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81 Cards in this Set

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Define midclavicular line.
An orientation line, medial to the nipple, that connects the lower ribs to the sternum.
What is the costal margin? What is it made of?
The inferior extent of rib cage (made of cartilage.
What is the jugular notch?
The superior depression in the manubrium (Follow the trachea down, pocket surrounded by bown)
What are the 3 parts of the sternum?
Manubrium, body, xiphoid process
How many ribs are there? Which are true/false/floating? What makes them this way? To what do they all attach to?
12 ribs
Ribs 1-7 Directly attach to sternum
False 8-10 Indirectly attach to sternum
Floating 11-12 cartilage does not make contact w/sterum

All attach to vertebrae
What is the superior extent of the diaphragm?
The 4th intercostal space.
What is thoracic outlet syndrome? Where is the superior thoracic apeture? What forms it? What can cause thoracic outlet syndrome?
Thoracic outlet syndome is where pressure is applied to the subclavian or other structures in the neck. It can be caused via narrowing of the space below the clavicle and 1st rib. Also an extra rib can cause this.

The superior thoracic apeture is defined by T1, vertebrae, the 1st rib, and the manubrium. THE CLAVICLE IS NOT PART OF IT!!!
Describe the shape of the manubrium. What does it articulate with?
It articulates wi/ the clavicle, 1st and the 2nd rib.
What is the sternal angle?
Joins the manubrium and sternum.
What is the inferior thoracic apeture? What defines its borders? Why is it important?
The inferior thoracic apeture is the attachment point for the diaphragm. It is bound by T12 vertabrae, 11th and 12th ribs and the costal margin.
What are the 3 functions of the thoracic cage?
1. Respiration - exhale/inhale change dimensions
2. Protection of visceria - heart/lung etc.
3. Anchor points for skeletal muscles.
What part of the rib articulates with the vertebral body?
The head of the rib.
Which vertebrae does the inferior facet of rib 6 articulate with? Which vertebrae does the superior facet of rib 6 articulate with?
With vertebrae T6 for inferior.
With vertebrae T5 for superior.
What is the costal angle?
Where the ribs turn and run anteiorly.
What are the two parts of the tubercle? With what structure do they articulate?
The Articular and nonarticular parts of the tubercle.

They articulate with the transverse processes of thoracic vertebrae of the same number.
What is the costal groove? Why is it important?
The costal groove provides a safe place for the neurovascular bundle (intercostal n.,a.,v.), it is on the inferior aspect of the rib.
Do ribs participate in hematopoesis?
What structures are involved in the costal vertebral joint?
Costal vertebral joints connecting the heads of the ribs with the bodies of the vertebrae.
What structures are involved in the costotransverse joint?
In the costotransverse joints unite the necks and tubercles of the ribs with the transverse processes.
What is the costochondral joint?
It is the transition from bone to cartilage.
What is the sternocostal joint? What kind of joint is it?
A synovial type joint between the sternum and cartilage.
Define ventilation.
The movement of air into and out of the lungs.
Define inspiration.
Requires an increase in the volume of the thoracic cavity which produces a negative air pressure in the lungs which draws air in.
Define quiet inspiration. Which dimension changes the most?
Diaphragm contracts, lowers the diaphragm and increaes the vertical dimensions.
Define active inspiration? What dimensions increase? What other things happen during this proces?
Heavy breathing, needs other respiratory muscles to contract, elevating the ribs and increasing the transverse and anterior-posterior dimensions.
What is quiet expiration? What tissue type does it involve?
A passive process of elastic tissue where the diaphram relaxes.
What is active expiration? What muscles contract?
Heavy breathing. Contracts the anterior ventral wall via the abdominal muscles.
What makes up the vertical axis of the respiration area?
The diaphragm = verticle
What makes up the anterior-posterior axis of the respiration area? What type of movement do these structures undergo?
The ribs and sternum = anterior/posterior undergo a pump handle type movement.
What makes up the transverse axis? What sort of movement do these undergo?
The ribs = transverse axis and make a bucket handle movement.
At what level is the Nipple at for men?
At the level of the 4th intercostal space.
What is the majority of tissue in the breast?
Adipose tissue.
What sort of glands (morphology) are mammary glands, where are they located?
Mammary glands are compound alveolar glands located in subcutaneous tissue
What are lactiferous ducts and what do they do?
They carry secretions towards the nipple. Found in breast and part of the mammary glands.
What are lactiferous sinues? What do they do?
Parts of lactiferous ducts that dialate just before exiting the breast and store a small amount of milk.
What are the suspensory ligaments of cooper?
A CT element that is contineuous w/ lobules and connects subcutaneous CT septa to the dermis of the breast.
What is the Retromammary space (bursa)?
Thin layer of loose CT that allows the breast to be moveable.
What innervates the breast?
The 4-6th intercostal nerves.
What is the blood supply of the breast (4)?
Tributaries of internal thoracic artery, pectoral branches of thoracromial artery, lateral thoracic artery, and posterior intercostal artery.
What is the venous supply of the breast (2)?
Axillary V. (majority drains here)
and Internal thoracic V.
What is the Lymphatic Drainage of the breast? (4)
Axillary, clavicular, sternal, and phrenic
What are the muscles of the thoracic wall (4 groups)?
The peripheral muscles, the intercostal muscles, the transverse thoracic muscle, and the subcostal muscle.
What are the peripheral muscles of the thoracic wall and how can they they function together?
Pectoralis major, serratus anterior, serraturs posterior superior, all can function in active inspiration.
What does the external intercostal muscle do?
It a membrane that elevatees the ribs.
What is the internal intercostal muscle and what does it do?
IT is a membrane where the interosseus part depresses the ribs and the interchondral part elevates the ribs.
Describe the veins, arteries and nerves of the neurovascular bundle in costal groove. Where do they drain/supply etc.?
Vein - drains into the azygous system, internal thoracic vein
Artery -posterior interocostal artery supplied by the thoracic aorta and the anterior intercostal artery supplied by the internal thoracic.
Nerves- Ventral rami of T1-T12 = subcostal nerve
What do innermost intercostal muscles do?
They are a membrane whose actions are the same as internal intercostal.
What 3 sets of muscles work together during active inspiration?
External, internal, innermost intercostal muscles.
WHat do transverse thoracic muscles do and where are they located?
They are located on the anterior and lower the ribs.
What do the subcostal muscles do and where are they located?
They are located on the posterior aspect and they act to depress the ribs (cross 2-3 ribs and attach superiorly and laterally)
Describe where each of these thins out to become a small membrane:
Innermost innercostal,
External innercostal, and
Internal intercostal.
Innermost thins posterior/anterior
External innercostal thins anteriorly, Internal innercostal thins posteriorly
What is the innermost layer of the thoracic wall and what is just superficial to it?
The parietal pleura is just deep to the endothoracic fascia.
What are the three compartments of the thoracic cavity?
2 pulmonary cavities laterally and 1 central mediastinum
What are the subdivisions of the PARIETAL pleura?
Costal, diaphragmatic, mediastinal and cervical. Look at diagram!
What is the pleural cavity?
Potential space w/ small amount of lubricating fluid.
Where is the costodiaphragmatic recess?
6/8 Anteriorly, 8/10 Laterally (drains fluid of 9th ribs) 10/12 -> rib #s (between ribs and diaphragm.
Where is the costomediastinal recess?
Between the rib and the mediastinum.
Where is the hilum of the lungs? What is it?
Point where the parietal and visceral pleura meet.
Where is the root of the lung?
Travel from mediastinum to lung, primary bronchi, pulmonary vein, pulmonary artery coverted by hilum.
What is the pulmonary ligament?
Anchors the lung to the mediastinum (like the cuff of a sleeve)
What is visceral pleura?
Covering of the lung.
How many lobes/what are they of the right lung?
3 Lobes: Superior lobe, middle lobe, inferior lobe.
What does the horizontal fissure seperate on the right lung? How about on the left?
Right -> Superior lobe and middle lobe
What does the oblique fissure seperate on the right lung? How about on the left?
Right -> The inferior lobe and the middle lobe
Left -> The superior and inferior lobe
Which lung has the cardiac notch?
Left on the superior lobe
What is the lingula?
(tongue), just inferior to the cardiac notch on the superior lobe of the left lung.
What type of cartilage are primary bronchi made of?
Hard cartilage
What do pulmonary arteries feel like?
Soft resistance.
What do pumonary veins feel like?
No resistance
Which lung has an impression for esophagus? How about arch of azygous? Superior vena cava? Inferior vena cava? Arch of aorta? Descending Aorta? Subclavian artery? Brachiocephalic vein? Tracheal area? Heart?
Both: Tracheal/esophagus
1st Rib

Right: Brachiocephalic vein
Superior vena cava
Inferior vena cava
Arch of azygos

Left: Arch of aorta
Descending aorta
Subclavian artery
How is the right bronchi different from the left?
The right bronchi is wider, shorter and more vertical.
Describe the differentiation of the lungs from the trachea on down.
Trachea - Carina - Main (primary bronchi) - Lobar (secondary bronchi) - Segmental (tertiary) bronchi - Bronchopulmonary segments (8-10 segments)
What are bronchopulmonary segments supplied by?
A segmental bronchi and artery NOT vein.
Describe the lymphatic drainage of the lungs, both superficial and deep
Superficial>bronchopulmonary nodes>tracheobronchial nodes>bronchomediastinal trung>right lymphatic duct or thoracic duct

Deep>pulmonary nodes? bronchopulmonary node > same as above
What is the parasympathetic innervation of the lungs?
Vagus nerve
What is the somatic innervation of the lungs?
NO somatic innervation!
What does the vagus nerve become/join?
The pulmonary plexus
What sort of reactions does the vagus nerve induce in the lungs?
Bronchoconstriction, vasodialation, secretion, and cough reflex.
What is the sympathetic innervation of the lungs?
Paravertebral sympathetic ganglia.
What does the paravertebral sympathetic ganglia join?
Pulmonary plexus.
What reactions does the paravertebral sympathetic ganglia induce in the lungs?
Bronchodialation, vasoconstriction, inhibition of secretions, visceral pain