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43 Cards in this Set

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Name the major contents of the mediastinum
the heart, great vessels, the descending esophagus, & trachea
Which ribs are considered true ribs?
The 1st 7 ribs are considered true ribs because they articulate with the body of the sternum itself by way of their condyl cartilages
Which ribs are considered false ribs?
ii. The 8th, 9th, 10th are all considered false ribs because the cartilages fuse together to join with the 7th rib to articulate with the inferior aspect of the body of the sternum.
Which ribs are floating ribs?
iii. 11th and 12th are floating ribs. They don’t have connecting cartilages that connect with the sternum. However, they do have cartilaginous ends. They float freely in the lateral aspects of the abdominal aspects of the wall.
Which ribs are considered to be atypical ribs?
The 1st, 2nd, 11th, and 12th are all considered atypical ribs. The 11th and 12th don’t articulate with the sternum.
What type of joint is the sternoclavicular joint?
A saddle joint
Name the three parts of the sternum
manubrium, body, and zyphoid process.

i. Manubrium: Opposite the 3rd and 4th thoracic vertebrae.

ii. The sternum: is opposite the 5th through the 9th

iii. Zyphoid process: Opposite of T10. Made of cartilage and gradually ossifies as we age.
What are two names for the angle between the body of the manubrium?
sternal angle, or sternal angle of Louis
Which muscles attach to the rib cage? Which are accessory muscles of respiration?
pectoralis major,
pectoralis minor
part of the serratus anterior
latissimus dorsi
scalene muscles

All except the latissimus dorsi.
What passes through the superior aperature into the thorax?
esophagus , vagus nerves, great vessels, trachea
What are the boundaries of the superior aperature?
It is bounded posteriorly by the 1st thoracic vertebrae, the 1st two ribs, and superior border of manubrium
What are the boundaries of the inferior aperature?
It is bounded by the inferior borders of the 11th and 12th ribs, the costal cartilages anteriorly, and by the zyphoid process

The diaphragm covers the inferior aperture of the thoracic cage
What passes through the inferior aperature?
the inferior vena cava, the abdominal aorta, other nerves, and lymphatics
What attaches to the rough area of the rib's tubercle?
The rough area of the tubercle is for the costal transverse ligament which holds that joint* in place

*articulation with the transverse process of thoracic vertebrae
What is the ribs weakest point?
The rib is weakest just anterior to the angle, and thus is the most likely place for a fracture to occur.
What does the costal groove contain?
intercostal vein, artery, and nerve in that order.
How could a removed rib grow back?
Sometimes a rib is taken out during surgery for access to the lung (s). The rib should grow back in place because the periosteum, which contains bone-generating cells, will regenerate itself.
What do you call the superior most aspect of the manubrium?
jugular notch
What type of joint exists between the 1st rib and the clavicle?
synovial joint
What type of joint exists between the 1st rib and the body of the sternum?
cartilaginous joint
What type of joints exist at the articulation for the costal cartilages
synovial joints
How many intercostal spaces make up the thorasic wall? What muscles are in them?
Eleven intercostal spaces

External intercostal muscles: run from the rib above it anteriorly and inferiorly to attach to the rib below. When contracted, they elevate the ribs.

Internal intercostals (deep to external): compresses the ribs.

Innermost intercostal muscle: The intercostal vein, artery, and nerve run in a groove on the inferior aspect of the rib and run between the Internal intercostal & Innermost intercostal muscles.
The intercostal nerve is a ______ ramus.
primary
Name the fascial lining which separates the muscles of the posterior and anterior thoracic wall from the pleura of the lungs.
endothoracic fascia
Name 2 muscle groups that elevate the ribs. Name 1 muscle group that depresses the ribs.
1. The external intercostals
2. The condyl part of the internal intercostals

The internal intercostals
Name the 2 arterial supplies to the thorasic wall.
Thorasic aorta and the internal thorasic (branch of the subclavian) which descends and becomes the musculophrenic as it reaches the diaphragm.
Which artery is frequently used in cardiac bypass surgery so that they may use it directly with the cardiac arteries?
internal thorasic
Name the congenital condition in which the aorta is constricted. Blood coming out of the heart will not be able to pass down inferiorly and as a result, the intercostal arteries and the internal thoracic take over and become enlarged so that blood may get to the descending aorta.
coarctation of the aorta
What veins form the right superior intercostal vein?
2nd, 3rd, 4th intercostal veins
Name two things that drain into the superior vena cava?
The azygos and the right superior intercostal veins
At which thorasic vertebrae does the Hemiazygos vein cross the midline to join the azygous vein?
8th
Name the two major layers of the thorasic pleura.
1. Visceral pleura: The part of the pleura that surrounds the lung itself is called the.

2. Parietal pleura: The part of the pleura that lines the cavity.
Name 4 parts of the parietal pleura
1. Diaphragmatic pleura
2. Mediastinal pleura
3. Costal pleura
4. Cervical portion of pleura, superiorly.
Name the pleura that covers the lung itself.
Visceral or pulmonary pleura
During a thoracentesis a needle is put posteriorly and laterally into the ___, ___, or ___ intercostal space and fluid is aspirated from the ________________.
the 6th, 7th, or 8th

Costodiaphragmatic Recess
Name an indication that a pt has an occult cancer. (Occult cancer is a small cancer that may give rise to clinically evident distant metastases before it is itself clinically detectable)
hyponatremia (low sodium)

Too little sodium is almost always an indication that the pt. has an occult cancer
Name a disease that is usually caused by cancer. What does the pt. present with psychiatric symptoms?
paraneoplastic limbic encephalitis.

Tt attacks certain structures in the CNS called the limbic lobes. Anti-HU antibodies attack only the limbic structures. This attack on thelimbic structures results in a psychiatric presentation.
Name a potential effect of squamos cell carcinoma?
Horner syndrome
Name the mechanism of Horner syndrome and some of the symptoms associated with it.
Compression the cervical chain ganglia, resulting in the classic triad of: miosis (constricted pupil), partial ptosis, and anhidrosis (loss of hemifacial sweating).
What is a pleural effusion?
1.Absence of breath sounds

2.Serous fluid present. Normally clear appearance. Can be serosanguineous fluid with blood present.

3.In patients with bilateral pleural effusions, one may do a thoracentesis to look for malignant cells. Billateral pleural effusions contain malignant cells that can diagnose which stage the cancer is in.
What is the term for air in the lungs?
Pneumothorax

Primarily iatrogenic in nature (inflicted by doctor). When passing a catheter through for a central line, the lung can collapse. You have punctured the space between the parietal pleura and the visceral pleura, and air has been introduced into that space.
What is the term for infection between the parietal pleura and the visceral pleura?
Pleuracy

Extremely painful. The lungs don’t move smoothly as they expand. In metastatic cancer patients, physicians go through the pleura and put in talcum poweder. Allows the lungs to expand and not collapse.
What do you call blood in the pleural space?
Hemothorax