Tusom Anatomy Shelf: Thorax 2012 (Alixdixon)

Front 1

What can be found at the sternal angle?

Back 1

Second ribs articulate w/ sternum.
Aortic arch begins and ends.
Trachea bifurcates into R and L bronchi at the carina.
Inferior border of superior mediastinum is demarcated.
Transverse plane can pass between T4 and T5.

Front 2

Thoracic outlet syndrome

Back 2

Compression of neurovascular structures in the thoracic outlet, causing a combination of pain, numbness, tingling or weakness and fatigue in the upper limb caused by pressure on brachial plexus. May be caused by cervical rib. Subclavian artery may also be compressed.

Front 3

Flail chest

Back 3

Loss of stability of the thoracic cage that occurs when a segment of the anterior or lateral wall moves freely because of multiple rib fx's. Extremely painful and impairs ventilation - causing respiratory failure

Front 4

2nd-9th ribs

Back 4

Two articular facets which articulate w/ bodies of N and N-1 vertebrae

Front 5

Internal intercostals

Back 5

I: Intercostal
A: Elevate ribs in inspiration

Front 6

Internal intercostals

Back 6

I: Intercostal
A: Depress ribs

Front 7

Innermost intercostals

Back 7

I: Intercostal
A: Elevate ribs

Front 8

Transversus thoracis

Back 8

I: Intercostal
A: Depress ribs

Front 9

Intercostal nerves

Back 9

Anterior primary rami of thirst 11 thoracic spinal nerves.

Front 10

Internal thoracic artery

Back 10

Usually arises from first part of subclavian artery. Divides into musculophrenic and superior epigastric arteries.

Front 11

Contents of superior mediastinum

Back 11

SVC, brachiocephalic veins, arch of aorta, thoracic duct, trachea, esophagus, vagus, L recurrent laryngeal nerve, phrenic nerve

Front 12

Contents of anterior mediastinum

Back 12

Remnants of th

Front 13

Innervation of parietal pleura

Back 13

Intercostal and phrenic nerves

Front 14

Pleurisy

Back 14

Inflammation of the pleura w/ exudation into its cavity, causing the pleural surfaces to be roughened. This roughening produces friction, and a pleural rub can be heard with the stethoscope on respiration. Exudate can form pleural adhesions.

Front 15

Pneumothorax

Back 15

Accumulation of air in the pleural cavity, thus the lung collapses because the negative pressure necessary to keep the lung expanded has been eliminated.

Front 16

Tension pneumothorax

Back 16

Life-threatening pneumothorax is a life-threatening pneumothorax in which air enters during inspiration and is trapped during expiration. Sxs include CP and dyspnea

Front 17

Pleural effusion

Back 17

Abnormal accumulation of excess fluid in the pleural space. Transudate - caused by CHF or liver/kidney disease. Exudate - caused by inflammation, PNA, lung CA, TB, asbestosis or PE. Sxs include SOB, CP and cough

Front 18

Location of thoracentesis

Back 18

At or posterior to the midaxillary line one or two intercostal spaces below the fluid level but not below the ninth intercostal space. Ideal site is 7-9th intercostal space.

Front 19

Pancoast's tumor

Back 19

Malignant neoplasm of the lung apex and Pancoast's syndrome, which comprises (a) lower trunk brachial plexopathy and (b) lesions of cervical sympathetic chain ganglia w/ Horner's syndrome.

Front 20

Pulmonary edema

Back 20

Involves fluid accumulation and swelling in the lungs caused by lung toxins, mitral stenosis or L ventricular failure that results in increased pressure in pulmonary veins. As pressure in the pulmonary veins rises, fluid is pushed into the alveoli and becomes a barrier to normal oxygen exchange, resulting in SOB.

Front 21

Atelectasis

Back 21

The collapse of a lung by blockage of the air passages or by very shallow breathing because of anesthesia or prolonged bed rest.

Front 22

Which cells secrete surfactant?

Back 22

Alveolar type II cells.

Front 23

Muscles of inspiration

Back 23

Diaphragm; external, internal and innermost intercostal; SCM; lecator costarum; serratus anterior; scalenus; pectoralis major and minor; and serratus posterior superior.

Front 24

Muscles of expiration

Back 24

Muscles of anterior abdominal wall, internal intercostals, and serratus posterior inferior muscles.

Front 25

Quiet expiration

Back 25

A passive process caused by the elastic recoil of the lungs

Front 26

Quiet inspiration

Back 26

Caued by contraction of the diaphragm

Front 27

Pulmonary embolism

Back 27

Obstruction of the pulmonary artery or one of its branches by an embolus which arises in the deep veins of the lower limbs or in the pelvic veins or occurs following an operation. Sxs may be sudden onset of dyspnea, anxiety and substernal CP.

Front 28

Lesion of phrenic nerve

Back 28

May or may not produce complete paralysis of the corresponding half of the diaphragm because the accessory phrenic nerve usually joins the phrenic nerve in the root of the neck or in the upper part of the thorax

Front 29

Pericarditis

Back 29

Inflammation of the pericardium which may result in cardiac tamponade, pericardial effusion, and precordial and epigastric pain. It also causes pericardial murmur or pericardial friction rub.

Front 30

Transverse sinus

Back 30

Lies posterior to the ascending aorta and pulmonary trunk, anterior to the SVC, and superior to L atrium and pulmonary veins. Surgeon can pass a finger and make a ligature through the sinus between the arteries and veins, thus stopping the blood circulation with the ligature.

Front 31

Oblique sinus

Back 31

Surrounded by reflection of the serous pericardium around the right and left pulmonary veins and inferior vena cava.

Front 32

Cardiac tamponade

Back 32

Acute compression of the heart caused by a rapid accumulation of fluid or blood in the pericardial cavity from wounds to the heart or pericardial effusion. Causes compression of venous return to the heart, resulting in decreased diastolic capacity, reduced cardiac output w/ an increased HR, increased venous pressure w/ JVD, hepatic enlargement and peripheral edema.

Front 33

Pericardial effusion

Back 33

Accumulation of fluid in the pericardial space resulting from inflammation caused by acute pericarditis, and the accumulated fluid compresses the heart, inhibiting cardiac filling.

Front 34

Location for pericardiocentesis

Back 34

A needle is inserted into the pericardial cavity through the 5th intercostal space left to the sternum.

Front 35

Sulcus terminalis

Back 35

Groove on the external surface of the R atrium, marking the junction of the primitive sinus venous with the atrium in the embryo. Corresponds to crista terminalis on internal heart surface.

Front 36

Sinus venarum

Back 36

Develops from the embryonic sinus venosus and receives the SVC, IVC, coronary sinus and anterior cardiac veins.

Front 37

IV Septum

Back 37

Mostly muscular but has a small membranous upper part, which is a common site of ventricular septal defects

Front 38

Prinzmetal's angina

Back 38

A variant form of angina pectoris caused by transient coronary artery spasm. The vasospasm typically occurs at rest, and in many cases, the coronary arteries are normal. ST elevation present.

Front 39

Pulmonary valve

Back 39

Opened by ventricular systole and shut slightly after closure of the aortic valve

Front 40

Aortic valve

Back 40

Closed during ventricular diastole. Its closure at the beginning of the ventricular diastole causes the second "dub" heart sound.

Front 41

Tricuspid valve

Back 41

Closed during ventricular systole; its closure contributes to the first "lub" heart sound

Front 42

Bicuspid (Mitral) valve

Back 42

Closed slightly before tricuspid valve by the first ventricular contraction (systole); its closure at the onset of ventricular systole causes the first "lub" heart sound.

Front 43

Mitral valve prolapse

Back 43

A condition in which the valve everts into the left atrium and thus fails to close properly when the left ventricle contracts. It may produce chest pain, SOB, palpitations and cardiac arrhythmia

Front 44

Endocarditis

Back 44

An infection of the endocardium of the heart, most commonly involving the heart valves and is caused by a cluster of bacteria on the valves. The valves do not receive any blood supply and white blood cells cannot enter, and thus they have no defense mechanisms.

Front 45

Cardiac murmur

Back 45

A characteristic sound generated by turbulence of blood flow through an orifice of the heart.

Front 46

First "Lub" sound

Back 46

Caused by the closure of the tricuspid and mitral valves at the onset of ventricular systole

Front 47

Second "dub" sound

Back 47

Caused by the closure of the aortic and pulmonary valves at the onset of ventricular diastole.

Front 48

Heart block

Back 48

Caused by damage to the conducting system. This interferes w/ the ability of the ventricles to receive the atrial impulses. A delay or disruption of the electrical signals produces an irregular and slower heartbeat, reducing the heart's efficiency in maintaining adequate circulation.

Front 49

Atrial or ventricular fibrillation

Back 49

A cardiac arrhythmia resulting from rapid irregular uncoordinated contractions of the atrial or ventricular muscle d/t fast repetitive excitation of myocardial fibers, causing palpitations, SOB, angina, fatige,CHF and sudden cardiac death

Front 50

Maximal blood flow through coronary arteries occurs...

Back 50

During diastole because of the compression of the arterial branches in the myocardium during systole.

Front 51

Fate of truncus arteriosus

Back 51

Forms aorta and pulmonary trunk by formation of the aorticopulmonary septum

Front 52

Fate of bulbus cordis

Back 52

Forms conus cordis or conus arteriosus and aortic vestibule

Front 53

Fate of primitive ventricle

Back 53

Forms trabeculated part of right and left ventricles

Front 54

Fate of primitive atrium

Back 54

Forms trabeculated part of right and left atrium

Front 55

Fate of sinus venosus

Back 55

Forms sinus venarum, coronary sinus, and oblique vein of left atrium

Front 56

Tetrology of Fallot

Back 56

Occurs when the AP septum fails to align properly with the AV septum, resulting in pulmonary stenosis, overriding aorta, VSD, and right ventricular hypertrophy. It is characterized by right-to-left shunting of blood and cyanosis

Front 57

Transposition or dextraposition of the great vessels

Back 57

Occurs when the AP septum fails to develop in a spiral fashion, causing the aorta to arise from the right ventricle and the pulmonary trunk to arise from the left ventricle. It results in right-to-left shunting of blood and cyanosis. Thus, the transposition must be accompanied by a VSD or a patent ductus arteriosus for the infant to survive.

Front 58

Atrial septal defect

Back 58

A congenital defect in the septum between the atria d/t failure of the foramen primun or secundum to close normally, resulting in a patent foramen ovale. This defect shunts blood from the left atrium to the right atrium and causes hypertrophy of the right atrium, right ventricle, and pulmonary trunk, and thus mixing of oxygenated and deoxygenated blood, producing cyanosis.

Front 59

Ventricular septal defect

Back 59

Occurs commonly in the membranous part of the IV septum because of the failure of the membranous IV septum to develop, resulting in left-to-right shunting of blood through the IV foramen, which increases blood flow to the lungs and causes pulmonary HTN. Loud, continuous murmur

Front 60

Aortic arch 1 derivative

Back 60

Nothing. Disappears soon after development

Front 61

Aortic arch 2 derivative

Back 61

Nothing. Persists only through early development

Front 62

Aortic arch 3 derivative

Back 62

Common carotid arteries and proximal part of internal carotid arteries

Front 63

Aortic arch 4 derivatives

Back 63

Aortic arch on the left and the brachiocephalic artery and proximal subclavian artery on the right

Front 64

Aortic arch 5 derivative

Back 64

Nothing.

Front 65

Aortic arch 6 derivative

Back 65

Proximal pulmonary arteries and ductus arteriosus

Front 66

Derivatives of posterolateral branches of dorsal aorta

Back 66

Intercostal, lumbar, vertebral, cervical, internal thoracic, and epigastric arteries and arteries to upper and lower limbs

Front 67

Derivatives of lateral branches of dorsal aorta

Back 67

Renal, suprarenal and gonadal arteries

Front 68

Derivatives of ventral branches of dorsal aorta

Back 68

Vitelline arteries form the celiac (foregut), superior mesenteric (midgut), and inferior mesenteric (hindgut) arteries.
Umbilical arteries form a part of the internal iliac and superior vesical arteries.

Front 69

Foramen ovale

Back 69

Opening in the septum secundum. Usually closes functionally at birth, but with anatomic closure occurring later. Shunts blood from the right atrium to the left atrium, partially bypassing the lungs.

Front 70

Ductus arteriosus

Back 70

Derived from the 6th aortic arch and connects the bifurcation of the pulmonary trunk with the aorta. Closes functionally soon after birth, with anatomic closure requiring several weeks. Becomes ligamentum arteriosum. Shunts blood from the pulmonary trunk to the aorta, partially bypassing the lungs.

Front 71

Patent ductus arteriosus

Back 71

Results from failure of the ductus arteriosus to close after birth, and is common in premature infants. The ductus arteriosus take sorigin from the left 6th aortic arch

Front 72

Ductus venosus

Back 72

Shunts oxygenated blood from the umbilical vein (returning from the placenta) to the IVC, partially bypassing the liver. Joins the left branch of the portal vein to the IVC and is obliterated to become the ligamentum venosum after birth

Front 73

Umbilical arteries

Back 73

Become medial umbilical ligaments after birth, after their distal parts have atrophied.

Front 74

Umbilical veins

Back 74

Consists of the right vein, which is obliterated during the embryonic period, and the left vein, which is obliterated to form the ligamentum teres hepatis after birth

Front 75

Three constrictions of esophagus

Back 75

Upper or pharyngeal constriction caused by cricopharyngeus.
Middle or thoracic constriction by the aortic arch and then left main bronchus.
Inferior or diaphragmatic constriction at esophageal hiatus.

Front 76

Achalasia of esophagus

Back 76

Condition of impaired esophageal contractions because of failure of relaxation of the inferior esophageal sphincter, resulting from degeneration of myenteric (Auerbach's) plexus in the esophagus. Causes an obstruction to the passage of food in the terminal esophagus and exhibits sxs of dysphagia for solids and liquids, weight loss, CP, nocturnal cough and recurrent bronchitis or PNA

Front 77

Systemic sclerosis (scleroderma)

Back 77

A systemic collagen vascular disease and has clinical features of dysphagia for solids and liquids, severe heartburn and esophageal stricture

Front 78

Coartation of the aorta

Back 78

Occurs when the aorta is abnormally constricted just inferior to the ductus arteriosus, in which case an adequate collateral circulation develops before birth. It causes a characteristic rib notching and high risk of cerebral hemorrhage, tortuous and enlarged blood vessels, elevated BP in radial artery and decreased BP in femoral artery, and femoral pulse to occur after radial pulse.

Front 79

Collateral circulation of thorax

Back 79

Occurs between anterior intercostal branches of internal thoracic artery and posterior intercostal arteries; superior epigastric branch of internal thoracic artery and inferior epigastric artery; superior intercostal branch of the costocervical trunk and the third posterior intercostal artery; and posterior intercostal arteries and descending scapular artery, which anastomoses w/ suprascapular and circumflex scapular arteries.

Front 80

Greater splanchnic nerve

Back 80

Arises usually from the 5th-9th thoracic sympathetic ganglia, perforates the crus of the diaphragm or occasionally passes through the aortic hiatus, and ends in the celiac ganglion.

Front 81

Lesser splanchnic nerve

Back 81

Derived usually from the 10th and 11th thoracic ganglia, pierces the crus of the diaphragm, and ends in the aorticorenal ganglion.

Front 82

Least splanchnic nerve

Back 82

Derived usually from the 12th thoracic ganglion, pierces the crus of the diaphragm and ends in the ganglia of the renal plexus.

Front 83

Superior intercostal vein

Back 83

Formed by the union of the second, thirds and fourth posterior intercostal veins and drains into the azygous vein on the right and the brachiocephalic vein on the left