The Thoracic Wall, Lungs and Middle Mediastinum Flashcards

1
Q

What are the 3 main parts of the Sternum?

A

Manubrium = head of sternum, has clavicular notch for sternoclavicular joint.

Body = joins manubrium at sternal angle (Of Louis)

Xiphoid process = lowest point of sternum

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2
Q

What are the 4 main parts of the ribs?

A

Head = articulates with 2 vertebral bodies & 1 disc

Tubercle = Articulates with 1 transverse process

Body = Region of greatest curve = angle

Costal Groove = formed by intercostal V. A. & N.

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3
Q

What are the 4 main parts of the ribs?

A

Head = articulates with 2 vertebral bodies & 1 disc

Tubercle = Articulates with 1 transverse process

Body = Region of greatest curve = angle

Costal Groove = formed by intercostal V., A. & N.

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4
Q

Internal Thoracic A & V run from _____ to ____.

A

2nd to 4th intercostal space

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5
Q

Lymphatics of the Pectoral region drain to where?

A

To parasternal nodes & axillary nodes

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6
Q

Lat. & Ant. Nerve of 4th to 6th intercostal nerves carry __________ innervation.

A

Cutaneous

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7
Q

What muscles make up the Pectoral Region?

A

Pectoralis major and Minor

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8
Q

__________ is divided into clavicular and sternocostal heads.

A

Pectoralis major

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9
Q

_______ is enveloped in clavipectoral Fascia.

A

Pectoralis minor

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10
Q

What are the structures of the Ant. Thoracic Wall?

A
  • Breasts
  • Ribs & sternum
  • Pectoral, intercostal & subcostal.
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11
Q

What are the structures of the Ant. Thoracic Wall?

A
  • Breasts
  • Ribs & sternum
  • Pectoral, intercostal & subcostal.
  • Intercostal vessels & nerves.
  • Internal Thoracic Vessels
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12
Q

How many ribs are there?

A

12 per side

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13
Q

What are the 3 intercostal muscles?

A

External
Internal
Innermost

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14
Q

Where is the Collateral Nerve, artery and vein located?

A

Superior edge of ribs (below the intercostal A,V & N because its on inferior edge of the rub above.)

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15
Q

What is the Pleura?

A

Serous secreting membranes that reduce friction.

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16
Q

What are the 2 main Pleura membranes?

A

Parietal Pleura

  • Covers Thoracic walls
  • Very Sensitive to Pain

Visceral Pleura

  • Covers lungs
  • NOT Sensitive (no sensory supply)
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17
Q

T or F, both Pleura membranes remain separate at the root of the lung.

A

False

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18
Q

T or F, both Pleura membranes remain separate at the root of the lung.

A

False they are continuous

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19
Q

What are pleural cavities?

A

are potential cavities.

  • can become actual.
  • pathological fluid = effusion; may fill space.
  • may compress lungs.
  • pleural effusions visible on chest films.
  • can obscure lung in film.
20
Q

What are pleural cavities?

A

are potential cavities.

  • can become actual.
  • pathological fluid = effusion; may fill space.
  • may compress lungs.
  • pleural effusions visible on chest films.
  • can obscure lung in film.
21
Q

_____ is an accumulation of air in pleural cavity.

A

Pneumothorax

- Collapses lung due to its own elasticity.

22
Q

______ is accumulation of blood in pleural cavity.

A

Hemothorax

- May cause adhesions & infection if not removed.

23
Q

What is Pleurisy?

A

Inflammation of the pleura.

  • leads to formation of pleural adhesions
  • between paritetal and visceral
  • Can produce exquisite pain relative to partial pleura.
24
Q

What is Pleurisy?

A

Inflammation of the pleura.

  • leads to formation of pleural adhesions
  • between parietal and visceral
  • Can produce exquisite pain relative to partial pleura.
25
Q

what is a plural tap?

A

Aspiration of fluids

  • Taken at IC space 6 or 7 at Midaxillary line.
  • If needle is inserted at 8 or 9 may pierce diaphragm, liver or spleen.
26
Q

Divisions of right lung?

A

Upper
Middle
Lower

27
Q

Divisons of Left lung?

A

Upper & Lower

28
Q

Where is the oblique fissure?

A

On both lungs

29
Q

Where is the Horizontal fissure?

A

On right lung only because it has 3 lobes

30
Q

_____ connects the lung to mediastinum.

A

Root of the lungs

  • covered in sleeve of pleura
  • consists of bronchi & pulmonary vessels
31
Q

Inferiorly, the sleeve of pleura that covers the root of the lung becomes ________.

A

Pulmonary Ligament

*has only a few lymph vessels in it at this point

32
Q

Trachea splits into _______, which splits into _________, which splits into ______.

A

into 2 primary main bronchi —–> splits into 2 or 3 secondary bronchi —–> splits into 8 or 10 tertiary (segmental) bronchi

33
Q

In General what is the neurovasculature of the root of the lungs?

A

Sympathetic trunks

  • Paravertebral
  • dilates Bronchioles

Vagus Nerve

  • Pass posteriorly to roots of lungs
  • Closely applied to trachea, esophagus & aorta.
  • Contribute to ant. & post. pulmonary plexuses.
  • Constrict the bronchioles
34
Q

What is the Neurovascualture of the RIGHT Root of lung?

A
  • Vagus nn. (pass post. to root of lungs)
  • Phrenic nn (Pass ant. to roots of lungs)
  • Pericardiacophrenic vessels (Run with phrenic nn.)
35
Q

What is the Neurovascualture of the LEFT root of lung?

A
  • Vagus nn.
  • Phrenic nn.
  • Pericardacophrenic vessels.
36
Q

____ supplies nutrients to bronchi & lungs.

A

Bronchial aa.

37
Q

Lymph is drained from the lungs via ________.

A

Tracheobronchial nodes & R/L bronchomediastinal trunks.

38
Q

________ is a broad central partition separating 2 pleural Cavities.

A

Mediastinum

39
Q

What are the 4 subdivisions of the mediastinum?

A
Superior 
Inferior
Anterior
Middle
Posterior
40
Q

The Mediastinum extends from ____ to _____ & from ______ to _______.

A

Thoracic inlet to diaphragm

Sternum to 12th Thoracic Vertebra

41
Q

What structures are found in the region of the Middle Mediastinum?

A
  • Pericardium & Heart
  • Phrenic nn. applied to pericardium
  • Pericardiacophrenic vessels
  • Roots of great vessels to & from heart.
42
Q

______ is a tough fibrous sac lined with serous membrane.

A

Pericardium

43
Q

What are the 2 portions of the Pericardium?

A

Fibrous portion - attached to the diaphragm inferiorly

Serous portion - divided into parietal and visceral layers

44
Q

_____ encloses the heart & is Pierced by roots of 8 vessels.

A

Pericardium

  • SCV
  • IVC
  • Aorta
  • Pulm. trunk
  • 4 pulm vv.
45
Q

What is the Pericardial Cavity?

A

Inside pericardial sac

  • Potential space between layers serous & Parietal layers.
  • only carries small amount of serous fluid.
46
Q

What is pericardial Effusion?

A

Accumulation of excess fluid in pericardial cavity .

  • results in compression of heart.
  • Common in conjunction with congestive heart failure.
47
Q

What is Hemoperricardium?

A

Accumulation of blood in pericardial cavity

  • Associated with penetrating heart wounds or perforated heart muscle following MI.
  • Arterial bleeding into cavity leads to Cardiac tamponade = compression of heart and roots of great vessels.