LV.It has to pump blood all over the body, resisting a higher pressure. |
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Term
| How many corda tendanae are at TV,PV,MV,AV and what are the names of the muscles where they attach? |
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Definition
TV has three: Anterior Papillary Muscle, Posterior Papillary Muscle, Septal Papillary Muscle. PV- none........................................ MV- two: Anterolateral Papillary muscle, Posteromedial Papillary muscle. AV-none........................................ |
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Term
Which one is NOT a pulmonary valve cusp: a-Left b-Right c-Non d-Anterior |
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Definition
| Answer is c-Non. Non coronary cusp is a cusp of AV. |
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Term
| Coronary arteries fill primary during diastole or systole? |
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Definition
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Term
| LV is less trabeculated than RV.What is the main advantage of this? |
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Definition
| Not creating blood clogs. |
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Term
| 3 branches of aortic arch |
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Definition
| brachiochephalic trunk, left common carotid artery, left subclavian artery |
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Term
| Define systole and diastole? |
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Definition
- Systole- when heart contracts diastole- when heart relaxes
- Diastolic pressure refers to the lowest pressure within the arterial blood stream occurring during each heart beat. The other component of blood pressure is systolic pressure, which refers to the highest arterial pressure during each heart beat.
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Term
| Where is the heart located |
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Definition
| in the middle mediastinum, left of the midline |
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Term
| What is the tip of the heart called and with what ventricle and intercostal space does it correlate? |
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Definition
Apex the left 5th Intercostal space |
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Term
| T/F: The parietal serous layer is the thickest membrane of the pericardium |
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Definition
| False, it is a serous, thin membrane |
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Term
| T/F: the visceral serous layer of the pericardium attaches to the heart itself |
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Definition
| true, it is the innermost layer of the pericardium |
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Term
What is the outermost of the three layers of the heart What is the second layer of the heart? What is the innermost layer of the Heart? |
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Definition
Pericardium Myocardium-thickest layer of the heart Endocardium |
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Term
| What are the tree layers that make up the pericardium |
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Definition
| fibrous layer, parietal serous layer, and visceral serous layer |
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Term
What is the Coranary sulcus? What is the anterior and posterior interventricular sulci? |
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Definition
- a groove on the external surface of the heart, marks the division between the atria and the ventricles.
- The anterior and posterior interventricular sulci separate the two ventricles-the anterior interventricular sulcus is on the anterior surface of the heart and contains the anterior interventricular artery and the great cardiac vein, and the posterior interventricular sulcus is on the diaphragmatic surface of the heart and contains the posterior interventricular artery and the middle cardiac vein.
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Term
| The point at which the interventricular and interatrial sulci cross the coronary sulcus is referred to as? |
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Definition
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Term
| What vessels return blood to the right atrium? |
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Definition
- the superior and inferior venae cavae, which together deliver blood to the heart from the body;
- the coronary sinus, which returns blood from the walls of the heart itself.
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Term
| What is the Crista terminalis |
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Definition
- Is a vertical muscular ridge running anteriorly along the right atrial wall from the opening of the SVC to the opening of the IVC, providing the origin of the pectinate muscles.
- Represents the junction between the primitive sinus venarum (a smooth-walled region) and the right atrium proper and is indicated externally by the sulcus terminalis.
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Term
| What is the space posterior to the crista terminalis referred to as? |
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Definition
| Sinus Venarum (sinus venarum cavarum) |
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Term
What is the Right Auricle? What covers the Right Auricle? |
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Definition
- Is the conical muscular pouch of the upper anterior portion of the right atrium, which covers the first part of the right coronary artery.
- Its walls are covered by ridges called the musculi pectinati (pectinate muscles), which fan out from the crista like the 'teeth of a comb'
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Term
| Where is the right ventricle located? |
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Definition
| The right ventricle forms most of the anterior surface of the heart and a portion of the diaphragmatic surface |
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Term
| What are the names of the numerous muscular, irregular structures found on the inflow of the RV |
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Definition
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Term
| What are the Papillary muscles and what are the three that are found in the RV. |
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Definition
Papillary muscles are special trabeculae carneae which have have only one end attached to the ventricular surface, while the other end serves as the point of attachment for tendon-like fibrous cords (the chordae tendineae), which connect to the free edges of the cusps of the tricuspid valve. There are three papillary muscles in the right ventricle: - anterior papillary muscle is the largest and most constant papillary muscle, and arises from the anterior wall of the ventricle;
- the posterior papillary muscle may consist of one, two, or three structures, with some chordae tendineae arising directly from the ventricular wall;
- the septal papillary muscle is the most inconsistent papillary muscle, being either small or absent, with chordae tendineae emerging directly from the septal wall.
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Term
| What are the cusps of the Tricuspid valve? |
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Definition
- Anterior, posterior, and septal cusps, which are attached by the chordae tendineae to three papillary muscles that keep the valve closed against the pressure developed by the pumping action of the heart.
- Is closed during the ventricular systole (contraction); its closure contributes to the first heart sound.
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Term
| Describe the pulmonary valve? |
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Definition
- consists of three semilunar cusps
- cusps are named the left, right and anterior semilunar cusps
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Term
| What atrium is the smallest and also has the thickest walls? |
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Definition
- LA
- It is the most posterior of the four chambers lying posterior to the right atrium but anterior to the esophagus and shows no structural borders on a posteroanterior radiograph.
- Its walls are smooth, except for a few pectinate muscles in the auricle
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Term
| How many papillary muscles are found in the LV. |
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Definition
| Contains two papillary muscles (anterior and posterior) with their chordae tendineae and a meshwork of muscular ridges, the trabeculae carneae cordis |
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Term
| What are the names of the cusps that are found in the Mitral valve and when are they closed in relation to the Tricuspid valve |
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Definition
- Two cusps: a larger anterior and a smaller posterior
- Closed slightly before the tricuspid valve by the ventricular contraction (systole); its closure at the onset of ventricular systole causes the first heart sound
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Term
How many semilunar cusps make up the Aortic valve? What is the function of this valve? |
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Definition
3. Functioning of the aortic valve is similar to that of the pulmonary valve with one important additional process: as blood recoils after ventricular contraction and fills the aortic sinuses, it is automatically forced into the coronary arteries because these vessels originate from the right and left aortic sinuses |
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