Thorax

Front 1

Thorax
Function of the thoracic wall?

Back 1

1) Protect contents of the thoracic cavity.
2) Provide mechanical function for breathing.

Front 2

Thorax
The endothoracic fascia lies between what structures?

Back 2

Parietal pleura and innermost intercostal MM

Front 3

Thorax
What are the upper and lower borders thoracic chest?

Back 3

Neck and abdomen

Front 4

Thorax
What are the contents of the thoracic cavity?

Back 4

Thymus
Heart
Lungs
Distal trachea
Most of esophagus

Front 5

Thorax
What are the 3 parts of the sternum?

Back 5

Manubrium, Body, Xiphoid process

Front 6

Thorax
What are the borders of the thoracic inlet/Superior Thoracic aperture?

Back 6

First pair of ribs
Manubrium
T1

Front 7

Thorax
What are the contents of the thoracic inlet?

Back 7

Trachea
Esophagus
Vagus CNX
Phrenic C3,4,5
Apex of lungs

Front 8

Thorax
What are the borders of the thoracic outlet/Inferior thoracic aperture?

Back 8

12th pair of ribs
T12
Costal margin - costal cartilage 7-10

Front 9

Thorax
Where is the xiphoid process located?

Back 9

T10 or T11

Front 10

Thorax
Where is the sternal angle/angle of Louis located?

Back 10

T4 or T5

Front 11

Thorax
Which costal cartilage articulates with the manubriosternal joint?

Back 11

Rib number 2

Front 12

Thorax
What structures are present at the angle of Louis?

Back 12

1) Bifurcation of trachea- carina.
2) Arch of aorta.
3) T4/T5, intervertebral disc

Front 13

Thorax
Longest rib?

Back 13

7

Front 14

Thorax
Shortest rib?

Back 14

12

Front 15

Thorax
Typical ribs?

Back 15

3-9

Front 16

Thorax
Atypical ribs?

Back 16

1,2,10-12

Front 17

Thorax
True Ribs?

Back 17

1-7

Front 18

Thorax
False ribs?

Back 18

8-10

Front 19

Thorax
Floating ribs?

Back 19

11,12

Front 20

Thorax
What structures are found on the costal groove?

Back 20

VAN
Vein, Artery, Nerve

Front 21

Thorax
Bucket Handle movement?

Back 21

Middle parts of ribs move lateral when elevated

Front 22

Thorax
Pump Handle movement?

Back 22

Elevation of upper ribs, with a greater emphasis as you move inferior, increases the AP diameter

Front 23

Thorax
The Diaphragm separates what 2 structures?

Back 23

Thoracic cavity from the abdomen

Front 24

Thorax
Contents and level of Aortic opening?

Back 24

Level of T12
1) Thoracic Aorta
2) Thoracic Duct
3) Greater Splachnic Nerves (T5-9)
4) Azygos Vein

Front 25

Thorax
Contents and level of the Esophageal Opening?

Back 25

Level of T10
1) Esophagus
2) R and L Vagus Nerve CNX
3) Esophageal branch of L and R Gastric Artery and Vein

Front 26

Thorax
Contents and level of Cavel Opening?

Back 26

Level of T8
1) Phrenic Nerve C3-5
2) IVC
3) Lymphatics

Front 27

Thorax
Blood supply to anterior thoracic wall?

Back 27

ICS 1-6 - Anterior thoracic from Internal thoracic artery
ICS 7-9 - Anterior thoracic from musculoohrenic artery
NO ANTERIOR TO ICS 10-11

Front 28

Thorax
Blood supply to the posterior thoracic wall?

Back 28

ICS 1 - Highest intercostal or Posterior intercostal Artery
ICS 2-11 - Posterior intercostal Artery
ICS 12 - Subcostal Artery

Front 29

Thorax
Which vein drains the anterior aspect of the thoracic cage?

Back 29

Internal thoracic vein which drains into the brachiocephalic vein

Front 30

Thorax
Which vein drains the posterior aspect of the thoracic wall?

Back 30

Azygos vein which drains into the SVC

Front 31

Thorax
Which veins drain the right side of the thoracic wall?

Back 31

ICS1 - Highest intercostal vein which drains into Brachiocephalic.
ICS2,3 - Higher intercostal vein which drains into Azygos vein.
ICS4-11 - Azygos vein which drains into SVC.
ICS 12 - Subcostal veins which drain into the Azygos vein.

Front 32

Thorax
Which veins drain the left side of the thoracic wall?

Back 32

ICS 1 - Highest Intercostal vein which drains into the brachiocephalic.
ICS 2,3,4 - Accessory hemiazygos vein which drains into the Azygos.
ICS 5-12 - Hemiazygos which drains into the Azygos vein

Front 33

Thorax
The right lymphatic duct drains what part of the body?

Back 33

Right side of head and neck.
Right thorax.
Right upper extremity.

Front 34

Thorax
The thoracic duct drains?

Back 34

80% of the body. Everything the right lymphatic duct doesn't.

Front 35

Thorax
Mid axillary line penetration?

Back 35

1) Skin
2) Superficial fascia
3) Deep fascia
4) Serratus anterior M
5) External intercostal MM
6) Internal Intercostal MM
7) Innermost Intercostal MM
8) Endothoracic fascia
9) Parietal pleura
10) Pleural cavity
11) Visceral Pleura
12) Lungs

Front 36

Thorax
The thickened endothoracic fascia over the apex of the lungs is called the?

Back 36

Sibsons fascia

Front 37

Thorax
Clinical significance of a Cervical rib?

Back 37

Rib arising from C7. Compression of brachial plexus and subclavian artery.

Front 38

Thorax
Clinical significance of a Lumbar rib?

Back 38

More common than cervical rib. May result in misidentification of vertebral levels and misidentified as a fractured transverse process of L1.

Front 39

Thorax
Flail chest?

Back 39

Paradoxical chest movement. Inward with inspiration and outward with expiration.

Front 40

Thorax
Rib dislocation?

Back 40

Costal cartilage from sternum (2-7).

Front 41

Thorax
Rib separation?

Back 41

Rib from costal cartilage

Front 42

Thorax
Rickets?

Back 42

Vit D deficiency. Enlargement of ends of ribs

Front 43

Thorax
Thoracostomy?

Back 43

Puncture of ICS 4 or 5

Front 44

Thorax
Serous sac surrounding the lungs?

Back 44

Pleural sac

Front 45

Thorax
Pleura lining the thoracic wall, thoracic diaphragm, and lateral mediastinum?

Back 45

Parietal pleura

Front 46

Thorax
Pleura covering the external lungs and extending into the interlobar fissures?

Back 46

Visceral pleura

Front 47

Thorax
Where does the parietal pleura become continuous with the visceral pleura?

Back 47

Hilum of each lung

Front 48

Thorax
What structure connects the lung to the heart and trachea?

Back 48

Lung root

Front 49

Thorax
Function of the pleural space/cavity?

Back 49

Lubrication separating the visceral and parietal pleura by reducing friction

Front 50

Thorax
What is the cupula?

Back 50

Parietal pleura over apex of lungs

Front 51

Thorax
What is a pleural recess and what is it's function?

Back 51

Potential space where parietal pleura are in contact with each other during respiration allowing for lung expansion during inspiration

Front 52

Thorax
Where is the lowest pleural recess?

Back 52

Costodiaphragmatic recess at mid axillary line, ICS 9

Front 53

Thorax
Blood supply to the parietal pleura?

Back 53

Intercostal AA and Internal thoracic AA

Front 54

Thorax
Blood supply to the visceral pleura?

Back 54

Bronchial AA from Thoracic Aorta

Front 55

Thorax
Nerve supply to the parietal pleura?

Back 55

Phrenic nerve C3-5
Intercostal N 1-11
Subcostal N 12

Front 56

Thorax
Nerve supply to the visceral pleura?

Back 56

Does not have a nerve supply

Front 57

Thorax
What ligaments attache the lungs to the pericadium?

Back 57

Pulmonary ligaments

Front 58

Thorax
The apex of the lung extends how far above the clavicle?

Back 58

1 in or 2.5 cm

Front 59

Thorax
The bronchi, vessels, and nerves enter the lung to form what structure and where?

Back 59

Lung root middle mediastinal surface

Front 60

Thorax
Describe the anterior border of the lung?

Back 60

Thin, overlaps the heart.

Front 61

Thorax
What is the cardiac notch and what costal cartilages does it correspond with?

Back 61

Notch on left lung overlapping the heart. Costal cartilage 4,5,6

Front 62

Thorax
Describe the posterior border of the lung?

Back 62

Thick, lies beside the vertebral column

Front 63

Thorax
Where does the oblique fissure start and end?

Back 63

Starts 2.5 cm from apex of lung. Ends at costal cartilage 6

Front 64

Thorax
Where is the horizontal fissure of the right lung located?

Back 64

Costal cartilage 4

Front 65

Thorax
What is the Lingula?

Back 65

The superior lobe of the left lung has a modified middle lobe.

Front 66

Thorax
What are the 7 depressions/grooves of the right lung?

Back 66

1) Tracheal groove
2) Esophageal groove
3) SVC groove
4) IVC groove
5) Azygos vein groove
6) Cardiac depression
7) Diaphragmatic depression

Front 67

Thorax
What are the 4 grooves/depressions of the left lung?

Back 67

1) Cardiac depression
2) Aortic Arch groove
3) Descending Aorta groove
4) Diaphragmatic depression

Front 68

Thorax
Blood supply to the lungs?

Back 68

1) Bronchial AA from thoracic aorta.
2) Pulmonary AA.

Front 69

Thorax
Venous supply of the lungs?

Back 69

Bronchial VV drain into Azygos system and into the Pulmonary VV

Front 70

Thorax
Lymphatic drainage of the lungs?

Back 70

From hilum -> pulmonary nodes -> Tracheobronchial nodes

Front 71

Thorax
Nerve supply to the lungs?

Back 71

1) Vagus which causes bronchial constriction, vasodilation, and increased glandular secretion. Also sensory.
2) Adrenal medulla through the sympathetic trunk (T2-5) causing bronchial dilation and vasoconstriction

Front 72

Thorax
Where does the trachea begin?

Back 72

Continuation of the larynx. Lower border of cricoid cartilage C6

Front 73

Thorax
The trachea deviates slightly to which side at the angle of louis?

Back 73

Right just before it splits

Front 74

Thorax
Where the does trachea divide?

Back 74

Sternal angle, disc between T4-T5

Front 75

Thorax
What are the measurements of the trachea?

Back 75

2.5cm in width 9-15cm in length. For a 70kg man

Front 76

Thorax
Which side of the trachea contains 15-20 C shaped cartilages?

Back 76

Anterior

Front 77

Thorax
Name the 5 structures anterior to the trachea?

Back 77

1) Sternum
2) Thmyus
3) Arch of aorta
4) Origin of brachiocephalic trunk
5) Origin of Left common carotid A

Front 78

Thorax
Name the 8 structures posterior to the trachea?

Back 78

1) Esophagus
2) Azygos V
3) Vagus NN
4) Left Phrenic N
5) Arch of aorta
6) Left common carotid A
7) Left subclavian A
8) Pleura

Front 79

Thorax
Blood supply to the trachea?

Back 79

1) Thyroid AA
2) Bronchial AA
3) Internal thoracic A

Front 80

Thorax
Nerve supply to the trachea?

Back 80

1) Vagus CN X
2) Sympathetic chain

Front 81

Thorax
What are the differences between the Right and Left main bronchi?

Back 81

Right is thicker, shorter, and more vertical. Gives off superior lobar bronchus before entering hilum. In hilum divides into middle and inferior.

Left divides into a superior and inferior in the hilum.

Front 82

Thorax
Blood supply to the bronchi?

Back 82

1) Bronichial AA (non respiratory)
2) Pulmonary AA to terminal bronchioles

Front 83

Thorax
Venous drainage of bronchi?

Back 83

Bronchial VV to Azygos V and Hemiazygos V

Front 84

Thorax
Nerve supply of the bronchi?

Back 84

Parasympathetic from vagus - bronchi constriction and mucus secretion.
Sympathetic chain - bronchi dilation

Front 85

Thorax
Superior and inferior borders of mediastinum?

Back 85

Superior - thoracic inlet/ root of neck.
Inferior - Diaphragm

Front 86

Thorax
Anterior and posterior borders of mediastinum?

Back 86

Anterior - Posterior surface of sternum to anterior surface of pericardial sac
Posterior - vertebral column

Front 87

Thorax
What thoracic vertebra are part of the superior/inferior mediastinum?

Back 87

Superior - T1-T4
Inferior - T5-T12

Front 88

Thorax
What are the contents of the superior mediastinum?

Back 88

1) Aortic arch, Brachiocephalic, Carotid, Subcalvian AA
2)SVC, brachiocephalic, jugular, subclavian VV
3) Thymus gland
4) Esophagus
5) Trachea
6) Thoracic duct
7) Phrenic N

Front 89

Thorax
What are the contents of the Inferior Anterior mediastinum?

Back 89

1) Fatty tissue
2) Thymus gland
3) Lymph nodes

Front 90

Thorax
What are the contents of the inferior middle mediastinum?

Back 90

1) Heart
2) Pericardium
3) Main bronchi
4) Great vessels
5) Phrenic N

Front 91

Thorax
What are the contents of the inferior posterior mediastinum?

Back 91

1) Esophagus
2) Thoracic aorta
3) Azygos V
4) Thoracic duct
5) Vagus N
6) Splanchnic N

Front 92

Thorax
The pericardium is located between what costal cartilages and what vertebra?

Back 92

Costal cartilage 2-6.
Vertebra T5-T8.

Front 93

Thorax
What ligament attaches the pericardium to the sternum?

Back 93

Sternopericardial ligament

Front 94

Thorax
What structure attaches the pericardium to the diaphragm?

Back 94

Central tendon

Front 95

Thorax
What are the layers of heart penetration starting with the pericardium?

Back 95

1) Pericardium
2) Fibrous pericardium
3) Parietal pericardium
4) Pericardial cavity
5) Visceral pericardium/Epicardium
6) Myocardium
7) Endocardium
8) Chambers of the heart

Front 96

Thorax
Where is the transverse sinus of the heart located?

Back 96

Posterior to the aortic arch and Pulmonary trunk.
Anterior to the left atrium and SVC.

Front 97

Thorax
Where is the oblique sinus of the heart located?

Back 97

Between the pulmonary veins and IVC

Front 98

Thorax
Nerve supply to the parietal pericardium?

Back 98

Phrenic C3-5
Vagus CN X

Front 99

Thorax
Nerve supply to the visceral pericardium?

Back 99

Coronary plexus

Front 100

Thorax
Blood supply to the heart?

Back 100

1) Pericardiophrenic
2) Musculophrenic
3) Pericardial branches of thoracic aorta
Visceral - Coronary AA from ascending aorta

Front 101

Thorax
Deviation of the heart in the median plane?

Back 101

2/3 left 1/3 right

Front 102

Thorax
Where is the apex of the heart located?

Back 102

Costal cartilage 6, 7-9cm from the median plane and just medial to the midclavicular line

Front 103

Thorax
Which left costal cartilages does the heart correspond to?

Back 103

3-5

Front 104

Thorax
Which vertebra does the heart correspond to erect and supine?

Back 104

Erect - T5-T9
Supine - T5-T8

Front 105

Thorax
What structure encircles most of the superior heart and separates the atria from the ventricles?

Back 105

Coronary groove or Sulcus

Front 106

Thorax
What surface structure separates the ventricles?

Back 106

Anterior and posterior interventricular groove

Front 107

Thorax
Know the blood supply to the heart

Back 107

Branches of the right and left Coronary AA

Front 108

Thorax
Which vein accompanies PAD?

Back 108

Middle Cardiac vein

Front 109

Thorax
Which vein accompanies the right Marginal Branch of the right Coronary A?

Back 109

Small Cardiac vein

Front 110

Thorax
Which vein accompanies LAD?

Back 110

Great cardiac vein

Front 111

Thorax
Anastomoses of left and right Coronary AA?

Back 111

1) Nodal
2) About the conus arteriosum
3) Circumflex
4) LAD
5) PAD

Front 112

Thorax
Know the venous supply of anterior and posterior heart?

Back 112

?????

Front 113

Thorax
Tributaries of the coronary sinus?

Back 113

1) Great Cardiac V
2) Small Cardiac V
3) Middle Cardiac V
4) Oblique Cardiac V
All except Anterior Cardiac VV

Front 114

Thorax
At the angle of louis which nerve hooks under the ligamentum arteriosum?

Back 114

Left recurrent laryngeal N

Front 115

Thorax
Which nerve passes under the Right Subclavian A?

Back 115

Right recurrent laryngeal N