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182 Cards in this Set

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