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83 Cards in this Set

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What are the names of the openings at top and bottom of thorax?
Superior + inferior thoracic aperture
What does sternum consist of?
Manubrium, sternum body + xiphoid process(T9)
What is sternal angle and what level is it at?
Secondary cartilaginous joint between manubrium + sternal body at T4
Describe articulations between ribs + vertebral column?
the head articulates with its own vertebral body + the one above
then the tubercle articulates with the transverse process
What type of joints are the articulations between the ribs + vertebral column?
plane synovial
Describe structure of ribs 2-10?
rounded top, sharp bottom and costal groove on inferior surface for intercostal artery/vein/nerve
Describe structure of 1st rib?
small + flattened with groove on top for subclavian artery + bottom for brachial plexus to pass over
What is the costal margin?
the costal cartilages of ribs 7-10 fused
How are ribs attached to costal cartilages?
Primary cartilaginous
Define and explain the permitted movement at sternocostal joints?
Plane synovial joint between sternum + costal cartilage of true ribs - no movement at 1st 2, only 3-7th for respiration
Explain diaphragm dome position?
right dome higher, reaching up to 5th rib
Describe the hiatus' penetrating the diaphragm?
oesophageal hiatus penetrates muscular part at T10
IVC hiatus pentrates central tendon at T8
Aorta passes behind at T12
Describe nerve innervation of diaphragm?
2 phrenic nerves originating from branches of cervical plexus (C3-5)
What is the costodiaphragmatic recess?
the space in mid-axilla line at ribs 8-10 due to lungs not quite filling pleural cavities
What is pleura made of?
serous membrane = simple squamous epithelium + connective tissue
Where would you carry out a pleural aspiration?
9th IC space, mid-axilla just above inferior rib to avoid nerves
What vessels supply the breasts?
2nd - 4th IC arteries
branches of axillary artery
branches of internal thoracic artery
Where do lymphatics from breast drain into?
mainly pectoral group of lymph nodes
What is the anterior axillary fold and what does it consist of?
musculocutaneous fold - pectoralis major muscle with lymph nodes/capillaries running along it
What is the posterior axillary fold and what does it consist of?
musculocutaneous ridge - latissmus dorsi + teres major muscles
What happens at T4/5?
sternal angle
aortic arch
trachea bifurcation
What are gray ramus communicans?
unmyelinated post-ganglionic fibres going from symp. ganglion > spinal nerve
What are white ramus communicans?
myelinated pre-ganglionic fibres going from spinal nerves T1-L2 > symp. ganglion
What does bucket handle movement do?
movement at costovertebral joints 7-10 increasing transverse diameter in lower ribs
What does pump handle movement do?
increases anterio-posterior diameter in upper ribs via costovertebral movement at ribs 2-6
Describe forced respiration?
Inspiration = external intercostals + scalene/sternocleidomastoid
Expiration = abdominal muscles
What do olfactory cells do?
provide sense of smell
Describe type 1 pneumocytes?
simple squamous epithelium that cover most of alveolar surface and allow gas exchange
Describe type 2 pneumocytes?
great alveolar cells that produce surfactant
Describe length of trachea + lining?
C6-T4 lined with pseudostratified columnar epithelium, ciliated + with goblet cells
U-shaped rings of hyaline cartilage with trachealis muscle at open ends
How are individual cartilage rings in trachea connected?
by fibro-elastic connective tissue
What is the carina?
the cartilaginous plate which supports the bifurcation at T4
Compare R + L bronchi?
R more vertical but shorter + wider
Describe relation of oesophagus to trachea bifurcation?
behind and slightly left of midline
Describe relation of aortic arch to trachea bifurcation?
in front and slightly to left of midline
What is the pulmonary ligament?
the folding between parietal and visceral pleura which hangs from hilum, taken up when lung inflates
Describe change in epithelium as progress through bronchial tree?
epithelium becomes simple columnar ciliated with goblet cells at terminal bronchioles then simple cuboidal in respiratory bronchioles
Describe blood supply of alveoli?
branches of pulmonary artery
Describe blood supply of bronchi, bronchioles, connective tissue + visceral pleura?
bronchial arteries - derived from descending aorta
Describe venous drainage of lungs except the alveoil?
azygous + acessory hemiazygous veins
alveoli via pulmonary veins
What is the sympathetic origin of the lungs?
T2-5 to dilate bronchioles + inc mucous secretion
Describe the afferent fibres of the lungs?
lung stretch receptors + mucous membrane receptors
Describe left lung lymphatic drainage?
into thoracic duct >> left subclavian
Describe right lung lymphatic drainage?
into right lymphatic duct >> right subclavian
What dermatome supplies bottom 2 ribs?
T9
Describe dermatome arrangement at sternal angle (T4)?
C4 adjacent to T2 since others pulled out to arms
Describe position of heart apex?
5th IC space, midclavicular line
Where is superior border of heart?
Deep to sternal angle T4
Describe left + right borders of heart?
Left = 2nd costal cartilage to apex
Right = 3rd to 6th costal cartilage
What is scoliosis + kyphosis?
Scoliosis = lateral curvature
Kyphosis = anterior
What causes pectus carinatum?
excess costal cartilage >> protruding chest
Describe layout + movement of external intercostals?
Point inferiorly + inwards to rib below
elevate ribs in inspiration
What is the external intercostal membrane?
continuation of muscle at costal cartilages as thin connective tissue aponeurosis
Describe structure + movement of internal intercostal muscles?
point downwards to rib below
moves ribs down in expiration
Describe structure + movement of innermost intercostal muscles?
3 parts running different directions + connected by fibrous connective tissue
acts with internal intercostals to move ribs down in expiration
Describe internal intercostal membrane?
extends to vertebral column - extension of deep fascia
Explain nerve + blood supply of IC spaces?
ventral ramus of spinal nerve + blood from thoracic/internal thoracic artery branches
Describe blood supply of posterior IC spaces?
first 2 = costocervical trunk (from subclavian)
Remaining = branches of descending aorta
Describe blood supply of anterior IC spaces?
upper 5/6 = internal thoracic branches
then internal thoracic divides with musculophrenic supplying remaining spaces + diaphragm
Describe origin + passage of internal thoracic artery?
it is branch of subclavian which passes behind costal cartilages then divides into musculophrenic + sup. epigastric
Where does sup. epigastric artery supply?
abdominal wall + diaphragm
Where does internal thoracic vein drain from?
musculophrenic, sup. epigastric, upper anterior intercostals >> into subclavian vein
Where does musculophrenic vein drain from?
costal margin, lower IC spaces + peripheral diaphragm
In general terms where does the azygous system drain?
posterior thoracic wall + part of posterior abdominal wall
Describe the right side of the azygous system?
Azygous vein - starts at L1/2 passing up thru aortic hiatus to arch over root of right lung + drain into SVC
Describe the left side of the azygous system?
Hemi-azygous vein - passes thru diaphragm via left crus and joins azygous at T9
Acessory hemiazygous - joins azygos at T8
To what are the hemiazygous + acessory hemiazygous also joined?
IVC to provide alternative route to SVC if blockage
Where does azygos vein drain from?
right posterior IC spaces except first 2 which drain directly into braciocephalic
Where does dorsal ramus from thoracic spinal nerves supply?
erector spinae
Where does ventral ramus from thoracic spinal nerves supply?
IC spaces as IC nerve
How does gray ramus communicans get to IC spaces?
via ventral ramus
Where do intercostal lymph nodes drain to?
upper spaces = thoracic duct or right lymphatic duct
lower 4/5 = cysterna chyli > thoracic duct
Describe lobes of the breast?
15-20 in each separated by connective tissue septum
Describe changes of breast during pregnancy?
adipose replaced by glandular
Where do breasts extend from and to?
ribs 2-6
Describe role of deep fascia which overlies pectoralis major in the breasts?
attaches to septae between lobes
Describe blood supply of breasts?
primarily mammary arteries - branches of internal thoracic
but also posterior IC arteries
What is the role of oxytocin in regards to the breasts?
causes contraction of myoepithelial cell
Which nerves pass through the oesophageal hiatus of diaphragm?
vagus nerve at T10
What is the motor innervation of the diaphragm?
Phrenic nerve - c3-5
At what level does spinal cord end?
L1/2
Define and give example of a synchondrial joint?
cartilaginous joint in which the connecting medium is hyaline cartilage i.e. sternocostal joint between sternum and 1st rib
Where is the main lymphatic drainage of the lungs to?
tracheobronchial nodes