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85 Cards in this Set
- Front
- Back
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What provides some protection for the intercostal nerve?
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costal groove
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What are the components of the typical ribs?
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1. head
2. Neck 3. Tubercle (2 facets) 4. Body |
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Which ribs are atypical?
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1st, 2nd, 10th-12th
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What does the thoracic skeleton consist of?
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*12 pairs of ribs and associated cartilages
*12 thoracic vertebrae and intravertebral discs *sternum |
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What is the purpose of the Thoracic cage?
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1. Protect internal organs
2. Resist negative (subatmospheric pressure) internally 3. Provide attachment/support weight of upper limbs 4. Provide anchoring attachment of skeletal muscles |
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Where does the inferior angle of the scapula end (r/t rib)?
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7th rib
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What are costochondral joints?
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Connect rib to cartilage that attaches to sternum
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How many true ribs? False Ribs? Floating Ribs?
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True 1-7
False 8-10 Floating 11-12 |
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What is another name for sternal angle?
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"Angle of Louis"
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What parts make up the sternum?
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Manubrium
Body Xiphoid Process |
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What is the floor of the thoracic cavity
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Diaphragm
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Lower rib fractures can cause a diaphragmatic tear. Why is this significant?
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This can lead to diaphragmatic hernia and abdominal structures to move into the chest cavity. Without repair, this leads to 100% mortality.
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Which rib fracture is most significant?
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1st- because the neurovascular bundle is located here. Also, it takes significant force to break and most likely includes internal organ damage.
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What is diastasis recti?
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Rectus muscle gets lax and buldges like a hernia (not a true hernia)
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What is another name for suprasternal notch (jugular notch)?
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Suprasternal "Notch of Burns"
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How do you determine where sebaceous glands lie?
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They lie in the direction that the hair follicle slants "toward"
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How are bones classified? Name and give an example of each?
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Shape
Long bones (humerus), short bone (ankle), flat bone (cranium), irregular bones (facial), sesamoid bones (patella) |
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What is the name of the fibrous connective tissue that surrounds the bone?
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periosteum
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What is the Rule of 9's?
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It is a way of determining burned area.
Anterior head and neck= 4.5% Posterior head and neck=4.5% Anterior and posterior head and neck=9% Anterior shoulders, arms, forearms, and hands= 9% Anterior AND posterior arms forearms, and hands= 18% Anterior AND posterior trunk=36% Perineum= 1% Anterior Thighs, legs, and feet= 18% Anterior AND posterior thighs, legs, feet= 36% |
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Which burn is most painful?
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2nd degree (partial thickness). Epidermis and dermis are damaged with blistering
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What is another name for tension lines?
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Langer lines
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What drains lymph from the bodies right upper quadrant (right side of head, neck, thorax, and right upper limb)?
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Right lymphatic duct
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Explain Cisterna Chyli.
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Its a dilated collecting sac formed by lymphatic trunks of lower half of body that merge into the abdomen.
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Describe the location of the thoracic duct.
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Junction of Left IJ and L subclavian veins.
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What areas does the thoracic duct drain?
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drains rest of body (other than head, neck, and thorax and upper right limb).
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Where is the right lymphatic duct located?
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At the root of the neck. It enters the junction of the R IJ and R subclavian veins (right venous angle)
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Define aponeurosis.
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These are flat sheets (formed by tendons) that anchor muscle to the skeleton, deep fascia, or aponeurosis of another muscle.
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What are 3 muscle types?
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skeletal striated, cardiac striated, and smooth muscle.
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There are 3 classes of joints. What are they?
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Synovial joints, fibrous joints, and cartilagenous joints
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What are joints?
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Articulations/ unions or junctions between 2 or more bones.
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What are efferent nerve fibers?
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Motor
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What are afferent nerve fibers?
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sensory
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List and describe the meningeal layers.
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Pia mater (covers brain and spinal cord)- innermost
Arachnoid mater Dura mater (internal aspect of neurocranium)- outermost **CSF located between pia and arachnoid layer |
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In terms of sympathetic and parasympathetic stimulation- how does this affect the bowel?
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Sympathetic decreases stimulation and parasympathetic increases stimulation.
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Divide the stomach into its different parts.
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1. Cardia (opening to the stomach)- head of the stomach.
2. Fundus Body 3. Pyloric part |
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What are the two nerves that run alongside the esophagus?
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Anterior vagal (left)
Posterior vagal (right) |
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What are the two curvatures of the stomach. Describe each?
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Greater (longer convex left border of stomach) and lesser curvatures (shorter concave right border of the stomach).
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Where does most of the water get absorbed?
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Large intestine (Ascending Colon)
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What are the different types of muscles of the esophagus?
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Upper- striated muscle
Middle- mixed striated/smooth muscle Lower- smooth |
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What two vessels of the portal vein?
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Superior mesenteric and Splenic vein
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What are the constrictions of the esophagus?
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1. Cervical (upper esophageal sphincter caused by the cricopharyngeus muscle)
2. Thoracic (compound constriction caused by the crossing of the aortic arch and crossing of the left main bronchus). 3. Diaphragmatic constriction ( where it passes through the esophageal hiatus and diaphragm). |
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If you were to cut the esophagus into a cross sectional view, what are the layers of the muscle?
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Longitudinal- external layer
Circular- internal layer |
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What is the z-line?
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It is a jagged line where the mucosa changes from esophageal to gastric mucosa. This is helpful for Endo and EGD.
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What is rugae?
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They are gastric folds of the stomach that increase the surface area.
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How can you find the pylorus?
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By identifying the prepyloric vein. It runs transverse ascending over the pylorus to the right gastric vein.
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What portion of the gut does the stomach connect to?
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Duodenum
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How many parts does the duodenum have and what are they?
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4 parts. Superior (1st), descending (2nd), inferior (3rd), and ascending (4th).
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How do you determine where the duodenum ends and the jejunum begins?
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Ligament of Treitz. Beginning at the duodenojejunal flexure and supported by suspensory muscle of the duodenum (which is ligament of Treitz).
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What quadrant is the sigmoid colon in?
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LLQ.
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What are the 3 most common reasons for intestinal obstruction (in order)?
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1. adhesions (usually from prior surgery
2. Strangulated hernia 3. Cancer |
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What makes up the portal triad?
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Hepatic artery, portal vein, and the bile duct.
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What is another name for the epiploic foramen?
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"Foramen of Winslow"
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What is the "gatekeeper" of the stomach?
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Pylorus
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What structure do surgeons call "a surgeon's best friend"? Why?
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Stomach. Because it has an abundance of blood supply.
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What is the blood supply to the stomach?
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Left and Right gastric arteries and left and right gastroomental (gastroepiploic arteries). The fundus and upper body receive blood from the short and posterior gastric arteries.
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What are teniae coli?
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Thickened bands of smooth muscle begins at the appendix and spearate into three bands.
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What is the ileocolic valve?
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Its located at junction of ileum and colon and not a "true" valve.
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Is the lower esophageal sphincter an anatomical or functional sphincter?
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It is a functional sphincter; therefore, you can't visualize it.
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Is the pyloric esophageal sphincter an anatomical or functional sphincter?
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It is an anatomical sphincter and you can visualize it.
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Which cervical nerves contribute to the diaphragm?
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C3, C4, C5
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What is the significance of paralysis of diaphragm (phrenic nerve)
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You have two and can still breathe.
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What is the main muscle in respiration?
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Diaphragm
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Muscles of the thoracic wall.
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scalene muscles of the neck and the accessory respiratory muscles- help in elevating the lower ribs during inspiration. The main muscle is the diaphragm.
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What is the main muscle of the chest?
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Pectoralis Major
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What are the 3 intercostal muscles?
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Internal (analogous to internal oblique), external (analogous to external oblique), and innermost intercostals (similar to internal and essentially their deep parts).
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Explain how the muscle fibers run in external oblique and internal oblique?
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External oblique- inferomedially- (direction as if you placed your hands in your pockets).
Internal oblique- superomedial (like your fingers when placing your hand on your chest)-perpendicular to external oblique fibers). |
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How are the intercostal spaces named?
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Named according to the rib forming the superior border of the space. e.g. 4th ICS lies between ribs 4 and 5
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How many intercostal spaces and how many intercostal nerves?
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11 intercostal spaces and 11 intercostal nerves with a 12th subcostal nerve and a subcostal space.
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What forms the sternal angle?
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The manubrium and body of the sternum lie in slightly different planes superior and inferior to their junction.
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What is the infrasternal angle?
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It is the angle formed by the right and left costal margins (subcostal angle).
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What is the largest, most superficial muscle of the anterolateral abdominal wall?
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External oblique
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Name the layers you'd dissect from superficial to deep.
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Skin->Camper's Fascia
-->Scarpa's Fascia--> External oblique--> internal oblique-->Transversalis abdominis-->Transversalis fascia--> Extraperitoneal fat--> Parietal Peritoneum |
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What are the three flat muscles of the anterolateral abdominal wall?
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External Oblique, Internal Oblique, and Transversus abdominis
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What is mass closure?
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This is a technique in closing the various layers of anterolateral abdominal wall all at once that is now more accepted surgeons (instead of closing each layer separately).
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In what order is the neurovascular structures aligned in the intercostal spaces?
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Vein (nearest to the rib)
-->artery-->nerve |
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Which is more superior Pectoral fascia or clavicopectoral fascia
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Pectoral fascia
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What is thoracic outlet syndrome?
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A syndrome due to neurovascular compression at the superior thoracic aperture due to extra cervical rib.
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What is the "Vineberg procedure"
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Canadian thoracic surgeon took the internal mammary artery and sewed it to the heart.
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What are the 2 branches of the internal mammary?
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Superior epigastric and musculophrenic arteries
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What is another name of the suspensory ligaments of the breast?
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Cooper's Ligaments
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What is another name of the subareolar lymphatic plexus?
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Sappey's Plexus
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Where does most of the lymph (~75%) drain to from the breast?
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Axillary lymph nodes
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What is polymastia?
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supernumerary breasts
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What is polythelia
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accessory nipples
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What is the prevalence of gynecomastia in men yearly
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about 1000 cases/yr
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