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102 Cards in this Set
- Front
- Back
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The TRANSVERSE dimension of the thoracic cavity is most affected by:
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Movement of the lower ribs
Bucket Handle Movement |
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The VERTICAL dimension of the thoracic cavity is most affected by:
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Movement of the diaphragm
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The ANTERIOR-POSTERIOR dimension of the thoracic cavity is most affected by;
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Movement of the sternum by the upper ribs
Pump Handle Movement |
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Movements of the thoracic wall and diaphragm during inspiration are due to:
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1.Movement at the costovertebral joints
2. Contraction of the external intercostals muscles 3. Elevation of the sternum 4. Increase in the transverse dimension of the thoracic cavity 5. Contraction of the diaphragm |
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What are the muscles of INSPIRATION?
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External Intercostals
Diaphragm Sternocleidomastoid Scalenes Pectoralis Major |
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What are the muscles of EXPIRATION?
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Internal Intercostals
Transversus Abdominis Abdominal Muscles |
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What structures go thru the CAVAL opening of the diaphragm?
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IVC
Phrenic Nerves Lymphatics |
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What structures go thru the ESOPHAGEAL opening of the diaphragm?
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Esophagus
Vagus Left Gastric Vessels: esophageal branch |
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What structures go thru the AORTIC opening of the diaphragm?
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Aorta
Thoracic Duct Greater Splanchnic Azygos Vein |
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What structures are ANTERIOR to the Trachea?
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Sternum
Thymus Arch of the Aorta Origins of brachiocephalic and Common carotid |
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What structures are POSTERIOR to the Trachea?
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Esophagus
To the right: Azygos Vein, Vagus, Pleura To the left: Aortic Arch, LCC, LS, Left Vagus, Left Phrenic, Pleura |
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Why are objects more likely to lodge on the right lung ?
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The right bronchus is wider, shorter, and more vertical than the left.
In the right lung the inferior lobe bronchus continues nearly in the same plane as the trachea |
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What part of the lung portrudes above the clavicle?
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The Apex
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In the right lung what are the boundaries of the middle lobe?
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The oblique and horizontal fissures
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Where can the AORTIC VALVE be heard on the chest?
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To the RIGHT of the sternum on the 2nd ICS
Inmediately to the Right of the Angle of Louis |
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Where can the PULMONARY VALVE be heard on the chest?
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To the LEFT of the sternum on the 2nd ICS
Inmediately to the Left of the Angle of Louis |
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Where can the TRICUSPID VALVE be heard on the chest?
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To the LEFT of the xiphoid process of the sternum on the 5th ICS
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Where can the BICUSPID/MITRAL VALVE be heard on the chest?
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To the LEFT of the sternum
Under the left nipple |
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What surface depressions are present on the RIGHT LUNG?
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Tracheal
Esophageal SVC and IVC Cardiac Diaphragmatic |
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What surface depressions are present on the LEFT LUNG?
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Aortic Arch
Descending Aorta Cardiac Diaphragmatic |
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What is the PARASYMPATHETIC effect on the LUNGS?
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Bronchial Constriction
Vasodilation Increase in glandular secretion Sensory |
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What is the SYMPATHETIC effect on the LUNGS?
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Bronchial Dilation
Vasoconstriction |
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Name the features of the LINGULA
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Part of the lower lobe of the left lung
Homologus to the middle lobe of the right lung Slides in and out of the costomediastinal recess during breathing It has two bronchopulmonary segments |
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What is the PARIETAL PERICARDIUM attached to?
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The sternum
The central tendom of the diaphragm The great vessels: aorta, pulmonary trunk |
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The VISCERAL PERICARDIUM is continous with:
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The FIBROUS PERICARDIUM
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The INTERVENTRICULAR sulcus indicates the division of the Right Ventricle and the:
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Left Ventricle
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What artery supplies the SA NODE?
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Right Coronary Artery
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Which is the first branch of the aorta?
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Right Coronary Artery
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The ANTERIOR INTERVENTRICULAR ARTERY/LAD runs with
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Great Cardiac Vein
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The POSTERIOR INTERVENTRICULAR ARTERY/PAD runs with:
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Middle Cardiac Vein
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The MARGINAL ARTERY from the right coronary artery runs with:
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Small Cardiac Vein
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The CIRCUMFLEX ARTERY runs with:
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Coronary Sinus
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What are the contents of the RIGHT ATRIUM?
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Some Can = SVC, IVC
Retarted A = Right Auricle People Muscle = Pectinate M Can't That = Cristae Ter Sing Vaginates =Sinus Ven Instead Still =Interatr Sep They Vaginate =Tricusp Val Start After =SA node Over Climax = Open Coro S |
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What are the contents of te RIGHT VENTRICLE?
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People = Papillary
Can = Chordae Tendinae Save = Septomarginal band/mod Time = Trabeculae Carnae Cramming = Conus Arteriosus |
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What are the contents of the LEFT ATRIUM?
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Left Auricle
Openings of pulmonary veins Renmant valve of foramen ovale Mitral Valve |
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What are the contents of the LEFT VENTRICLE?
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Interventricular Septum
Papillary Muscles Chordae Tendinae Trabeculae Carnae Aortic Vestibule |
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The right recurrent laryngeal nerve wraps around which structure before ascending to the larynx?
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The ligamentum arteriosum
The ligamentum arteriosum can compress the nerve and cause Hoarse Voice |
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Damage to what structure would obstruct the majority of the venous drainage to the heart?
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The Coronary Sinus
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What vessel is continous with the RIGHT VENTRICLE?
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The Pulmonary Trunk
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What provides the force of perfusion for the coronary circulation?
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The Left Ventricle
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If a patient develops an arrythmia due to occlusion of a coronary artery, which artery would it be?
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Right Coronary Artery
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Horner's Syndrome Symptoms:
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horners syndrome: cancer of apex of the lungs, decrease sympathetics
flushing of skin retracted eyeball ptosis: droopy eyelids constriction of pupil anhydrosis anopthalmose (eye sinks into socket) |
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Horner's Symdrome could be caused by?
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Cancer of the Apex of the lungs compressing the sympathetic chain
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When the left atrium swells it can press on?
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The Esophagus
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The LEFT PULMONARY ARTERY is attached to the aorta by:
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Ligamentum Arteriosum
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All the cardiac veins drain into te Coronary sinus EXCEPT:
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The Anterior Cardiac Veins which drain directly into the right atrium
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Which valves are OPEN during SYSTOLE?
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Aortic and Pulmonary
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Which valves are CLOSED during SYSTOLE?
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Mitral and Tricuspid
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What are the contents of the SUPERIOR MEDIASTINUM?
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The Boy ATE Veggies & Turkey
T: Thymus B: Brachiocephalic veins & SVC A: Arch of aorta TE: Trachea & Esophagus V: Vagus, phrenic, & left recurrent laryngeal T: Thoracic duct |
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What are the contents of the POSTERIOR MEDIASTINUM?
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DATES:
Descending aorta Azygos and hemiazygous veins Thoracic duct Esophagus Sympathetic trunk/gangli |
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Tetralogy of Fallot
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Pulmonary Veins Oxygenate Heart By Blood:
Pulmonary stenosis Ventricular septal defect Overriding aorta Hypertrophy Blue Babies |
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Grey vs. white rami communicantes
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WhIte = On the Way In to the sympathetic trunk
GrEy = Exiting the sympathetic trunk |
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Thoracic duct: which half of upper body does it drain?
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It drains all of lower body.
Drains Lymph from the Left of the upper body |
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What are the contents of the MIDDLE MEDIASTINUM?
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HARP
Heart Arch of azygos Roots of great vessels and lungs Phrenic nerves |
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The coronary sulcus is located between the ventricles and the:
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Atria
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What approach is taken when performing a PERICARDIOCENTHESIS?
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Pericardiocenthesis: large needle inserted at the left sternal margin of ICS 4 (ICS 5 or 6)
For this procedure one wants to take the paraxiphoid approach instead the costoxiphoid approach in order to avoid the internal thoracic artery |
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What approach is taken when performing a THORACOCENTESIS?
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Thoracocentesis: surgical puncture of the chest wall to remove excess fluid in the pleural cavity (which reduces ventilation capacity)
A needle is inserted thru an ICS into the pleural cavity. Needle is inserted in the middle of ICS to avoid costal groove inferiorly and collateral vessels superiorly |
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Which portion of the lung will be closest to the CUPULA?
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The Apex
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Which condition leads to bony changes visible on X-rays?
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Coarctation of the Aorta
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Which artery is on the diaphragmatic surface of the heart?
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Right Marginal Artery
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Which heart chamber is located at the sternal margin of the left 5th ICS?
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The Right Ventricle
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What structures are deep to the sternum?
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Thymus
Arch of Aorta:BCS SVC Azygos Vein and Trachea Esophagus |
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What is location of the TRANSVERSE SINUS?
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_____ SVC, LV
_____ Large vessels: Aorta, P.Trunk |
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The VISCERAL PERICARDIUM is reflected onto the heart where it forms:
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The epicardium (external layer of heart muscle)
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What are the two layers of the PERICARDIUM?
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The Fibrous pericardium
The Serous pericardium: 2 layer sac |
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What are the two layers of the SEROUS PERICARDIUM?
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Parietal pericardium
Visceral pericardium |
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The PERICARDIUM is attached to the sternum and the diaphragm by:
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The sternopericardial ligament
The central tendon of the diaphragm |
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What are PERICARDIAL SINUSES?
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These are recesses that develop during embryonic folding of the pericardial sac
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What are the layers of penetration in the heart?
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1. Pericardium
2. Fibrous pericardium 3. Serous sac 4. Parietal layer 5. Pericardial cavity 6. Visceral layer (epicardium) 7. Heart 8. Epicardium 9. Myocardium 10. Endocardium 11. Chambers of the heart |
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Innervation of the PARIETAL PERICARDIUM:
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Phrenic and Vagus Nerves
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Innervation of the VISCERAL PERICARDIUM:
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Coronary Plexus
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SYMPATHETIC effects on the HEART:
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Increases HR and force of contraction, causing dilation of the coronary arteries that supply the heart resulting in more oxygen and nutrients to the myocardium
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PARASYMPATHETIC effects on the HEART:
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Decreases the heart rate and force of contraction, causing constriction of the coronary arteries.
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The coronary plexus is formed by:
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The cardiac plexus is formed by branches from both the vagus and the sympathetic trunks
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What is the innervation to the heart?
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Heart is supplied by the ANS from the vagus (parasympathetic) and the sympathetic trunk (T1-T5)
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What is the function of the PAPILLARY MUSCLE?
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The cusps in the heart valves are attached to the papillary muscles by the chordae tendinae. When the papillary muscle contracts it facilitates the closure of the valves during ventricular systole
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What vessel has the SHORTEST intrathoracic course?
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IVC
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What vessel has the LONGEST intrathoracic course?
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Aorta
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If you block the SECONDARY BRONCHI of the right lung, you would obstruct blood flow to:
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A lobe of the right lung
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The phrenic nerve is in contact with:
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Phrenic nerve is located b/w the parietal pleura and the fibrous pericardium
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Enlarged intercostal arteries are suggestive of:
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Coartaction of the aorta
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What is the function of the COSTAL GROOVE?
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*Conceals intercostals neurovascular bundle: VAN
On inferior border of rib In upper aspect of ICS Between the external intercostals and internal intercostals |
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Placement of the needle between the ICS for thoracocentesis:
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Middle of ICS: to avoid intercostal VAN at upper border of ICS and the collateral branches at the lower border of the ICS
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What structures are at the ANGLE OF LOUIS?
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Second Costal Cartilage
Aortic Arch Bifurcation of the trachea T4/T5 Ligamentum arteriosum Right recurrent laryngeal nerve hooks under ligamentum arteriosum at angle of Louis |
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SUPERIOR THORACIC APERTURE
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First pair of ribs
Manubrium T1 Contents: trachea, esophagus, vagus and phrenic nerves, and apex of lungs |
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INFERIOR THORACIC APERTURE
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Costal cartilages 7-10
T12 Rib #12 |
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BLOOD SUPPLY to the Anterior aspect of the thoracic wall:
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Supplied by the internal thoracic artery
Anterior Intercostal Arteries to ICS 1-6: come from internal thoracic artery ICS 7,8,9: come from musculophrenic artery ICS 10-11: no anterior intercostals arteries |
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BLOOD SUPPLY to the Posterior aspect of the thoracic wall:
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ICS 1: Posterior Intercostal or Highest Intercostal
ICS 2-11: Posterior Intercostal (thoracic aorta) ICS 12: Subcostal (thoracic aorta) |
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Lymphatic drainage of the THORACIC DUCT:
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• Drains lymph from the whole body EXCEPT:
o right upper extremity o right thoracic cavity o right side of head and neck ---→these areas are drained by the right lymphatic duct, which enters the right internal jugular vein |
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Where does the thoracic duct begin?
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Begins as the cisterna chili at the level of L2
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Relationships of lungs and pleura
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Mid-Clavicular Mid-Axillary Back
Lung is @ Rib 6 8 10 Pleura is @ Rib 8 10 12 |
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COSTODIAPHRAGMATIC RECESS:
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Costodiaphragmatic recesses: Lowest area of the pleural cavity into which the lungs expand during inspiration. Here the diaphragmatic pleura is in contact with the costal pleura. A tap may be performed here at ICS 9
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What is the innervation of the PARIETAL PLEURA?
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Phrenic nerve
Intercostal nerves 1-11 Subcostal nerves |
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PARASYMPATHETIC effect on the LUNGS/BRONCHI:
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Vagus:
Bronchial Constriction Vasodilation Increase in glandular secretion Sensory |
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SYMPATHETIC effect on the LUNGS/BRONCHI:
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Sympathetic Trunk: Vasomotor innervation from T2-T5
Bronchial Dilation Vasoconstriction |
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What are the contents of the ANTERIOR MEDIASTINUM?
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1. Fatty Tissue
2. Thymus gland (infants) 3. Lymph nodes |
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Features of the SYMPATHETIC nervous system
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Sympathetics:
Paravertebral (in column) T1-L2 Starts in lateral horn (posterior horn) Leaves thru ventral root Goes to sympathetic chain (synapses at sympathetic chain) |
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Leaves at 4 different places
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1. Greater splanchnic T5-T9: synapses at ciliac ganglion (postsynaptic)
2. Lesser splanchnic T10-T11: synapses at superior mesenteric 3. Lowest splanchnic T12: synapses at aorticorenal ganglion (postsynaptic) 4. Lumbar splanchnic L1-L2: synapses at inferior mesenteric---→ once they leave the ganglia they are postsynaptic |
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Features of the PARASYMPATHETIC nervous system
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Craniosacral:
CN 3 oculomotor CN 7 facial CN 9 glossopharyngeal CN 10 vagus Sacral: S2-S4 |
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LENGHT OF NEURON
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Sympathetic: short presynaptic long postsynaptic (travels with arteries everywhere)
Parasympathetic: long presynaptic (vagus nerve) short postsynaptic (viscera of glands) |
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EFFECTS OF SYMPATHETICS
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sympathetic (fight or flight): 1. Dilates conorary arteries an bronchioles 2. Constricts urinary bladder 3. Dilates pupil
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EFFECTS OF PARASYMPATHETICS
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parasympathetic: rest, sex and
digest contricts bronchiles and coronary arteries dilates urinary bladder sphincter constriction of pupil |
