HSF Anatomy - Thorax

64 terms by jal2044

Create a new folder

Advertisement Upgrade to remove ads

Anatomy Exam 2

Manubrium Sterni

upper section of the sternum

Manubriosternal joint/ sternal angle of louis

• secondary fibrocartilagenous joint
• articulates iwth 2nd costal cartilage
• count ribs from sternal angle

Body of the sternum

main part of the sternum from costal cartilage of 2nd rib to 7th costal cartilage

xihisternum

tip of the sternum - starts out cartilaginous and ossifies by middle age

true ribs

first 7 ribs, articulate directly with sternum in front and vertebrae behind

false ribs

last 5 ribs, 8-10 articulattew with sternum thru 7th costal cartilage

floating ribs

11, 12, dont articulate with sternum at all.

xiphisternal joint

with 7th costal cartilage

Head of the rib

has two articular facets - upper (articulates with T vertebra above and IV disk above) - lower - articulates with corresponding vertebra

neck of rib

narrowing below the head

Tubercle of rib

articulates with trasnverse process of corresponding vertebra

Angle of rib

where the rib takes a sharp turn anteriorly

Costal Groove

inferior border of the rib towards the viscera. houses Vein Artery Nerve VAN

typical ribs

3-9 look alike

atpycical ribs

1,2

scalene tubercle

on first rib attaches to scalenus anterior, on second rib also attaches to scalenus anterior

groove for subclavian artery and lower trunk of brachial plexus

posterior to scalene tubercle

groove for subclavian vein

anterior to scalene tubercle

Thoracic outlet syndrome

caused by cervical rib or spasm of scalenus anterior muscle pressing on brachial plexus. results in ischemia and nerve pressure atrophy of muscles in upper limb

Cephalic vein

runs in deltopectoral groove, drains into axillary vein

Anterior cuteneous nerves and vessels

branches of upper 6 intercostal nerves, pierce pectoralis major muscles, supply skin of anterior chest wall; lower 5 (7-11) intercostal and subcostal T12) supply skinof anterior abdominal wall

Lateral cutaneous nerves and vessels

branches of intercostal nerves

External Intercostal Muscle

run dowards and forwards like hands in pockets; replaced anteriorly by external intercostal membrane

Internal intercostal muscel

fibers run at 90º angle from external muscle fibers. replaced by internal intercostal membrane posteriorly - medial to angle of the rib

Innermost Intercostal muscle

has 3 parts:
• transversus thoracis (sternocostalis) in front behind sternum
• innermost intercostal membrane/muscle in middle
• subcostalis - posteriorly

neruovascular intercostal bundle - posterior intercostal vein, posterior intercostal artery and intercostal nerve

lie between internal and innermost intercostal muscles

sternocostalis/transversus thoracis muscle

takes origin from posterior surface of lower half of body of sternum and attaches to 2nd to 6th costal cartilages

Internal thoracic artery / Internal Mammary artery

branch of first part of subclavian artery
branches into:
• anterior intercostal arteries in upper 6 interostal spaces
• pericardioacophrenic artery
• perforating branches to mammary gland
• terminates into superior epigastric and musculophrenic arteries
• anterior intercostal arteries in lower (7-9) intercostal spaces branch from musculophrenic artery

subcostalis muscle

from inner surface of rib near angle and jumps up 1-2 ribs to upper border of rib below

posterior intercostal arteries

branch from descending thoracic aorta in 3rd - 11th IC spaces.
• branch from superior intercostal artery (branch of costocervical trunk of subclavian artery) in upper 2 intercostal spaces
anastamose with anterior intercostal arterires from the internal thoracic artery/musculophrenic artery

Ventral ramus intercostal nerve

from rami communicantes after the sympathetic ganglionic chain. gives rise to laterla and anterior cutaneous branches

1-6th intercostal nerves

give motor muscular branches to intercostal muscles in corresponding spaces
anteior cutaneous and lateral cutaneous branches along chest wall

7-11th intercostal and subcostal T12 nerves

give motor muscular branches to intercostal muscels in corresponindg spaces and muscels of anterior abdominal wall
give anterior and lateral cutenous branches to skin of abdomen

Herpes Zoster

shingles, viral infection of dorsal root ganglion. red painful blisters along course of intercostal nerve

Visceral Pleura

covers lung and fuses with lung tissue
• supplied by autonomic nerves and insensitive to pain
• pulmonary vessels and bronchial vessles supply it and lymphatisc drain into bronchopulmonary lymph nodes

Parietal pleura

four parts:
• costal (IC nerves)
• diaphragmatic (peripheral part by IC nerves)(medial part by phrenic nerve)
• mediastinal (phrenic nerve)
• cervical / cupola (intercostal nerves)

cupola

cervical pleura, covers apex of lung and ocvered by suprapleural memrbane, apex of lung is 1 inch above medial 1/3rd of clavicle

Pneumothorax

abnormal presence of air in the pleural cavity resulting in the collapse of the lung, abnormal presence of air in the pleural cavity resulting in the collapse of the lung

Costomediastinal recess of pleura

left recess larger because of cardiac notch on left lung

costodiaphragmatic recess of pleura

allow expansion oflungs in deep respiration; 8th rib MCL, 10th rib MAL, 12th rib at neck of rib

lower border of lung

MCL 6th rib, 8th rib at MAL, 10th rib at neck of rib

pleurisy

inflammation of pleura, sound like a rub

pleural effusion

fluid in pleura - hydrothorax if water, hemothorax if blood, pneumothorax if air

Pleural Tap, Thoracocentesis

in 8th or 9th intercostal space at MAL higher at area of maximum dullness with a lot of fluid and chest tube inserted: needle passes skin, superficial fascia, external intercostal muscle, internal intercostal muscle, innermost intercostal membrane/muscle, endothoracic fascia, parietal pleura

Phrenic Nerve

ventral rami of C3-5
• motor to diaphragm (c3,4,5 keeps the diaphragm alive)
• sensory pleura mediastinal and central part of diaphragmatic pleura, pericardium and peritoneum
• pericardiacophrenic vessels

Root of lung

Pulmonary veins (superior inferior)
pulmonary artery
primary prinicple bronchus
bronchial arteries (branches of throacic aorta)
anterior & posterior pulmonary plexus
lymph nodes
anchored to mediastinum

right lung

3 lobes, upper middle lower

left lung

2 lobes upper lower

oblique fissure

divides upper and lower lobes in left lung, divides upper and middle from lower lobe in right lung

horizontal fissure

divides upper and middle lobes of right lung

apex of lung

top of lung

lingula

extension of left lung corresponds to midle lobe of right lung

Hilum of lung

Midline region where the bronchi, blood vessels, and nerves enter and exit the lungs.
top to bottom:
pulmonary artery
superior and inferior pulmonary veins
principal bronchus

eparterial bronchus

right superior lobar bronchus on right lung to superior lobe

pulmonary ligament

point of reflection from visceral to parietal pleura of lung below the hilum

ligamentum arteriosum

hooked by left recurrent laryngeal nerve from vagus nerve, connects aortic arch to pulmonary artery?

azygous vein

impresson on right lung

left lung impressions

• groove for 1st rib
• groove for left subclavialn artery
• trachea and esophagus
• groove for arh of descending thoracic aorta
impression for lower end of esophagus
• cardiac notch
• cardiac impression

right lung impressions

impressions for right brachiocephalic vein and SVC
• groove for trachea and esophagus
• groove for arch of azygos vein
• groove for esophagus
• groove for IVC
• cardiac impression

bronchopulmonary segments

independent respiratory units of lung supplied by tertiery bronchus, and own pulmonary artery
10 on right and 10 on left
right has 3 in upper, 2 in middle and 5 in lower lobe
left has 5 in upper lobe (including 2 in lingula) and 5 in lower lobe

trachea

leads to bronchi

right principal bronchus

broader and shorter 2.5cm in dorect continuation of trachea, things can get trapped here.

left principal bronchus

primary bronchus longer 5 cm narrower and at an angle

carina

division between right and left principal bronchi

Please allow access to your computer’s microphone to use Voice Recording.

Having trouble? Click here for help.

We can’t access your microphone!

Click the icon above to update your browser permissions above and try again

Example:

Reload the page to try again!

Reload

Press Cmd-0 to reset your zoom

Press Ctrl-0 to reset your zoom

It looks like your browser might be zoomed in or out. Your browser needs to be zoomed to a normal size to record audio.

Please upgrade Flash or install Chrome
to use Voice Recording.

For more help, see our troubleshooting page.

Your microphone is muted

For help fixing this issue, see this FAQ.

Star this term

You can study starred terms together

NEW! Voice Recording

Create Set