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83 Cards in this Set
- Front
- Back
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What are the names of the openings at top and bottom of thorax?
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Superior + inferior thoracic aperture
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What does sternum consist of?
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Manubrium, sternum body + xiphoid process(T9)
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What is sternal angle and what level is it at?
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Secondary cartilaginous joint between manubrium + sternal body at T4
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Describe articulations between ribs + vertebral column?
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the head articulates with its own vertebral body + the one above
then the tubercle articulates with the transverse process |
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What type of joints are the articulations between the ribs + vertebral column?
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plane synovial
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Describe structure of ribs 2-10?
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rounded top, sharp bottom and costal groove on inferior surface for intercostal artery/vein/nerve
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Describe structure of 1st rib?
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small + flattened with groove on top for subclavian artery + bottom for brachial plexus to pass over
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What is the costal margin?
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the costal cartilages of ribs 7-10 fused
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How are ribs attached to costal cartilages?
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Primary cartilaginous
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Define and explain the permitted movement at sternocostal joints?
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Plane synovial joint between sternum + costal cartilage of true ribs - no movement at 1st 2, only 3-7th for respiration
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Explain diaphragm dome position?
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right dome higher, reaching up to 5th rib
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Describe the hiatus' penetrating the diaphragm?
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oesophageal hiatus penetrates muscular part at T10
IVC hiatus pentrates central tendon at T8 Aorta passes behind at T12 |
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Describe nerve innervation of diaphragm?
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2 phrenic nerves originating from branches of cervical plexus (C3-5)
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What is the costodiaphragmatic recess?
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the space in mid-axilla line at ribs 8-10 due to lungs not quite filling pleural cavities
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What is pleura made of?
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serous membrane = simple squamous epithelium + connective tissue
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Where would you carry out a pleural aspiration?
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9th IC space, mid-axilla just above inferior rib to avoid nerves
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What vessels supply the breasts?
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2nd - 4th IC arteries
branches of axillary artery branches of internal thoracic artery |
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Where do lymphatics from breast drain into?
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mainly pectoral group of lymph nodes
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What is the anterior axillary fold and what does it consist of?
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musculocutaneous fold - pectoralis major muscle with lymph nodes/capillaries running along it
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What is the posterior axillary fold and what does it consist of?
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musculocutaneous ridge - latissmus dorsi + teres major muscles
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What happens at T4/5?
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sternal angle
aortic arch trachea bifurcation |
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What are gray ramus communicans?
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unmyelinated post-ganglionic fibres going from symp. ganglion > spinal nerve
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What are white ramus communicans?
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myelinated pre-ganglionic fibres going from spinal nerves T1-L2 > symp. ganglion
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What does bucket handle movement do?
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movement at costovertebral joints 7-10 increasing transverse diameter in lower ribs
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What does pump handle movement do?
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increases anterio-posterior diameter in upper ribs via costovertebral movement at ribs 2-6
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Describe forced respiration?
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Inspiration = external intercostals + scalene/sternocleidomastoid
Expiration = abdominal muscles |
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What do olfactory cells do?
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provide sense of smell
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Describe type 1 pneumocytes?
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simple squamous epithelium that cover most of alveolar surface and allow gas exchange
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Describe type 2 pneumocytes?
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great alveolar cells that produce surfactant
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Describe length of trachea + lining?
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C6-T4 lined with pseudostratified columnar epithelium, ciliated + with goblet cells
U-shaped rings of hyaline cartilage with trachealis muscle at open ends |
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How are individual cartilage rings in trachea connected?
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by fibro-elastic connective tissue
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What is the carina?
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the cartilaginous plate which supports the bifurcation at T4
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Compare R + L bronchi?
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R more vertical but shorter + wider
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Describe relation of oesophagus to trachea bifurcation?
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behind and slightly left of midline
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Describe relation of aortic arch to trachea bifurcation?
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in front and slightly to left of midline
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What is the pulmonary ligament?
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the folding between parietal and visceral pleura which hangs from hilum, taken up when lung inflates
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Describe change in epithelium as progress through bronchial tree?
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epithelium becomes simple columnar ciliated with goblet cells at terminal bronchioles then simple cuboidal in respiratory bronchioles
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Describe blood supply of alveoli?
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branches of pulmonary artery
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Describe blood supply of bronchi, bronchioles, connective tissue + visceral pleura?
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bronchial arteries - derived from descending aorta
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Describe venous drainage of lungs except the alveoil?
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azygous + acessory hemiazygous veins
alveoli via pulmonary veins |
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What is the sympathetic origin of the lungs?
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T2-5 to dilate bronchioles + inc mucous secretion
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Describe the afferent fibres of the lungs?
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lung stretch receptors + mucous membrane receptors
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Describe left lung lymphatic drainage?
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into thoracic duct >> left subclavian
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Describe right lung lymphatic drainage?
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into right lymphatic duct >> right subclavian
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What dermatome supplies bottom 2 ribs?
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T9
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Describe dermatome arrangement at sternal angle (T4)?
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C4 adjacent to T2 since others pulled out to arms
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Describe position of heart apex?
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5th IC space, midclavicular line
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Where is superior border of heart?
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Deep to sternal angle T4
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Describe left + right borders of heart?
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Left = 2nd costal cartilage to apex
Right = 3rd to 6th costal cartilage |
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What is scoliosis + kyphosis?
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Scoliosis = lateral curvature
Kyphosis = anterior |
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What causes pectus carinatum?
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excess costal cartilage >> protruding chest
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Describe layout + movement of external intercostals?
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Point inferiorly + inwards to rib below
elevate ribs in inspiration |
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What is the external intercostal membrane?
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continuation of muscle at costal cartilages as thin connective tissue aponeurosis
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Describe structure + movement of internal intercostal muscles?
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point downwards to rib below
moves ribs down in expiration |
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Describe structure + movement of innermost intercostal muscles?
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3 parts running different directions + connected by fibrous connective tissue
acts with internal intercostals to move ribs down in expiration |
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Describe internal intercostal membrane?
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extends to vertebral column - extension of deep fascia
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Explain nerve + blood supply of IC spaces?
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ventral ramus of spinal nerve + blood from thoracic/internal thoracic artery branches
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Describe blood supply of posterior IC spaces?
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first 2 = costocervical trunk (from subclavian)
Remaining = branches of descending aorta |
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Describe blood supply of anterior IC spaces?
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upper 5/6 = internal thoracic branches
then internal thoracic divides with musculophrenic supplying remaining spaces + diaphragm |
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Describe origin + passage of internal thoracic artery?
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it is branch of subclavian which passes behind costal cartilages then divides into musculophrenic + sup. epigastric
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Where does sup. epigastric artery supply?
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abdominal wall + diaphragm
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Where does internal thoracic vein drain from?
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musculophrenic, sup. epigastric, upper anterior intercostals >> into subclavian vein
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Where does musculophrenic vein drain from?
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costal margin, lower IC spaces + peripheral diaphragm
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In general terms where does the azygous system drain?
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posterior thoracic wall + part of posterior abdominal wall
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Describe the right side of the azygous system?
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Azygous vein - starts at L1/2 passing up thru aortic hiatus to arch over root of right lung + drain into SVC
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Describe the left side of the azygous system?
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Hemi-azygous vein - passes thru diaphragm via left crus and joins azygous at T9
Acessory hemiazygous - joins azygos at T8 |
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To what are the hemiazygous + acessory hemiazygous also joined?
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IVC to provide alternative route to SVC if blockage
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Where does azygos vein drain from?
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right posterior IC spaces except first 2 which drain directly into braciocephalic
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Where does dorsal ramus from thoracic spinal nerves supply?
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erector spinae
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Where does ventral ramus from thoracic spinal nerves supply?
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IC spaces as IC nerve
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How does gray ramus communicans get to IC spaces?
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via ventral ramus
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Where do intercostal lymph nodes drain to?
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upper spaces = thoracic duct or right lymphatic duct
lower 4/5 = cysterna chyli > thoracic duct |
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Describe lobes of the breast?
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15-20 in each separated by connective tissue septum
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Describe changes of breast during pregnancy?
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adipose replaced by glandular
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Where do breasts extend from and to?
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ribs 2-6
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Describe role of deep fascia which overlies pectoralis major in the breasts?
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attaches to septae between lobes
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Describe blood supply of breasts?
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primarily mammary arteries - branches of internal thoracic
but also posterior IC arteries |
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What is the role of oxytocin in regards to the breasts?
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causes contraction of myoepithelial cell
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Which nerves pass through the oesophageal hiatus of diaphragm?
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vagus nerve at T10
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What is the motor innervation of the diaphragm?
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Phrenic nerve - c3-5
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At what level does spinal cord end?
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L1/2
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Define and give example of a synchondrial joint?
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cartilaginous joint in which the connecting medium is hyaline cartilage i.e. sternocostal joint between sternum and 1st rib
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Where is the main lymphatic drainage of the lungs to?
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tracheobronchial nodes
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