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182 Cards in this Set
- Front
- Back
- 3rd side (hint)
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cupula of lungs
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part of lungs that extend into the neck, above the clavicles, in the pleural cavity
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location of nipples (in males)
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4th intercostal space
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intercostal space
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space between ribs
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majority of lungs located
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superior to a horizontal line passing through the nipples
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liver located
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under right dome of diaphragm
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stomach & spleen located
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under left dome of diaphragm
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kidney, location, superior pole, R
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on diaphragm anterior to 12th rib
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kidney, location, superior pole, L
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on diaphragm anterior to 11th & 12th ribs
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thoracic cavity, divisions
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three major spaces
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thoracic cavity, # of apertures
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two, superior & inferior
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mediastinum
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central compartment of thoracic cavity, houses thoracic viscera, except lungs
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pleural cavities
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left and right compartments of thoracic cavity, surrounds lungs
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each pleural cavity
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surrounds a lung
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encloses the thoracic cavity anteriorly
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diaphragm
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*osteology & general locations, slide 4
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thoracic skeleton, composition
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osteocartilagenous
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thoracic skeleton, includes
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intercostal spaces, 12 pairs of ribs, costal cartilabes, 12 thoracic vertebrae, 12 thoracic IV discs, sternum
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sternum comprised of
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manubrium, body of sternum, sternal angle, jugular notch
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sternal angle aka
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angle of Louis
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# of types of ribs
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3
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names of types of ribs
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true, false, floating
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true ribs comprise
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vertebralcostal ribs, # 1-7
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true ribs, attachment
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attach directly to the sternum via costal cartilages
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false ribs comprise
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vertebrochondral ribs, # 8-10
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false ribs, attachment
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costal margin
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floating ribs comprise
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ribs # 11 & 12
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floating ribs, attachment
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none; do not connect to sternum
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typical ribs include
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head, neck, tubercle, articular facets, body/shaft, angle, costal groove, costal cartilage
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tubercle of rib includes
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articular facet for transverse process and a non-articular part
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articular facets of ribs attach to
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vertebral bodies superiorly & inferiorly
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* osteology of ribs, slide 6
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1st and 2nd ribs are
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atypical
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1st rib has
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grooves for subclavian vessels & one articular facet on its head
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2nd rib has
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two articular facets & tubercles for muscle attachment
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ribs 10-12 are
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atypical
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ribs 10-12 have
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single articular facets on their heads
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ribs 11 & 12 are
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floaters
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ribs 11 & 12 do not have
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necks or tubercles
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superior angle of scapula located at
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T2 spinous process
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inferior angle of scapula located at
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T7 spinous process
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jugular notch located at
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T2 vertebral body
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sternal angle aka
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manubrosternal joint or angle of Louis
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lungs are (structurally)
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segmental
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2nd costal cartilages attach to
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sternal angle
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sternal angle located at
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level of IV disc btwn T4 & T5
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breast composed of
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subcutaneous fat, glands, & ligaments
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who has well-developed mammary glands?
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women
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mammary glands are _________ glands
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modified sweat glands
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modified sweat glands of breasts form
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lobules
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lobules drain into
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lactiferous ducts
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nipple has
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multiple lactiferous duct openings
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breasts are supported by
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suspensory ligaments
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breasts are located
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vertically over 2nd - 6th ruvs
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two thirds of breast overlies
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pectoralis major m.
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one third of breast overlies
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serratus anterior m.
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space between pectoral fascia and breast named
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retromammary space
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retromammary space allows for
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movement of breast
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male niple located at
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4th intercostal space
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blood supply to breast is via
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multiple routes
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three arteries that supply the breast
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lateral thoracic a., internal thoracic a., & posterior intercostal a.
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lateral thoracic a. gives off _________ branches
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lateral mammary branches
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internal thoracic a. gives off __________ branches
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medial mammary branches
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posterior intercostal a. arise from
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2nd, 3rd, & 4th intercostal spaces
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venous drainage of breast is to
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the lateral, medial, & intercostal mammary veins
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lateral mammary veins drain into
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axillary v.
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medial mammary veins drain into
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internal thoracic v.
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intercostal veins eventually drain into
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azygous system
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innervation of the breast is via
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anterior & lateral cutaneous branches of 2nd to 6th intercostal nerves
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nipple is innervated by
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4th intercostal nerve
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nerves of breast provide both
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sensory & smooth muscle innervation
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sensory fibers of breasts innervate
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skin over breasts
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smooth muscle fibers of breasts innervate
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smooth muscle of blood vessels in breasts
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order of passage of lymph in breast
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nipple, areola, lobules, subareolar lymphatic plexus
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most lymph (75%) from the breasts drains
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laterally and superiorly into axillary nodes
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None
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eventual destination of most lymph from breasts
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right lymphatic or thoracic duct
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most of medial quadrant of breast drains into
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parasternal nodes & internal thoracic veins
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lymph from parasternal nodes & internal thoracic veins can travel to
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contralateral breast or lymphatic or thoracic duct
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lymph drainage follows
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lateral branches of posterior intercostal vessels
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posterior intercostal lymphatic vessels drain into
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axygous system and thoracic duct
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additional locations of lymph drainage from breast
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subdiaphragmatic nodes & liver
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primarily, what nerve may be damaged during radical mastectomy?
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long thoracic nerve
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syndrome that develops from damage to long thoracic nerve
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winged scapula
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other the long thoracic nerve, what other nerve may be damaged during radical mastectomy?
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thoracodorsal n.
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pectoralis major m. overlies
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pectoralis minor m.
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pectoralis minor m. is enclosed by
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clavipectoral fascia
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pectoralis major m., action
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assists in forceful respiration
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# layers, intercostal muscles
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three
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names of layers, intercostal muscles
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external, internal and innermost
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extenal intercostals, features
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membranous anteriorly and continuous with External Oblique mm.
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internal intercostals, features
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membranous posteriorly and continuous with Internal Oblique mm.
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innermost intercostals, features
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membranous anteriorly and posteriorly
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intercostal mm are all innervated by
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intercostal nerves
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intercostal mm, action
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major contributors to respiration
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other muscles that contribute to respiration
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scalene mm, posterior serratus mm, deep back mm (e.g. levator costorum), and transverse throacic mm.
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subcostal mm, innermost
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posteriorly spans 2-3 intercostal spaces & can be considered a counterpart of the transversus thoracis
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transversus thoracis mm span
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more than one intercostal space
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two main sources of blood supply to thorax
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posterior intercostal aa and anterior intercostal aa
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posterior intercostal aa originate from
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thoracic aorta
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superior two posterior intercostal arteries originate from
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superior thoracic a, a branch from the costocervical trunk
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anterior intercostal aa are usually
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paired
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anterior intercostal aa originate from
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internal thoracic aa
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internal thoracic aa terminate in the
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superior epigastric & musculophrenic aa.
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musculophrenic a supplies
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the lower intercostal spaces
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venous drainage of thorax paraleles
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arterial supply
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ultimately, blood drains back to the venous system
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via two routes
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two routes of venous drainage in throax
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internal thoracic veins & azygous system
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internal thoracic veins drain into
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brachiocephalic veins
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azygous system drains
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into superior vena cava
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innervation of thorax is via
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intercostal nn, subcostal nn, collateral branches, & intercostal branches
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intercostal nn aka
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anterior rami of T1-T11 spinal nn
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subcostal nn aka
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anterior ramus of T12 spinal nn
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collateral nerve branches are found near
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superior border of ribs
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intercostal branches contain sympathetic motor fibers to
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smooth muscle in the body wall vasculature, hair follicles, etc.
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intercostal space, vessels & nerves pass
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posterior to anterior btwn inntermost & internal intercostal mm.
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intercostal spaces are protected by
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costal grooves in the inferior edge of the ribs
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vessels of intercostal spaces arranged
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VAN superior to inferior
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collateral branches of intercostal space vessels run
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superior to the ribs
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thoracic wall movement during inspiration
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rib cage expands with vertical, lateral and anteroposterior dimension rib movements
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thoracic wall movements during expiration
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diaphragm muscle relaxes & rib cage contracts
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movements of thoracic wall can be described as
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bucket handle & pump handle
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lung is located
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outside pleural cavity
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pleural lining touching lung is
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visceral pleura
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pleural lining outside lung is
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parietal pleura
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potential space between plurae is
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pleural cavity
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at root of lung, visceral & parietal pleura are
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continuous
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parietal pleura can be subdivided by
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region of approximation
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cervical pleura extends
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into root of neck
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costal pleura lies adjacent to
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ribs and intercostal spaces
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mediastinal pleura covers
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mediastinum
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diaphragmatic pleura covers
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diaphragm
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at T5 - T7, pleura
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reflects back on itself
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reflection of plura forms
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root of lung
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layers of root of lung join the lung at
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hilum of lung
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extension of two pleural layers continues inferiorly as
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pulmonary ligament, which allows for movement of lung
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endothoracic fascia, tissue type
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loose connective tissue
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endothoracic fascia separates
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parietal pleura from internal surface of thoracic wall
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visceral & parietal pleura are separated by
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regions of thorax that are not invaded by lungs during quiet respiration, resulting in recesses
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in the recesses the parietal pleura become
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closely opposed
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recesses allow for
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expansion during forced respiration & provides a space for fluid collection
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most important recess is
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costodiaphragmatic recess
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costodiaphragmatic recess is located
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below the 6th rib in midclavicular line and 8th rib in midaxillary lines
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costomediastinal recess is located
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anteriorly where costal pleura and mediastinal pleura meet
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# of lobes, right lung
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three
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lobes of right lung separated by
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horizontal & oblique fissure
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# of lobes, left lung
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two
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lobes of left lung separated by
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oblique fissure
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hilum of lung contains
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pulmonary veins & arteries and bronchus
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pulmonary ligament is the cut edge where
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visceral & parietal pleura unite
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lung bronchi -- see slides
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# of bronchopulmonary segments in each lung
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10
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largest subdivision of a lobe is
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bronchopulmonary segment
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bronchial aa supply
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lungs
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ronchial veins drain
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lung tissue
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bronchial vessels unite along
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the bronchi
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bronchial vessels form
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a single vein that exits at the hilum
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on the right side the bronchial vein drains into
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the azygous vein
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on the left side the bronchial vein drains into
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hemiazygous system
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bronchial veins drain within the lungs to tributeries of
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the pulmnonary veins
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drainage by veins in lung results in
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less blood return to systemic veins than blood supplied by bronchial aa delivering to lungs
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nerves to lungs & visceral pleura arise from
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pulmonary plexuses
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parasympathetc fibers of lungs are from
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vagus & sympathetic from the sympathetic trunks
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paralysis of half the diaphragm aka
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hemidiaphragm
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paralysis of diaphragm caused by
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injury to its motor supply from phrenic nerve
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only affects one half of diaphragm because
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each dome has separate nerve supply
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see slide for image of paralysis of diaphragm
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thoracocentesis
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see slide re: thoracocentesis
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pneumothorax
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entry of air into the pleural cavity
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pneumothorax, causes
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trauma, etc
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hydrothorax
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accymylation of fluid in the pleural cavity that may be due to pleural effusion
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hemothorax
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accumulation of blood in the pleural cavity
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hemothorax usually caused by
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injury of intercostal vessels
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bronchial asthma, causes
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contraction (spasm) of smooth muscle, edema of the mucosa & mucus in the lumen of the bronchi & bronchioles
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bronchial asthma, wheezing/breathing difficulties occur during
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expiration
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bronchiolar carcinoma, arises from
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epithelium of bronchial tree
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bronchiolar carcinoma, primary cause
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smoking
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bronchiolar carcinoma, metastasis
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occurs widely due to arrangement of lymphatics
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bronchiolar carcinoma, tumor cells travel
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into systemic circulation by invading the wall of a sinusoid or venule in the lung
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pulmonary embolism, definition
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obstruction of pulmonary artery by a thrombus (nlood clot) due to fat globule, air from leg vein, etc.
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pulmonary embolism, mechanism
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clot may block blood flow (in part or completely) causing ischemia
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pulmonary embolism, presentation
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acute respiratory distress due to major decrease in oxygenation of blood
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pulmonary embolism, possible result
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expiration in minutes due to deoxygenation
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