Clinical Anatomy > Thorax > Flashcards

Thorax Flashcards

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1
Q

where is the thorax

A

the area of body between the neck and the inferior border of the ribs

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2
Q

what is the thoracic cavity

A

a hollow space within the chest which has boundaries to determine the space

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3
Q

what are the boundaries in the thoracic cavity

A

anterior - sternum, lateral -ribs, posterior - vertebral column (T1-T12)

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4
Q

what is the contents of the thoracic cavity

A

heart, lungs and diaphragm

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5
Q

what is the heart contained in and what’s the space called

A

pericardium in the pericardial cavity

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6
Q

what is the lungs contained in and what’s the space called

A

pleura in the pleural cavity

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7
Q

what is the pleural cavity

A

a potential space formed by the pleura surrounding each lung

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8
Q

what is the pericardial cavity

A

a potential space formed by pericardium surrounding the heart

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9
Q

in terms of the pleura and pericardium, what is the layers involved

A

visceral layer sticks to the organ and the parietal layer is on the outside

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10
Q

what are the compartments of the thorax

A

right and left pleural cavities
mediastinum

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11
Q

what is the mediastinum

A

minus the lungs and the pleura, it is everything else within the thorax

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12
Q

describe some of the regions of the thoracic skeleton

A

osseo-cartilaginous cage and the intercostal muscles

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13
Q

what type of bones are the ribs

A

flat

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14
Q

what are the functions of the ribs

A

protection of the heart, mediasternum and thorax

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15
Q

what is the classification of the ribs and how do you classify them?

A

typical or atypical

typical have a more prominent costal groove

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16
Q

describe the requirements of the ribs to be:
true
false
floating

A

true must be directly attached to the sternum
false attaches via a cartilage to the sternum indirectly
floating have no attachment to the sternum

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17
Q

describe how to identify a typical rib

A

it has:
a head, tubercle (bump), neck, angle and costal group

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18
Q

what distinguishes an atypical rib from a typical rib

A

it has a less prominent costal group

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19
Q

why does a chest drain require the needle to be inserted above the rib

A

less likely to damage a vein or artery (or nerve) which is held in the costal groove, the ones above the rib are smaller so it doesn’t matter if they get damaged

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20
Q

why with a chest drain, is the patient usually sat up

A

due to gravity and more space inferiorly

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21
Q

what distinguish the cervical, thoracic and lumbar vertebrae

A

cervical - vertebral body
thoracic - spinous process and transverse process
lumbar - laminae

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22
Q

how do you distinguish the typical thoracic vertebrae

A

facet for articulation with tubercle on rib
demifacets for articulation with head of ribs

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23
Q

name the regions of the sternum

A

manubrium sterni, body, xiphoid process

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24
Q

what is a region that helps determine the surface anatomy of the sternum

A

sternal angle

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25
what is the importance of the sternal angle
used for rib counting guides the stethoscope for heart monitoring helps locate lung sounds accurately helps with accuracy for chest tube insertion common fracture site which needs to be assessed for heart or lung injury
26
how is the sternum bone classifed
flat
27
why was there an issue with taking bone marrow samples from the sternum
the needle could be inserted too far which could puncture the arch of the aorta
28
what is the alternative location for taking bone marrow samples
top of iliac crest
29
what is the sternal angle, what is it useful for
also called the angle of louis joint formed by the articulation between the manubrium and body of the sternum this is a clinical landmark for surface anatomy
30
how do you identify the external intercostal muscles and what is their function
elevate the ribs during forced expiration downwards and medially
31
how do you identify the internal intercostal muscles and what is their function
elevate the ribs during forced expiration upwards and medially
32
what are the three types of intercostal muscles
external internal innermost
33
how do you identify the innermost intercostal muscles
there is a neuromuscular bundle between the inner and innermost (vein, artery, nerve and lymphatic vessel)
34
how is the mediastinum split
superior and inferior then from inferior there is anterior, middle and posterior
35
describe the location of the heart
located behind the mediastinum behind the sternum between 2nd and 6th ribs and then from the back from T5-T8
36
describe the EXACT definition for the location of the apex of the heart
located at the 5th intercostal space in the left mid-clavicular line NOTE: if the apex has moved over, the heart must be enlarged
37
in relation to intercostal cartilage, describe the surface anatomy of the heart
right: 3rd and 6th intercostal cartilage left: 2nd costal cartilage and apex
38
name the auscultatory sites (and the purpose of them)
aortic valve - right second intercostal space pulmonary valve - left second intercostal space tricuspid value - left fourth, fifth intercostal spaces mitral valve - apex beat finding and listening to murmurs
39
pericardium
loose fitting sac surrounding the heart
40
what can the pericardium be split into
fibrous pericardium and serous pericardium then from serous pericardium into parietal and visceral from the parietal layer, the pericardial space can be found
41
fibrous pericardium
tough, loose-fitting, inelastic
42
parietal layer
lines the inside of the fibrous pericardium
43
visceral layer
adheres to outside of the heart
44
pericardial space
between the parietal and visceral layer filled with 10-15mL pericardial fluid
45
function of the pericardial fluid
decreases friction
46
how do you differentiate ct scan and mri scans
ct the bone appears whiter
47
function of the heart
permit blood flow in one direction during circulation prevent back flow of blood
48
name the four valves
tricuspid mitral pulmonary aorta
49
tricuspid valve
between right atrium and ventricle 3 flaps connected to ventricular papillary muscle via chordae tendineae
50
mitral valve
between left atrium and ventricle also called bicuspid valve two flaps or cusps
51
pulmonary valve
between the right ventricle and pulmonary trunk
52
aorta valve
between left ventricle and aorta
53
which valves classify into the semilunar valves
pulmonary and aorta
54
which valves classify into the atrioventricular valves
tricuspid and mitral
55
atria
two superior chambers blood from veins enters atria
56
ventricles
two inferior chambers pumping chambers separated by interventricular septum
57
great vessels
from arch of aorta brachiocephalic artery there are two that come off (right subclavian artery and right common cartoid artery) then off the left subclavian two come off two separate branches (left common cartoid artery and left subclavian artery)
58
describe the running from the head to the heart of the veins
right internal jugular vein right subclavian vein right brachiocephalic vein which runs into the superior vena cava right ventricle (same on the left, right and left join at the superior vena cava)
59
describe the surface anatomy for the pleura and lungs
the pleura is almost touching at the midline the apex of the pleura is found an inch above the clavicle the pleura reaches down to the 10th rib deviates from the right side at the 6th rib deviated from the left at the 4th rib the lungs end at the 8th rib
60
describe the fissures of the lungs
right: upper lobe lower lobe middle lobe left: upper lobe lower lobe oblique fissure on left and right horizontal fissures on right only
61
what is hilum
acts as a gateway to what enter and exits the organ
62
do the left and right hilum differ
yes
63
describe the left hilum
artery bronchus vein
64
describe the right hilum
pulmonary vein bronchus artery vein
65
what is the structure of the left pulmonary artery across the bronchi
the left goes over the left principle bronchus then under the right upper bronchus with the right pulmonary artery
66
why is the recovery position on the left
the left principle bronchus is narrower an mire angular so anything lodged can't go further down it the right is wider and more vertical
67
which way is chest x-ray usually taken
posterior to anterior
68
function of the lymphatic system
complements circulatory system to remove excess fluid from the body and return it to the bloodstream
69
how much from the blood is lymph (interstitial fluid)
3L
70
what does the lymphatic system contain
lymphatic fluid lymphocytes lymphatic vessels lymph nodes lymphatic ducts lymphatic organs
71
lymphatic vessels
carry lymph away from the tissues to deliver it back into the blood's circulation
72
lymph nodes
filtering interstitial fluid collected from soft tissues and returning to the vascular system
73
lymphatic ducts
empty lymphatic fluid into the venous system
74
name the two lymphatic ducts
right lymphatic duct thoracic duct
75
two subsections of lymph organs
primary secondary
76
primary lymph organs
bone marrow, thymus produce lymphocytes to fight infection
77
secondary lymph organs
spleen maturation of lymphocytes initiate acquired immune response (immunological memory)
78
why is the cartilage in the trachea C shaped
for structure and support but allows oesophagus to expand when swallowing
79
why the metastatic spread of some cancers may be easier to detect than others
superficial is closer to the skin surface meaning that any lumps can be felt or seen
80
what pleural cavity is smaller and why
left due to the location of the heart
81
at what vertbral levels is the sternal angle located
T4 T5
82
what are the names of the openings of the thoracic cage
superior thoracic aperture inferior thoracic aperture
83
what rib attaches at the sternal angle
second rib
84
at T5 which number rib will articulate with its superior an inferior demi-facets
superior - 5 inferior - 6
85
what is the function of the neurovascular bundle
to innervate and supply blood to the intercostal muscles
86
what is the function of the phrenic nerve
triggers contraction of the diaphragm and sensory for the pericardium and peripheral pleura?
87
what spinal cord levels does the phrenic nerve arise at
C3,4,5
88
what location does the pleural membrane reflect back on itself
the hilum of the lung
89
what layer of the pleural membrane can detect pain and why
parietal due to sensory nerve fibres being present (innervated by somatic nerves)
90
what is the lingula
found at the bottom of the lung which tucks around the heart
91
three main functions of the fibrous pericardium
holds heart inn place in the mediastinum prevents excessive dilation protects the heart from infection from the lungs
92
clinical terminology for inflammation of the pericardium
pericarditius
93
what is the term for excessive fluid within the pericardium
pericardial effusion
94
why is there a difference to where the valves in the heart are to where we normally auscultate them
in situ, the bones are in the way and we can't listen through the bones (sternum and ribs are in the way)
95
on the heart, was is the surface called where the sternum sits?
sternocostal surface
96
what does the heart sit on?
inferiorly the diaphragmatic surface
97
what is the first part of the heart you can see in situ
right ventricle
98
what can you not see of the heart in situ
left atrium
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