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95 terms

(4) Chest Wall, Lungs, and Breasts

STUDY
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___ nerves arise near the angles of the ribs
collateral
the internal thoracic artery arises from the ____
subclavian artery
the internal thoracic artery divides at the ____ intercostal space
6th
the internal thoracic artery divides into the ___ and ____
- superior epigastric artery
- musculophrenic artery
dermatomes of the thorax
the intercostal nerves are the ___ rami of the first ___ thoracic spinal nerves
ventral; 11
the ventral ramus pf the 12th thoracic spinal nerve is called the ___ nerve
subcostal
the intercostal nerves exit from the vertebral canal through the intervertebral foramen, enter the intercostal spaces, and run between the ___ and ____ intercostal muscles
innermost and internal
the intercostal artery, vein, and nerve runs in the ____ under each rib
costal groove
the _____ runs superior to each rib
collateral neurovascular bundle
the CT between the intercostals is called the ___
internal intercostal membrane
the CT surrounding the costovertebral joint is the ___
radiate ligament
the intercostal artery, vein, and nerve runs ___ to the rib
inferior
the collateral nerve and vessels runs ___ to the rib
superior
because of the location of the intercostal nerve, artery, and vein, you always want to place a needle ____ to the rib
superior
the intercostal spaces 3-11 have posterior intercostal arteries that branch off of the ___
descending thoracic aorta
the artery below the 12th rib is the ____, giving blood to the posterior thoracic wal
subcostal artery
the main blood supply to the anterior chest wall is the ____
internal thoracic artery
the internal thoracic artery is a branch off of the ____
subclavian artery
the internal thoracic artery gives rise to the _____, which supply the intercostal spaces
anterior intercostal arteries
the internal thoracic artery ends at the _____ intercostal space
6th
at the 6th intercostal space, the internal thoracic artery branches into the ___ and _____
superior epigastric and musculophrenic
the superior epigastric artery is always the ____ branch
medial
the musculophrenic artery is always the ____ branch
lateral
the main blood supply to the posterior thoracic wall is the posterior intercostal artery, which is a branch off of the ___
descending aorta
the main blood supply to the anterior thoracic wall is the anterior intercostal artery, which is a branch off of the ____
internal thoracic artery
the ___ is the passageway into the lung tissue
hilum
there are ___ lobes in the right, ___ lobes in the left lung
3, 2
there are ___ oblique fissures
2
there are ___ horizontal fissures
1
the lingula and cardac notch are in the ____ of the ___ lung
superior lobe; left lung
the ____ is a mesenteric fold that extends between the inferior part of the medastinal surface of the lung and the pericardium
pulmonary ligament
the right main bronchi connects to the ___
hilum directly
the left main bronchi is ___ to the aortic arch and ____ to the esophagus
inferior, anterior
in the RIGHT LUNG, the ____ fissure is more anterior and only spans the anterior part of the lung
horizontal
in the RIGHT LUNG, the ____ fissure is anterior and posterior and cuts down through the entire lobe
oblique
the structures that are at the right hilum are the ___ (8 things)
- pulmonary arteries
- pulmonary veins
- superior lobar bronchus
- right main bronchus
- bronchial vessels
- broncho-pulmonary lymph nodes
- inferior lobar bronchus
- middle lobar bronchus
the hilum is surrounded by the ____
pleural sleeve
the pleural sleeve has a folded extension inferiorly known as the ___, which is where the visceral pleura folds in
pulmonary ligament (though it isn't actually a ligament)
in the LEFT LUNG, there is a(n) _____ fissure
oblique
the ____ is in the left superior lobe, and wraps around the base of the heart
lingula
the indent in the left lung for the heart is known as the ___
cardiac impression (cardiac notch)
there are a fair number of lymph glands in the hilum; this means that if there is lung CA, the earliest metastases might manifest as ___
enlarged hilar lymph nodes
the structures that are at the left hilum are the ___ (7 things)
- pulmonary artery
- pulmonary veins
- bronchial vessels
- broncho-pulmonary lymph node
- inferior lobar bronchus
- left main bronchus
- superiror lobar bronchus
___ is an acquired disorder of the major bronchi and bronchioles that is characterized by permanent abnormal dilatation and destruction of bronchial walls
bronchiectasis
bronchiectasis is most commonly found in the ___ lobe
lower
the 2 signs of severe bronchiectasis are ____ and ____
- saccular dilatations
- grape-like clusters with pools of mucus
the breast is a modified ___
sweat gland
the breast is embedded in ____
superficial fascia
the breast has fat and ____ activity contributing to size and contour
secretory
the breast is rudimentary in ___ and ___
males and prepubertal females
the breast overlies ribs __-___ in the young adult female
2-6
the pigmented, projecting nipple is surrounded by a circular, pigmented ____ in adult females
areola
in males and young females, the nipple lies over the ____ intercostal space; in adult females, position of the nipple varies
4th
the breasts are supported by ____ ligaments that attach to overlying skin
suspensory (Cooper)
the breasts are separated from deep fascia over pectoralis major muscle (pectoral fascia) by the ____ space, which allows movement on the chest wall
retromammary space
the mammary gland has ___-__ lobes
15-20
each of the lobes of the mammary gland are drained by a single corresponding ____, which opens on the nipple
lactiferous duct
the ____ is an expansion for each lactiferous duct that is deep to the nipple, and serves as a milk reservoir during lactation
lactiferous sinus
the mammary gland may extend into the axilla as the ___
axillary tail of Spence
the lymphatic drainage of breast pathologically facilitates the metastasis of ___
breast CA
___% of women have malignant tumors of the breast
4
____ tumors of the breast often place traction on the suspensory ligaments (of Cooper), which causes DIMPLING of the skin of the breast
scirrhous (hard) tumors
the breasts lymphatics drain primarily into the _____ lymph nodes
anterior axillary (pectoral)
cells from a tumor in the medial part of the breast would drain towards the _____ nodes
internal thoracic (parasternal) nodes
the breast is split into 4 quadrants, which are ___
superior medial and lateral, inferior medial and lateral
the ___ stages of development are important in premature or delayed puberty
Tanner
there are __ stages of Tanner development
5
____ is the name for accessory nipples
polythelia
____ is the name for accessory breasts
polymastia
____ is the name for adolscent males with breasts
gynecomastia
___% of males get breast CA
1.5
the ____ is the line where extra nipples tend to appear because of the course of nipples through development
mammary ridge
4 signs of breast cancer are ____
- skin dimpling
- edema of the skin
- nipple retraction and deviation
- abnormal contours of the breast
edema of the skin of the breast is known as the ____ sign
Peau d'orange (looks like skin of an orange peel)
a common method of screening for BRCA is ___
mammography
____ is a condition that makes it difficult to screen with mammograms
fibrous cystic disease (not really a disease)
some fibrous tissue and calcification is normal in the breast, but an isolated lesion is ___
an early sign of BR CA
scarring and disfiguration of the skin around the breast is a sign of ____
breast cancer
male thorax
female thorax
from an anterior view, the ____ notch is also known as the suprasternal notch
Jugular
from an anterior view, the jugular notch is in line with the _____ line
anterioe median (midsternal)
from an anterior view, the ____ lines are on either side of the midsternal line
midclavicular
from an anterior view, the ____ angle is a little below the jugular notch
sternal
from a lateral view, the line that is right in the middle of the axilla is the ___
midaxillary line
from a lateral view, the line that is a few inches in front of the midaxillary line is the __
anterior axillary line
from a lateral view, the line that is a few inches behind the midaxillary line is the ____
posterior axillary line
from a posterior view, the the _____ line is in line with the spinous processes
posterior median (midvertebral)
from a posterior view, the _____ lines are lateral to the midvertebral line
scapular
the ____ muscle inserts inferiorly to the axilla
latissimus dorsi
the ____ muscle is in the front of the chest
pectoralis major
digitations of the ___ muscle can be seen on the chest
serratus anterior
the ____ margins are the borders of the bottom of the ribcage
costal
supernumary nipple