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77 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What are the branches of the subclavian artery?
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1) Superior thoracic artery
2) Thoraco-acromial artery 3) Lateral thoracic artery 4) Subscapular artery 5) Anterior circumflex Humoral 6) Posterior circumflex |
Screw The Lawyers Save A Patient
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Major branches off of the aortic arch
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- Coronary arteries
1) Brachiocephalic trunk 2) Left Common Corotid 3) Left Subclavian |
Know your ABCs
- Aortic Arch gives rise to: B CC S |
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Where is the brancial artery located
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Brachial artery is medial to bicepts in elbow
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BAMBI
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Branches of the right subclavian artery
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1) Vertebral artery
2) Thyrocervical trunk 3) Inferior thyroid 4) --- 5) --- 6) Costocervical artery 7) --- 8) --- |
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Thoracic cage: relations to the important venous structures:
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- Behind the STERNOCLAVICULAR JOINTS: the BRACHIOCEPHALIC VEINS begins
- Behind the 1st COSTAL CARTILAGE: the SUPERIOR VENA CAVA begins - Behind the 2nd COSTAL CARTILAGE: the AZYGOS VEIN ends - Behind the 3rd COSTAL CARTILAGE: the SUPERIOR VENA CAVA ends |
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External jugular vein tributaries
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- Posterior external jugular vein
- Anterior jugular vein - Suprascapular vein - Transverse cervical vein |
PAST
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Structures of the Superior Mediastinum
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1) Phrenic nerve
2) Vagus nerve 3) Thoracic duct 4) Left recurrent laryngeal nerve 5) Brachiocephalic veins 6) Aortic arch & its 3 branches 7) Thymus 8) Trachea 9) Lymph nodes 10) Esophagus |
PVT Left BATTLE
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Structures of the Posterior Mediastinum
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1) Descending aorta
2) Azygos and Hemiazygos veins 3) Thoracic duct 4) Esophagus 5) Sympathetic chain/trunk / Ganglia |
DATES
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Heart valve sequence
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1) Tricuspid
2) Pulmonary 3) Mitral 4) Aorta |
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Jugular notch
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at top of manubrium of sternum
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Components of the sternum
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1) manubrium
2) Angle of Louis/Manubriosternal notch 3) Body 4) Xiphoid process / Xiphisternum |
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Breast
- Ribs - Quadrants |
- Ribs 2-6
- 4 quadrants (3 in the subcutaneous & axillary tail in the deep fascia) |
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Dermatomes
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T4 - Breast
T7 - epigastric / xiphisternum T10 - umbilicus T12 - suprapubic Brachial plexus: C5-T1 |
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Pectoralis major
- Attachments - Innervation - Function |
Attachments:
- medial 1/3 of clavicle - sternum (ribs #1-6) - humerus (lateral lip of the intertubercular groove) Innervation: lateral & medial pectoral nerves Function: ADducts & medially rotates humerus |
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Pectoralis minor
- Attachments - Innervation - Function |
Attachments:
- Ribs 3-5 - Coracoid process Innervation: Medial & Lateral pectoral nerves |
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Serratus anterior
- Attachments - Innervation - Function |
Attachments:
- ribs 1-8 - medial border of scapula Innervations: - long thoracic nerve (C5,6,7 raise your arms to heaven) Function: - protracts scapula |
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Diaphragm
- Innervation - Function |
Innervation:
- Phrenic nerve (C3,4,5 keeps the diaphram alive) Function: - Contracts to push down to increaes the area of the rib cage |
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Components of the right and left lung
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1) RIGHT lung:
- oblique fissure - horizontal fissure - impressions 2) LEFT lung: - oblique fissure - lingula - impressions |
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Relationship of pulmonary artery to the bronchus
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Right pulmonary artery is anterior to the bronchus
Left pulmonary artery is superior to the bronchus |
RALS
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Pleural cavities of the lung
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1) Parietal pleura (Lines wall)
- diaphragmatic - costal surfaces - mediastinal Innervation: Phrenic and intercostal nerves 2) Visceral pleura (lines lung) - No innervation |
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Pneumothorax
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Cavity is ruptured by air
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Hemothorax
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Cavity is ruptured by blood
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Muscles of inspiration/expiration
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Inspiration:
- Diaphragm - Intercostal muscles - SCM/Scalene muscles (Accessory) Expiration: - Elastic recoil of lung |
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Mediastinum
- Boundaries - Subdivisions |
Boundaries:
- sternum - thoracic vertebrae - thoracic inlet - diaphragm Subdivisions - superior mediastinum - inferior mediastinum (Anterior, middle - pericardium*heart, posterior) |
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Superior mediastinum
- Contents - Boundaries |
Contents:
- Great vessels - Arch of aorta - trachea - esophagus Boundary: - Imaginary line of angle of louis to T4 |
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Anterior mediastinum
- Contents |
Contents:
- Thymus - Fat - Small vessels - Lymph nodes |
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Middle mediastinum
- Contents |
Contents:
- Fibrous pericardium - Heart - Roots of the great vessels (especially the ascending aorta) |
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Posterior mediastinum
- Contents |
Contents:
- Esophagus - Bronchi - Descending aorta - Thoracic duct |
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Components of the right atrium:
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- Inflow: from SVC, IVC, coronary sinus
- Outflow: to RV via tricuspid valve - Right auricle/atrial appendage: embryonic derivative - Crista terminalis: ridge, runs from SVC to IVC openings - Pectinate muscles - Fossa Ovalis: formerly foramen ovale - IVC and coronary sinus “valves” - Right heart border on CXR (chest X-ray) |
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Components of the right ventricle:
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- Inflow: from RA via tricuspid valve
- Outflow: to pulmonary artery (deoxy blood) via pulmonary valve - Trabeculae carneae: ridged muscle - Papillary Muscles (ant, post & septal): prevent valve prolapse during systole - Chordae tendineae: fibrous cords - Moderator band: transmits AV bundle - Thinner walled (normally) - Most anterior part of heart |
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Components of the left atrium:
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- Inflow: from pulmonary veins (usually 4)
- Outflow: to LV via mitral valve - Auricle: embryological remnant (only part with pectinate muscle) - Other side of the fossa ovalis - Most posterior part of heart |
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Components of the left ventricle
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- Inflow: from LA via mitral valve
- Outflow: to aorta via aortic valve - Trabeculae carneae - Papillary muscles (ant. & post): prevent prolapse during systole, larger then RV - Chordae tendineae - Heart apex |
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Heart conduction
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1) Sinoatrial (SA) node: pacemaker (normally), RA close to SVC inlet
2) Atrioventricular (AV) node: in IAS close to tricuspid valve 3) Atrioventricular bundle/bundle of His: in IVS 4) Right & left bundle branches (note: left has 2 parts): in IVS 5) Purkinje fibers: ventricular muscle |
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Azygos vein
- location |
- Right side of the bodies of the thoracic vertebrae
- Passes behind right lung hilum (lung impression) - Drains posterior thorax and dumps into SVC - Sometimes: hemiazygos vein and accessory azygos vein on left hand side (begins @ 4th IC space) - Connect to azygos vein |
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Thoracic duct
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- Carries lymph from the cisterna chyli (abdomen) and thoracic cavity
- Between the esophagus and abdominal aorta - Empties into the venous circulation, junction of left internal jugular vein and left subclavian vein - Hard to see |
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Subclavian relationships
- Anterior to posterior |
1) Subclavian vein
2) Anterior scalene (with Phrenic nerve) 3) Subclavian artery 4) Brachial plexus 5) Middle scalene 6) Posterior scalene ** Phrenic lies on top of Ant. Scalene ** Vagus nerve runs in carotid sheath |
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Thyrocervical trunk
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Branch of the subclavian artery
Branches: - inferior thyroid - transverse cervical - suprascapular |
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Internal thoracic artery
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Branch off of the part 1 of the axillary artery
- go to the intercostal arteries |
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Vertebral artery
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1st branch off of both the right and left subclavian arteries
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Trapezius
- Attachment - Innervation - Function |
- Attachment:
- Innervation: Accessory nerve (CXI) - Function: |
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Latissimus dorsi
- Attachment - Innervation - Function |
- Attachment: Spine, iliac crest, intertubercular groove
- Innervation: Thorocodorsal nerve - Function: |
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Rhomboid
- Types - Attachment - Function |
- Types: major and minor
- Attachment: spine & medial border of the scapula - Function |
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Levator scapulae
- Attachment - Function |
- Attachment: superior angle of the scapula
- Function: shrug shoulders |
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Deltoid
- Attachment - Innervation - Function |
- Attachment: clavical, acromion, spine of scapula & distally 1/3 down of humerus
- Innervation: axillary nerve - Function: ABduction after 1st 15 degrees |
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Terres major
- Attachment - Function |
- Attachment: inferior angle of the scapula, intertubercular groove
- Innervation - Function: medial rotation |
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Tricepts:
- Attachment - Innervation - Function |
- Attachment:
3 heads: long- infraglenoid tubercule; lateral & medial-humerus; Distally to the alecronon of the ulna - Innervation: radial nerve (innervates the posterior compartment of the arm) - Function: Extension of the elbow |
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Subscapularis
- Attachment - Function |
- Attachment: subscapular fossa, lesser tubercle
- Innervation: - Function: median rotation |
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Rotator cuff muscles:
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1) terres minor
2) subscapularis 3) supraspinatus 4) infraspinatus |
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Supraspinatus
- Attachment - Function |
- Attachment: suprasinous fossa, greater tubercule
- Innervation: - Function: lateral rotation & 1st 15 degree ABduction |
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Infraspinatus
- Attachment - Function |
- Attachment: infraspinous fossa & greater tubercle
- Function: lateral rotation |
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Teres minor
- Attachment - Innervation - Function |
- Attachment: lateral border scapula and greater tubercle
- Function: lateral rotation |
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Components of the brachial plexus
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1) Roots
2) Trunks 3) Divisions 4) Cords 5) Branches |
"RT drinks cold beer"
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How are the chords named?
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in relation to the axillary vein
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What nerve(s) come off the roots?
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1) Long thoracic nerve (C5,6,7 raise your arms to heaven) to the serratus anterior
2) Phrenic nerve (C3,4,5 keeps the diaphragm alive) |
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What nerve(s) come off the chords?
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Posterior chord:
- Thoracodorsal nerve to the latissiumus dorsi muscle Lateral & Medial chord: - Lateral and medial pectoral nerves to the pectoralis major and minor muscles |
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What nerve(s) come off the branches?
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Posterior chord:
- Axillary nerve to the deltoid and teres minor - Radial nerve to the extensor compartment of the arm and forearm(Tricepts) Lateral chord: - Musculocutaneous nerve to all flexors in the anterior compartment of the arm Medial chord: - Ulnar nerve to flexor carpi ulnaris (FCU), 1/2 flexor digitorum profundus, some muscles of the hand (hypothenar, palmaris brevis, dorsal, adductor pollicis and palmar interossei and 3rd & 4th lumbricals) Lateral & Medial chords: Median nerve to forearm flexor muscles, thenar compartment, & lateral two lumbricals |
Radial nerve innervates the BEST (Brachioradialis, extensors, supinator, tricepts)
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What does the radial nerve innervate?
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Radial nerve innervates the BEST (Brachioradialis, extensors, supinator, tricepts)
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Radial nerve innervates the BEST (Brachioradialis, extensors, supinator, tricepts)
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Where does the ULNAR NERVE come from? & What does it innervate?
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- From the medial chord
- Ulnar nerve to flexor carpi ulnaris (FCU), 1/2 flexor digitorum profundus, some muscles of the hand (hypothenar, palmaris brevis, dorsal, adductor pollicis and palmar interossei and 3rd & 4th lumbricals) |
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Where does the THORACODORSAL NERVE come from? & What does it innervate?
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- From the posterior chord
- Thoracodorsal nerve to the latissiumus dorsi muscle |
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Where does the LONG THORACIC NERVE come from? & What does it innervate?
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- From the roots of the brachial plexus, C5,6,7 raise your arms to heaven
- Innervates the serratus anterior |
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Where does the MEDIAL & LATERAL PECTORAL NERVEs come from? & What does it innervate?
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- From the medial and lateral chords of the brachial plexus
- Innervates pectoralis major and minor muscles |
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Where does the PHRENIC NERVE come from? & What does it innervate?
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- From C3,4,5 keeps the diaphragm alive
- Only 5 from the brachial plexus - Innervates the diaphragm |
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Where does the RADIAL NERVE come from? & What does it innervate?
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- From the posterior chord
- Innervates the extensor compartment of the arm and forearm --> Radial nerve innervates the BEST (Brachioradialis, extensors, supinator, & tricepts) |
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Where does the AXILLARY NERVE come from? & What does it innervate?
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- From the posterior chord
- Innervates the deltoid and teres minor muscles |
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Where does the MEDIAN NERVE come from? & What does it innervate?
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- From the Lateral and Medial chords
- Innervates forearm flexor muscles, thenar compartment, and lateral 2 lumbricals |
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Where does the MUSCULOCUTANEOUS NERVE come from? & What does it innervate?
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- From the lateral chord
- Pierces the coracobrachialis to supply the flexor muscles of the arms |
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What muscles comprise the first anterior layer of the forearm (Superficial flexors)?
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1) Flexor carpi ulnaris
2) Flexor carpi radialis 3) Palmaris longus 4) Pronator teres 5) Brachioradialis |
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What are the muscles of the 2nd anterior layer?
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Flexor digitorum superficialis
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Flexor carpi ulnaris
- Attachment - Innervation - Function |
- Attachment:
- Innervation: ulnar nerve - Function |
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Flexor carpi radialis
- Attachment - Innervation - Function |
- Attachment: medial epicondyle to the base of the 2nd metacarpal
- Innervation: median nerve |
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Brachioradialis
- Attachment - Innervation - Function |
- Attachment: lateral supracondyle to the lateral surface of the distal radius
- Innervation: radial nerve |
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Pronator teres
- Attachment - Innervation - Function |
- Attachment: Medial epicondyle and coronoid process of the ulna
to the middle of the lateral suface of the radius - median nerve |
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Palmaris longus
- Attachment - Innervation - Function |
- Attachment: medial epicondyle to the palmar aponeurosis
- median nerve |
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What muscles comprise the 3rd layer of the anterior forearm?
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1) Flexor pollicis longus
2) Flexor digitorum profundus 3) Pronator quadratus |
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Flexor pollicis longus
- Attachment - Innervation - Function |
- Attachment:
- Innervation: median nerve |
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Flexor digitorum profundus
- Attachment - Innervation - Function |
- Attachment
- Innervation: digits 2&3 -> Median and digits 4&5 ulnar - Function: flexor |
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Brachioradialis
- Attachment - Innervation - Function |
- Attachment
- Innervation: radial nerve - Function |
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