Term
| the muscles of the back are divided into three groups: |
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Definition
1. superficial group
2. intermediate group
3. deep group |
|
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Term
•Superficial group
–Those muscles that insert into bones of the __.
•Intermediate group
–Those muscles that insert into __.
•Deep group
–Those muscles that are involved in movement of the __ and __. |
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Definition
- upper extremity
- ribs
- head; vertebral column |
|
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Term
- the superficial muscles insert onto the __,__, and __
-- these muscles are: |
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Definition
- clavicle, scapula, humerus
- trapezius, latissimus dorsi, levator scapulae, rhomboid major, rhomboid minor |
|
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Term
Trapezius
- Origin:
- Insertion:
- Actions: 1. 2. 3.
- Innervation: |
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Definition
- Medial part of the nuchal line, external occipital protuberance, ligamentum nuchae, spinous processes of C7 through T12 vertebrae.
-Lateral third of the clavicle; acromion and spine of the scapula.
1.Upper fibers – elevate scapula
2.Middle fibers – pull scapula medially
3.Lower fibers – pull medial border of scapula downward
-Cranial nerve XI (accessory nerve), C3 and C4 sensory. |
|
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Term
Latissimus Dorsi
- Origin:
- Insertion:
- Action:
- Innervation: |
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Definition
- Origin:Lower six thoracic, lumbar, and sacral vertebrae; posterior iliac crest, lower three or four ribs.
- Insertion:Intertubercular (bicipital) groove of the humerus.
- Action: Extends, adducts, and medially rotates the humerus; raises body during climbing.
- innervation: thoracodorsal nerve |
|
|
Term
Levator Scapulae
- Origin:
- Insertion:
- Action:
- Innervation |
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Definition
- origin:The transverse processes of the upper four cervical vertebrae.
- insertion: Medial border of the scapula.
- action: Helps stabilize, elevate and inferiorly rotate the scapula.
- innervation: C3 and C4; dorsal scapular nerve. |
|
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Term
-rhomboid minor origin:
-rhomboid major origin:
- insertion:
- action:
- innervation: |
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Definition
rmin origin:lower part of the ligamentum nuchae and spinous processes of C7 and T1 vertebrae.
- rmaj origin:spinous processes of T2 through T5 vertebrae.
- insertion:Both muscles insert onto the medial border of the scapula.
- action:Both muscles help stabilize, retract, and inferiorly rotate the scapula.
- innervation: dorsal scapular nerve |
|
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Term
Intermediate muscles
- these muscles insert onto __
- they are considered to be accessory muscles of ___
- the intermediate muscles are: |
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Definition
- ribs
- respiration
- serratus posterior superior; serratus posterior inferior |
|
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Term
serratus posterior superior
- located deep to the __
- origin:
- insertion:
- action:
- innervation: |
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Definition
- rhomboid muscles
- Ligamentum nuchae, spinous processes of C7 through T2 or T3.
- insertion:Second to fifth ribs (muscle fibers run in an inferorlateral direction).
- action: elevates the ribs
- innervation: intercostal nerves |
|
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Term
serratus posterior inferior
- located deep to the __
- origin:
- insertion:
- action:
- innervation: |
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Definition
- latissimus dorsi
- origin:Spinous processes of T11 to L2 or L3.
- insertion:Lower four ribs (muscle fibers run in a superolateral direction).
- action: depresses the ribs
- innervation: intercostal nerves |
|
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Term
•The deep back muscles are further subdivided into three layers:
–__ layer – this is present only in the __ and __ regions of the back.
–__ layer – this extends the entire length of the __.
–__ layer – also extends the entire length of the __. |
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Definition
- superficial; cervical; upper thoracic
- intermediate; spine
- deep; spine |
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Term
| the muscles in the deep superficial layer consist of: |
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Definition
| splenius capitis; splenius cervicis |
|
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Term
1.splenius capitis
- origin:
- insertion:
2. splenius cervicis
- origin:
- insertion: |
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Definition
- origin:Lower part of ligamentum nuchae, spinous processes of C7 through T3 vertebrae.
- insertion:Lateral part of nuchal line of the occipital bone and mastoid process of temporal bone.
- origin:Spinous processes of T3 through T6 vertebrae.
- insertion:Transverse processes of C1 through C3 or C4 |
|
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Term
splenius capitis and cervicis
- action (bilateral contraction):
- action (unilateral contraction):
- innervation: |
|
Definition
- bilateral:extension of the head and neck.
- unilateral:lateral flexion and rotation of the head and neck to the same side of the contracting muscles.
- innervation: dorsal rami or cervical spinal nerves |
|
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Term
-deep intermediate layer: __
-The __ (previous) muscles are a very large muscle mass that extends from the __ part of the __, __ surface of the __, and spinous processes of the lower two __ and all of the __ vertebrae.
- it divides into three columns of muscle: __, __, and __ |
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Definition
- erector spinae
- erector spinae; posterior; iliac crest; posterior; sacrum; thoracic; lumbar vertebrae
- iliocostalis; longissimus; spinalis (remember by I Love Spaghetti) |
|
|
Term
•Each column of the erector spinae has regional subdivisions that are based upon there location or superior attachment of the muscle fibers.
–Iliocostalis – __, __, and __
–Longissimus – __, __, and __
–Spinalis – __, __, and __. |
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Definition
- lumborum, thoracis, and cervicis
- thoracis, cervicis, and capitis
- thoracis, cervicis, and capitis |
|
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Term
erector spinae
- action (bilateral contraction):
- action (unilateral contraction):
- Also contracts during __ of the spine (called __) to control movement against __.
-innervation: |
|
Definition
- bi: extension of the vertebral column
- uni:lateral flexion of the spine to the same side of the contracting muscle
- flexion; (eccentric contraction); gravity
- dorsal rami of spinal nerves |
|
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Term
deep layer muscles of the deep layer
- the __ muscles are divided into three components:
1.
2.
3. |
|
Definition
- transversospinalis
1. semispinalis
2. multifidus
3. rotatores |
|
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Term
transversospinalis muscles
- semispinalis: has __, __, and __ subdivisions
- multifidus: present along the length of the __, and it is best developed in the __ region.
- rotatores: best developed in the __ region |
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Definition
- thoracis; cervicis; capitis
- vertebral column; lumbar
- thoracic |
|
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Term
| more deep layer muscles include __, __, and __ |
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Definition
| intertransversarii; interspinales; levatores costarum |
|
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Term
•Intertransversarii
–Extend between __
•Interspinales
–Extend between __
•Both the intertransversarii and interspinales are best developed in the __ and __ regions.
•Levatores costarum
–Extend __ from the tips of __ to between the __ and __ of the __. |
|
Definition
- adjacent transverse processes
- adjacent spinous processes
-- cervical; lumbar
- inferolaterally; transverse processes (C7 to T11); tubercle; angle; ribs |
|
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Term
suboccipital triangle
•The boundaries of the suboccipital triangle are:
–Medial – __
–Lateral – __ (__)
–Inferior – __ (__)
–Roof – __
–Floor – __ and the __.
•Contents – __ and __ |
|
Definition
–Medial – rectus capitis posterior major muscle
–Lateral – obliquus capitis superior (superior oblique)
–Inferior – obliquus capitis inferior (inferior oblique)
–Roof – semispinalis capitis
–Floor – posterior arch of the atlas (C1) and the posterior atlanto-occipital membrane.
•Contents – vertebral artery, and suboccipital nerve |
|
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Term
suboccipital muscles
•Four short muscles make up the suboccipital muscles:
1.
2.
3.
4.
•The innervation of all of the muscle is the __ (__ of __). |
|
Definition
1. rectus capitis posterior major
2. rectus capitis posterior minor
3. obliquus capitis superior
4. obliquus capitis inferior
- suboccipital nerve (dorsal ramus of C1) |
|
|
Term
Rectus capitis posterior major:
–Origin – __.
–Insertion – __
–Action – __ |
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Definition
Rectus capitis posterior major:
–Origin – spinous process of C2 (axis).
–Insertion – lateral part of inferior nuchal line
–Action – extension of the head and lateral rotation of head to the same side as the contracting muscle. |
|
|
Term
Rectus capitis posterior minor:
–Origin – __
–Insertion – __
–Action – __ |
|
Definition
Rectus capitis posterior minor:
–Origin – posterior tubercle of C1 (atlas)
–Insertion – medial part of inferior nuchal line.
–Action – extension of the head. |
|
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Term
Obliquus capitis superior:
–Origin – __
–Insertion – __.
–Action – __ |
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Definition
Obliquus capitis superior:
–Origin – transverse process of the atlas.
–Insertion – occipital bone.
–Action – extension of the head and lateral flexion of the head to the same side as the contracting muscle. |
|
|
Term
Obliquus capitis inferior:
–Origin – __
–Insertion – __
–Action – __ |
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Definition
Obliquus capitis inferior:
–Origin – spinous process of the axis.
–Insertion – transverse process of the atlas.
–Action – rotation of the head to the same side as the contracting muscle. |
|
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Term
Suboccipital Region
•The __ crosses over the suboccipital triangle.
•It pierces the __ and __ to reach the scalp.
•It innervates the __ part of the __.
•Its branches run with branches of the __. |
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Definition
- greater occipital nerve (dorsal ramus of C2)
- semispinalis capitis; trapezius
- posterior; scalp
- occipital artery |
|
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Term
The skeleton has two divisions:
1.__ skeleton – which consists of the bones of the skull, the hyoid bone, bones of the vertebral column, sternum, and ribs.
2. __ skeleton consists of the bones of the upper extremity, including the pectoral girdle; and bones of the lower extremity, including the pelvic girdle. |
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Definition
1. axial skeleton
2. appendicular skeleton |
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Term
-The __ is the central support for the body.
-It supports the __, __, __, and __.
-It also transmits body weight to the __.
-The vertebral column contains and protects the __, __, and the __. |
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Definition
- vertebral column
- skull, pectoral girdle, upper limb, thoracic cage
- lower limbs
- spinal cord; roots of the spinal nerves; meninges of the spinal cord |
|
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Term
- the vertebral column is made up of __ vertebrae
-- give the break down: |
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Definition
- 33
-- 7 cervical vertebrae, 12 thoracic vertebrae, 5 lumbar vertebrae, 1 sacrum (actually 5 fused vertebrae), and 1 coccyx (4 vertebrae, with the lower 3 usually fused) |
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Term
-The vertebral column is a flexible structure because it is __ and composed of __, __, and __ composed of __.
-The __ actually form about a one fourth of the vertebral column |
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Definition
- segmented; vertebrae, joints, intervertebral discs; fibrocartilage
- intervertebral discs |
|
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Term
general characteristics of a vertebra
-Although vertebrae show regional anatomical differences, all vertebrae possess a common pattern.
-A typical vertebra consists of a __ (that is __ anteriorly and has a __ posteriorly). |
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Definition
-
- body; (rounded; vertebral arch) |
|
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Term
general characteristics of a vertebra
-The spinal cord and its coverings run through the __.
-The vertebral arch consists of a pair of cylindrical __ which form the sides and the flattened __, which complete the arch posteriorly. |
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Definition
- vertebral foramen
- pedicles; laminae |
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Term
general characteristics of a vertebra
- the vertebral arch gives rise to seven processes: |
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Definition
- one spinous process
- two transverse processes
- four articular processes |
|
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Term
general characteristics of a vertebra
- The spinous process, or spine, is directed in a __ direction from the junction of the __.
-The transverse processes project __ from the junction of the __ and the __.
-Both the spinous process and the transverse processes act as __ and serve as sites of attachment for __ and __ |
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Definition
- posterior; laminae
- laterally; laminae; pedicles
- levers; muscles; ligaments |
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Term
-The articular processes are vertically oriented and consist of two __ and two __ processes.
-They arise from the junction of the __ and the __.
-The articular surfaces are covered with __.
-The two superior articular processes of __ articulate with the two inferior articular processes of the __.
-__ are formed by these articulations |
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Definition
- verteically; superior; inferior
- laminae; pedicles
- hyaline cartilage
- one vertebral arch; arch above
- synovial joints |
|
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Term
-The __ are notched on their upper and lower surfaces, forming the __ and __.
-On each side, the superior notch of one vertebra and the inferior notch of the vertebra __ to it form an __.
-These foramina, transmit __ and __
-The __ and __ of a spinal nerve unite within the foramina. |
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Definition
- pedicles; superior; inferior vertebral notches
- superior; intervertebral foramen
- spinal nerves; blood vessels
- dorsal; ventral nerve roots |
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Term
characteristics of a typical cervical vertebra
-The transverse processes have a __ that transmits the __and __ (the vertebral artery does not pass through the foramina transversaria of the __ cervical vertebra).
-The spines are __ and __.
-The body is __ and __ from side to side.
-The vertebral foramen is __ and __.
-The superior articular processes have facets that face __ and __.
-The inferior articular processes have facets that face __ and __. |
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Definition
| - foramen transversarium; vertebral artery; veins; (seventh) - small; bifid (have two prongs) - small; broad - large; triangular - backward; upward - downward; forward |
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Term
-The __, __ and __ cervical vertebrae are atypical.
-The first cervical vertebra, the __, does not have a __ or a __.
--It has an __ and __.
--There is a lateral mass on each side with processes that articulate with the __ (forms the __)
--There are articular sites on the inferior surface for articulation with the axis (__)
-The second cervical vertebra, or __, has a peg that is called the __ or __ (that was once the vertebral body of the atlas that fused with the body of the axis).
-The seventh cervical vertebra, or __, has the longest __, which is not __.
--The transverse process is __, but the __ is small and only transmits the __. |
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Definition
- first, second, seventh
- atlas; body; spinous process
-- anterior; posterior arch
-- occipital condyles; (atlanto-occipital joints)
-- (atlanto-axial joints)
- axis; dens; odontoid process
- vertebra prominens; spinous process; bifid
-- large; foramen transversarium; vertebral vein |
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Term
characteristics of a typical thoracic vertebra
-The body is __ sized and __ shaped.
-The vertebral foramen is __ and __.
-The spines are __ and point __.
-__ are present on the transverse processes for articulation with the tubercles of the ribs (__ and __ lack facets on the transverse processes).
-The superior articular processes have facets that face __ and __; the facets on the inferior articular processes face __ and __.
-The inferior articular processes of the T12 face __. |
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Definition
- medium; heart
- small; circular
- long; downward
- costal facets; T11; T12
- backward; laterally; forward; medially
- laterally |
|
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Term
Characteristics of a typical lumbar vertebra
-The body is __ and __ shaped.
-The pedicles are __ and directed __.
-The laminae are __.
-The vertebral foramina are __.
-The transverse processes are __ and __.
-The spinous processes are __, __, and project __.
-The articular surfaces of the superior articular processes face __.
-The articular surfaces of the inferior articular processes face __. |
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Definition
- large; kidney
- strong; backward
- thick
- triangular
- long; slender
- short; flat; backward
- medially
- laterally |
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Term
-The sacrum consists of __ rudimentary vertebrae that have fused together to form a wedge shaped bone.
-The sacrum is concave __.
-The upper border, or base, articulates with the fifth lumbar vertebra.
-The narrow inferior border articulates with the __.
-Laterally, the sacrum articulates with the __ to form the __.
-The anterior and upper margin of the first sacral vertebra bulges __ and is called the __ |
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Definition
- five
- anteriorly
- fifth lumbar vertebra
- coccyx
- two iliac bones; sacroiliac joints
- anteriorly; sacral promontory |
|
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Term
-The coccyx consists of __ vertebrae fused together to form a single, small __ shaped bone.
-It articulates with the lower end of the __.
-The first coccygeal vertebra is usually not __ or __ with the second coccygeal vertebra. |
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Definition
- four; triangular
- sacrum
- fused; incompletely fused |
|
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Term
important variations in the vertebrae
-Cervical vertebrae are constant in numbers, but the __ cervical vertebra may have a cervical rib.
-The __ lumbar vertebra may also have a rib.
-The __ lumbar vertebra may be incorporated into the sacrum.
-The __ sacral vertebra may be partially or totally separate from the rest of the sacrum, technically becoming the __ lumbar vertebra. |
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Definition
- seventh
- first
- fifth
- first; sixth |
|
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Term
important variations in the vertebrae
-A large portion of the posterior wall of the __ may be absent due to failure of the laminae and spines to develop.
-The coccyx, which usually consists of __ fused vertebrae, may have __ or __ vertebrae.
-The __ coccygeal vertebra may be separate. |
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Definition
- sacral canal
- four; three; five
- first |
|
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Term
- Atlanto-occipital joints:These are synovial joints that are formed between the __ of the __ and the __ of the __
-- the joints are enclosed by a __
-- ligaments include the __ and __
---Anterior atlanto-occipital membrane: a continuation of the __ ligament, which runs as a band down the anterior surface of the vertebral column. It connects the anterior arch of the atlas to the anterior margin of the __
---Posterior atlanto-occipital membrane: similar to the __ and connects the posterior arch of the atlas to the posterior margin of the __.
- movements include: |
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Definition
- occipital condyles; occipital bone; superior surfaces; lateral masses of the atlas
-- capsule
-- anterior; posterior atlanto-occipital membrane
--- anterior longitudinal; foramen magnum
--- ligamentum flavum; foramen magnum
- flexion, extension, and lateral flexion, no rotation is possible |
|
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Term
- there are 3 __ synovial joints
--One is between the __ and the anterior arch of the __.
--The other two joints are between the __ of the __.
-- the joints are enclosed by __
-- the ligaments of the atlanto axial joints include __ and __
---Apical ligament – a median ligament that connects the apex of the __ to the anterior margin of the __.
---Alar ligaments – lie on each side of the apical ligament and connect the __ to the medial sides of the __ |
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Definition
- atlanto axial
-- odontoid process; atlas
-- lateral masses; bones
-- capsules
-- apical ligament; alar ligament
--- odontoid process; foramen magnum
--- odontoid process; occipital condyles |
|
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Term
- other atlanto-axial joints include __ and __
-- cruciate ligaments:– consists of a __ part and a __ part. The transverse part is attached on each side to the inner aspect of the lateral mass of the __ and binds the __ to the anterior arch of the __. The vertical part runs from the posterior surface of the body of the __ to the anterior margin of the __.
-Membrana tectoria – is an upward extension of the __, and is attached above to the the occipital bone just inside the __. It covers the posterior surface of the odontoid process, and the apical, alar, and cruciate ligaments
- movements: there can be extensive __ of the __, and __ on the __ |
|
Definition
- cruciate ligaments; membrana tectoria
- transverse; vertical; atlas; odontoid process; atlas; axis; foramen magnum
- posterior longitudinal ligament; occipital bone; foramen magnum
- rotation; atlas; head; axis |
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Term
Joints of the vertebral column below the axis
-With the exception of the first __ cervical vertebrae, the remainder of the mobile vertebra articulate with each other by means of __ between their bodies and by __ between their articular processes. |
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Definition
| - two; cartilaginous joints; synovial joints |
|
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Term
joints between two vertebral bodies
-The upper and lower surfaces of the bodies of adjacent vertebrae are covered by thin plates of __
-Sandwiched between the plates of hyaline cartilage is an __ of __.
-__ of the disc strongly unite the bodies of the two vertebrae.
-In the lower cervical region, small __ are present at the sides of the intervertebral disc between the upper and lower surfaces of the bodies of the vertebrae. |
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Definition
- hyaline cartilage
-intervertebral disc; fibrocartilage
- collagen fibers
- synovial joints |
|
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Term
-The __ are responsible for one fourth of the length of the vertebral column.
--They are thickest in the __ and __ regions where the movements of the vertebral column are the __.
--They act as __ when the load on the vertebral column is suddenly increased.
--Their __ allows the vertebrae to move one on the other.
--The resilience is gradually lost with advancing __. |
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Definition
- intervertebral discs
-- cervical; lumbar; greatest
-- shock absorbers
-- elasticity
-- age |
|
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Term
Intervertebral discs
-Each disc consists of a peripheral part, the __, and a central part, the __.
-The anulus fibrosis is composed of __, where the __ are arranged in concentric sheets.
-The nucleus pulposus in children and adolescents is an __ mass of gelatinous material that contains a large amounts of __.
-With advancing age, the __ content of the nucleus pulposus diminishes and is replaced by __.
-The semifluid nature of the nucleus pulposus allows it to change shape and permits one vertebra to rock forward or backward on the other. |
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Definition
- anulus fibrosis; nucleus pulposus
- fibrocartilage; collagen fibers
- ovoid; water
- water; fibrocartilage |
|
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Term
-The __ and __ run as continuous bands down the anterior and posterior surfaces of the vertebral column from the skull to the sacrum.
-The anterior ligament is wide and is strongly attached to the front and sides of the __ and to the __.
-The posterior ligament is weak and narrow and is attached to the __ borders of the __.
-The ligaments hold the vertebrae together __, but do allow a __ amount of movement to occur. |
|
Definition
- anterior; posterior longitudinal ligaments
- vertebral bodies; intervertebral discs
- posterior; discs
- firmly; small |
|
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Term
-The joints between two vertebral arches consist of __ (freely moveable joints) between the superior and inferior __ of adjacent vertebrae.
-The articular facets are covered with __ and the joints are surrounded by a __ |
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Definition
- synovial joints; articular processes
- hyaline cartilage; capsular ligament |
|
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Term
-__ – runs between the tips of adjacent spines.
-__ – connects adjacent spines.
-__ – runs between adjacent transverse processes.
-__ – connects the laminae of adjacent vertebrae.
-__ – greatly thickened supraspinous and interspinous ligaments in the cervical region. |
|
Definition
- supraspinous ligament
- interspinous ligament
- intertransverse ligament
- ligamentum flavum
- ligamentum nuchae |
|
|
Term
nerve supply of vertebral joints
-The joints between the vertebral bodies are innervated by the small __ of each __.
-The nerve arises from the spinal nerve as it exits from the __
-It then re-enters the vertebral canal through the __ and supplies the __, __, and __.
-The joints between the articular processes are innervated by branches from the __ of the spinal nerves. |
|
Definition
- meningeal branches; spinal nerve
- spinal nerve; intervertebral foramen
- intervertebral foramen; meninges; ligaments; intervertebral discs
- posterior rami |
|
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Term
-Vertebrae are held together by strong __ that severely limit the degree of movement that is possible between adjacent vertebrae.
-However, when all of the movements between the vertebrae are added together, the vertebral column as a whole demonstrates a remarkable degree of __.
- the following movements are possible in the vertebral column |
|
Definition
- ligaments
- movement
- flexion, extension, lateral flexion, rotation, circumduction |
|
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Term
-__ – a forward movement, and __ – a backward movement; both flexion and extension movements are extensive in the __ and __, but limited in the __ region.
-__ – bending of the body from one or the other side; extensive in __ and __ regions, limited in the __ region.
-__ – twisting of the vertebral column; limited in the __ region.
-__ – a combination of all the above movements. |
|
Definition
- flexion; extension; cervical; lumbar; thoracic
- lateral flexion; cervical; lumbar; thoracic
- rotation; lumbar
- circumduction |
|
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Term
-The type and range of movements possible in each region of the vertebral column depends on the shape and direction of the __ processes, as well as the thickness of the __.
-The limited movements in the __ are due to the presence of ribs, costal cartilages, and sternum, which all contribute to restrict the range of movement. |
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Definition
- articular processes; intervertebral discs
- thoracic region |
|
|
Term
-The __ is the region between the neck and the abdomen.
-The __, which is the framework of the walls of the thorax, is formed by the __, the __, the __, and the __ and __.
-Superiorly the thorax communicates with the __.
-Inferiorly the thorax is separated from the abdomen by the __.
-The thoracic cage protects the heart, lungs, and is used as a site of attachment for __ of the thorax, upper extremity, abdomen, and back. |
|
Definition
- thorax
- thoracic cage; vertebral column; ribs; intercostal spaces; sternum; costal cartilages
- neck
- diaphragm
- heart; lungs; muscles |
|
|
Term
-The thoracic cavity is divided into a median area called the __, and the laterally placed __ and __.
-The lungs are covered by a thin membrane called the __, which passes from each lung at its __ (where the bronchi and blood vessels enter and exit) to the inner surface of the thoracic wall where it becomes the __.
-Two membranous sacs called the __ are formed, one on either side of the thoracic cavity, between the lungs and the thoracic walls. |
|
Definition
- mediastinum; pleurae; lungs
- visceral pleura; root; parietal pleura
- pleural cavities |
|
|
Term
-The thoracic wall is covered on the outside by __ and by __ attaching the shoulder girdle to the trunk.
-It is lined with __.
-Boundaries:
--Posterior:
--Anterior:
--Lateral: |
|
Definition
- skin; muscles
- parietal pleura
-
-- thoracic part of the vertebral column
-- sternum
-- ribs and intercostal spaces |
|
|
Term
| -The sternum is a flat bone that can be divided into three parts: |
|
Definition
| - manubrium; body of the sternum; xiphoid process |
|
|
Term
-The __ is the upper part of the sternum.
--It articulates with the __ at the __.
--It also articulates with the __ and with the __ and the __ on each side. |
|
Definition
- manubrium
-- body of the sternum; manubriosternal joint
-- clavicles; first costal cartilage; upper part of the second costal cartilages |
|
|
Term
-The body of the sterum articulates above with the __ at the __ and below with the __.
-On each side, it articulates with the __ to the __. |
|
Definition
- manubrium; manubriosternal joint; xiphoid process
- second; seventh costal cartilages |
|
|
Term
-The __ is a thin plate of cartilage that becomes ossified at its proximal end during adult life.
-No __ or __ are attached to it.
-The junction between the xiphoid process and sternum is called the __.
-The xiphisternal joint lies opposite the body of the __. |
|
Definition
- xiphoid process
- ribs; costal cartilages
- xiphisternal joint
- ninth thoracic vertebra |
|
|
Term
-The __, is formed by the articulation of the manubrium with the body of the sternum.
-It can be recognized by a transverse ridge on the anterior surface of the __.
-This ridge lies at the level of the __, the point from which all costal cartilages and ribs are counted.
-The __ lies opposite the intervertebral disc between the __ and __. |
|
Definition
- sternal angle (of Louis)
- sternum
- second costal cartilage
- sternal angle; fourth; fifth thoracic vertebrae |
|
|
Term
-Ribs are curved, flat bones that contain __.
-Ribs can be classified as __ or __.
-There are three types of ribs classified according to their attachments: |
|
Definition
- red bone marrow (hematopoietic tissue)
- typical; atypical
- true; false; floating |
|
|
Term
-True: attach directly to the __ via their own __.
-False: their cartilages are connected to the cartilage __, so their attachment to the __ is __.
-Floating: do not connect at all with the __; instead they end in the __. |
|
Definition
- sternum; costal cartilages
- above them; sternum; indirect
- sternum; posterior abdominal musculature |
|
|
Term
-A typical rib is a long, twisted flat bone that has a __, __ superior border and a __, __ inferior border.
-The inferior border overhangs and forms the __, which accommodates the __ and __.
-The anterior end of each rib is attached to the corresponding __.
- a rib has a __, __, __, __, and __ |
|
Definition
- rounded, smooth; sharp; thin
- costal groove; intercostal vessels; nerve
- costal cartilage
- head, neck, tubercle, shaft, angle |
|
|
Term
anatomy of a typical rib
-The __ has two facets for articulation with the numerically corresponding vertebral body and that of the vertebra immediately above.
-The __ is a constricted portion situated between the head and the tubercle. |
|
Definition
|
|
Term
-The __ is a prominence on the outer surface of the rib at the junction of the neck with the shaft.
-The tubercle has a facet for articulation with the __ of the numerically corresponding vertebra.
-The __ is thin, flattened, and twisted on its long axis.
-The inferior border of the shaft has the __.
-The __ is where the shaft of the rib bends sharply forward. |
|
Definition
- tubercle
- transverse process
- shaft
- costal groove
- angle |
|
|
Term
atypical ribs
-The __ is the broadest, shortest, and most sharply curved of the seven true ribs.
-It has a single facet on its head for articulation with the __ only.
-It also has two transversely directed grooves for the ___*.
-These grooves are separated by a __ and ridge, where the __ muscle is attached. |
|
Definition
- first rib
- T1 vertebra
- subclavian vessels
- scalene tubercle; ridge; anterior scalene |
|
|
Term
atypical ribs
-The __ has a thinner, less curved body; it is __ the first rib.
-Its head has two facets for articulation with the bodies of the __ and __.
-The main atypical feature is a rough area on its upper surface is the __ for the __, a part of that muscle’s origin. |
|
Definition
- second rib; longer
- T1; T2 vertebrae
- tuberosity; serratus anterior |
|
|
Term
atypical ribs
-The __, have only one facet on their heads and articulate with a __.
-The __ ribs are short and have no __ or __. |
|
Definition
- 10th - 12th ribs; single vertebra
- 11th - 12th ribs; neck; tubercle |
|
|
Term
Costal Cartilages
-The costal cartilages are pieces of cartilage that connect the __ ribs to the lateral edge of the __ and the __ ribs to the __ immediately above.
-The cartilages of the 11th and 12th ribs are embedded in the __
-The costal cartilages contribute to the __ and __ of the thoracic walls.
-The costal cartilages lose some of their flexibility as the result of __ as a person ages. |
|
Definition
- upper seven; sternum; 8th-10th; cartilage
- abdominal musculature
- elasticity; mobility
- superficial calcification |
|
|
Term
-Joints of the sternum
--The __ is a cartilaginous joint between the manubrium and the body of the sternum. A small amount of angular movement is possible during respiration.
--The __ is a cartilaginous joint between the xiphoid process and the body of the sternum. The xiphoid process usually fuses with the body of the sternum during middle age. |
|
Definition
-- manubriosternal joint
-- xiphisternal joint |
|
|
Term
-Joints of the heads of the ribs
--The __ rib and the __ ribs have a __ with their corresponding vertebral body.*
--For the __ through the __ ribs, the head articulates by means of a __ with the corresponding vertebral body and that of the vertebra above it.
--There is a strong __ that connects the head to the intervertebral disc. |
|
Definition
-- first rib; 3 lowest; synovial joint
-- 2nd; 9th; synovial joint
-- intraarticular ligament |
|
|
Term
-Joints of the tubercles of the ribs
--The __* articulates by means of a synovial joint with the __* of the corresponding vertebra.
--This joint is absent on the __ and __ ribs.
-Joints of the ribs and costal cartilages
--These joints are __; they are __ |
|
Definition
-- tubercle of the rib; transverse process
-- 11th; 12th rib
-- cartilaginous joints; immovable |
|
|
Term
-The first costal cartilages articulate with the __ that do not permit __.
-The __ costal cartilage articulate with the lateral border of the sternum by __.
-Additionally, the __ costal cartilages articulate with one another along their borders by __.
-The cartilages of the 11th and 12th ribs are embedded in the __ |
|
Definition
- manubrium; movement
- 2-7th; synovial joints
- 6th-10th; small synovial joints
- abdominal musculature |
|
|
Term
-The __ ribs and their costal cartilages are fixed to the manubrium and are immovable.
-The raising and lowering of the ribs during __ are accompanied by movements in both the joints of the __ and __.
-This permits the __ of each rib to rotate around its own axis. |
|
Definition
- 1st
- respiration; head; tubercle
- neck |
|
|
Term
superior thoracic aperture
Boundaries:
-Posterior:
-Lateral:
-Anterior:
Structures passing through: |
|
Definition
Boundaries:
-Posterior – first thoracic vertebra (the body protrudes into the opening).
-Lateral – first pair of ribs plus their costal cartilages.
-Anterior – superior border of the manubrium.
-Structures passing through:
Trachea, esophagus, nerves, vessels that supply and drain the head, neck, and upper limbs. |
|
|
Term
inferior thoracic aperture
Boundaries:
-Posterior:
-Posterolateral:
-Anterolateral:
-Anterior:
-Structures passing through: |
|
Definition
Boundaries:
-Posterior – 12th thoracic vertebra (the body protrudes into the opening).
-Posterolateral – 11th and 12th pair of ribs.
-Anterolateral – the joined cartilages of ribs 7 through 10.
-Anterior – xiphisternal joint.
-Structures passing through:
Esophagus, large vessels, nerves, all of which pierce the diaphragm. |
|
|
Term
section through an intercostal space
-The spaces between the ribs contain three muscles of respiration:
-The innermost intercostals are lined internally by the __, which in turn is lined by the __
- the __* run between the internal and innermost intercostals |
|
Definition
- external intercostals, internal intercostals, innermost intercostals
- endothoracic fascia; parietal pleura
- intercostal vessels and nerves |
|
|
Term
Intercostal muscles
-The __* muscle forms the most superficial layer.
-Its fibers are directed __ and __ from the inferior border of the rib above to the superior border of the rib below.
-The muscle extends forward to the __ where it is replaced by an __, the __*.
- __: a thin sheet like membrane |
|
Definition
- external intercostal
- downward; forward
- costal cartilage; aponeurosis; external intercostal membrane
- aponeurosis |
|
|
Term
Intercostal muscles
-The __* form the intermediate layer.
Its fibers are directed __ and __ from the subcostal groove of the rib above to the upper border of the rib below.
-The muscle extends backward from the sternum in front to the angles of the ribs behind, where the muscle is replaced by an __, the __. |
|
Definition
- internal intercostal muscle
- downward; backward
- internal intercostal membrane |
|
|
Term
intercostal muscles
-The __ forms the deepest layer and corresponds to the __ of the abdominal wall.
-It is an __ muscle layer and crosses more than one __ within the ribs.
-It is related internally to the __ and __ and externally to the __ and __.
-The innermost intercostals can be divided into the __ (at the interior surface of the lower ribs at their angles) and the __ (posterior to the sternum). |
|
Definition
- innermost intercostal muscle; transversus abdominis
- incomplete; intercostal space
- endothoracic fascia; parietal pleura; intercostal nerves; vessels
- subcostal muscles; transversus thoracis |
|
|
Term
actions of the intercostal muscles
-When the intercostal muscles contract, they all tend to pull the ribs __ to one another.
-If the 1st rib is fixed by the contractions of muscles in the root of the neck, the scaleni muscles, the intercostal muscles raise the 2nd to the 12th ribs towards the 1st rib, as in __.
-If the 12th rib is fixed by the quadratus lumborum muscle and the oblique muscles of the abdomen, the 1st to the 11th ribs will be lowered by the contraction of the intercostal muscles, as in __. |
|
Definition
- nearer
- inspiration
- expiration |
|
|
Term
movements of the thoracic wall
-Respiration consists of two phases – __ and __.*
-The __ is the primary muscle of inspiration; expiration is mostly a __, brought on by the __ of the lungs.*
-Inspiration and expiration are accomplished by the alternate increase and decrease of the capacity of the __.
-The thoracic cavity can be thought of as a box, with a single entrance at the top, the tube, or trachea.
-The capacity of this box can be increased by elongating all its dimensions or diameters, which results in air under atmospheric pressure __ the box through the tube.
-There are __ of the thoracic cavity that can be increased.* |
|
Definition
- inspiration; expiration
- diaphragm; passive process; elastic recoil
-thoracic cavity
- trachea
- entering
- three dimensions |
|
|
Term
movements of the thoracic wall
-When the diaphragm contracts, the domes of the diaphragm become __, the diaphragm __, and the __* increases.
-If the downward sloping ribs are raised at the sternal ends, the __* increases and the lower end of the sternum is thrust __. (this is called __).
-There is a greater increase in the anteroposterior dimension, occurring __, as at the end of the pump handle.
-The ribs articulate in front with the sternum via the __ and behind with the __.
-Because the ribs curve downward as well as forward, they resemble bucket handles.
-So, if the ribs are raised like __ (__), the __ will increase.* |
|
Definition
- flattened; drops; vertical dimensions
- anteroposterior dimension; forward; (pump handle action)
- inferiorly
- costal cartilages; vertebral column
- bucket handles
- bucket handles (bucket handle action); transverse dimension |
|
|
Term
intercostal arteries
-Each intercostal space contains a __* artery and __* arteries.
-The posterior intercostal arteries of the first two spaces are branches from the __, a branch of the costocervical trunk of the __.
-The posterior intercostal arteries of the lower nine spaces are branches of the __. |
|
Definition
- large single posterior intercostal; two small anterior intercostal
- superior intercostal artery; subclavian artery
- descending thoracic aorta |
|
|
Term
intercostal arteries
intercostal arteries
-The anterior intercostal arteries of the first six spaces are branches of the __, which arises from the first part of the __.
-The anterior intercostal arteries of the lower spaces are branches of the __*, one of the terminal branches of the __. |
|
Definition
- internal thoracic artery; subclavian artery
- musculophrenic artery; internal thoracic artery |
|
|
Term
veins of the thoracic wall
-The corresponding posterior intercostal veins drain backward into the __.
-The anterior intercostal veins drain forward into the __ and __. |
|
Definition
- azygos or hemiazygos veins
- internal thoracic; musculophrenic veins |
|
|
Term
The Breast
-The breasts, or __, consist of __ and __ connective tissue embedded in fat, blood vessels, lymphatics, and nerves.
-Both men and women have breasts, however, men have only a few __.
-The breasts are found in the __ that overlies the __ muscle.
-A small part of the breast, called the __*, extends upward and laterally, pierces the __ at the lower border of the pectoralis major muscle, and enters the __, or __. |
|
Definition
- mammary glands; glandular; fibrous
- small ducts
- subcutaneous tissue; pectoralis major
- axillary tail; deep fascia; axilla; armpit |
|
|
Term
the breast
-Each breast consists of __, which __.*
-The __ from each lobe opens separately onto the __.
There is a widened area of the duct called the __ that is located just prior to the termination of the duct on the __.
-The base of the nipple is called the __.
-Tiny bumps on the areola are due to the underlying areolar glands.
-The lobes of the gland are separated by fibrous septa that serve as __*.
-Behind the breast is a space filled by loose connective tissue called the __. |
|
Definition
- 15 to 20 lobes; radiate out from the nipple
- main duct; nipple
- ampulla; nipple
- areola
- areolar glands
- suspensory ligaments (of Cooper)
- retromammary space |
|
|
Term
blood supply of the breast
-The arterial branches to the breast include the __ of the __ and the __.*
-The __ also supplies the gland via its __ and __.
-The veins correspond to the arteries. |
|
Definition
- perforating branches; internal thoracic artery; intercostal arteries
- axillary artery; lateral thoracic; thoracoacromial branches |
|
|
Term
lymphatic drainage of the breast
-The lymphatic drainage of the breast is of great clinical importance because of the frequent development of cancer in the breast and the __ along the lymph vessels to the lymph nodes.
-There are at least __ different lymphatic pathways that drain the breast. |
|
Definition
- subsequent spread (metastasis) of malignant cells
- 5 |
|
|
Term
lymphatic drainage of the breast
-The lateral quadrants of the breast drain into the anterior axillary or pectoral group of nodes just posterior to the lower border of the pectoralis major.
-The __ drain by means of vessels that pierce the intercostal spaces and enter the __ (situated along the course of the internal thoracic artery).
-A few lymph vessels follow the __* and drain posteriorly into the __ (situated along the course of the posterior intercostal arteries).
-Some lymph vessels communicate with the lymph vessels of the __*.
-Others communicate with lymph vessels of the __*. |
|
Definition
- lateral quadrants of the breast
- medial quadrants; internal thoracic nodes
- posterior intercostal arteries; posterior intercostal nodes
- opposite breast
- anterior abdominal wall |
|
|
Term
spinal cord
-Part of the __
-Located in the __
-Begins superiorly at __
--Continuous with the __
-Ends inferiorly at the level of the __ intervertebral disc (adult)
-Roughly cylindrical in shape but varies in cross sectional shape and diameter |
|
Definition
- central nervous system (cns)
- vertebral canal
- foramen magnum
-- medulla oblongata
- L1/L2 |
|
|
Term
spinal cord
-Cervical Enlargement
--Extends from __ to __ spinal cord segments
--Gives rise to the __
--Innervation of the __
-Lumbosacral (Lumbar) Enlargement
--Extends from __ to __ spinal cord segments
--Gives rise to the __ and __
--Innervation of __ |
|
Definition
-- C5; T1
-- brachial plexus
-- upper limb
-
-- L1-S3
-- lumbar; sacral plexuses
-- lower limb |
|
|
Term
spinal cord
-__: The inferior extent of the spinal cord tapers off in a cone shape
-__: A connective tissue filament that extends from the conus medullaris to the coccyx where it attaches
-__: Spinal nerve roots that extend inferiorly below the conus medullaris |
|
Definition
- conus medullaris
- filum terminale
- cauda equina |
|
|
Term
spinal cord development
-In the embryo, up to the __ of development, the spinal cord runs the entire length of the __
--Spinal cord segments are aligned with corresponding __
--The nerve course from spinal cord to vertebral canal exit point is __ |
|
Definition
- 8th week; vertebral canal
-- vertebrae
-- short |
|
|
Term
spinal cord development
-Beginning in the __ of development the __ begins lengthening faster than the __
--This results in the inferior end of the spinal cord lying at progressively higher vertebral levels
---6 months gestation:
---Birth:
---Adult: |
|
Definition
- 3rd month; vertebral column; spinal cord
--
--- S1
--- L3
--- L1/L2 |
|
|
Term
spinal cord development
-In order to maintain innervation in the face of the differential growth, the spinal nerve roots elongate
--The roots descend obliquely from the spinal cord to the __
--__ and __ become especially long
--Nerve roots descending below the conus medullaris form the __ |
|
Definition
- elongate
-- intervertebral foramina
-- lumbar; sacral roots
-- cauda equina |
|
|
Term
spinal cord surface features
-__:Deep groove along anterior midline
--Contains __
-__: Shallow groove along posterior midline
-__: Attachment area of the rootlets of the anterior roots of the spinal nerves |
|
Definition
- anterior median fissure
-- anterior spinal vessels
- posterior median sulcus
- anterolateral sulcus |
|
|
Term
spinal cord surface features
-__: Attachment area of the rootlets of the posterior roots of the spinal nerves
- __: Located between the posterior median sulcus and the posterolateral sulcus
--Present only in the __ and __ |
|
Definition
- posterolateral sulcus
- posterior intermediate sulcus
-- cervical; upper thoracic |
|
|
Term
Internal structure of the spinal cord
- __: Narrow cavity in center of spinal cord
--Communicates with the __
--Lined by __
- __: located centrally
- __: located peripherally |
|
Definition
- central canal
-- ventricular system of the brain (4th ventricle)
-- ependymal cells
- gray matter
- white matter |
|
|
Term
__: butterfly or H-shaped area in central cord
- regions include: |
|
Definition
gray matter of spinal cord
- posterior horn; anterior horn; lateral horn; intermediate zone |
|
|
Term
gray matter of spinal cord
- posterior horn
-- __ function
--Groups of __ influenced by information entering though __
--Many neurons have __ that ascend in the __ to the brain (Project __ to higher levels of the neuraxis) |
|
Definition
-- sensory
-- neurons; posterior roots
-- axons; white matter; (sensory info) |
|
|
Term
gray matter of spinal cord
-Anterior Horn
--Mostly involved with __
-Contains neurons that have axons that leave through the __ to supply __ (__)
-Anterior horn is large in __ and __ enlargements where it contains the motor neurons for the __ of the limbs |
|
Definition
-- voluntary movements
-- anterior roots; skeletal muscle fibers (somatic motor neurons)
-- cervical; lumbosacral; muscles |
|
|
Term
gray matter of spinal cord: lateral horn
- __ nucleus
-- forms the __
-- segments __
-- __ neurons |
|
Definition
- intermediolateral
-- lateral horn
-- T1-L2
-- preganglionic sympathetic neurons |
|
|
Term
gray matter of spinal cord
- intermediate zone
--Located between __ and __ continuous medially with the gray matter around the central canal
--Consists primarily of __ for __ and __ integration of spinal functions |
|
Definition
-- anterior; posterior horns
-- interneurons; segmental; intersegmental |
|
|
Term
white matter of the spinal cord has 3 regions:
-__: Between posterior median sulcus and posterolateral sulcus
-__: Between posterolateral and anterolateral sulci
-__: Between anterolateral sulcus and anterior median fissure |
|
Definition
- posterior funiculus
-lateral funiculus
-anterior funiculus |
|
|
Term
white matter of spinal cord
- Consists of __ and __ fibers
--Long __ and __ fibers or tracts
---Interconnect __ to __ |
|
Definition
- ascending; descending
-- ascending; descending
--- spinal cord; brain |
|
|
Term
-__: Formed by the union of two roots that enter and leave the spinal cord
--Anterior (ventral) root: Nerve fibers carrying information __ from the spinal cord (__)
--Posterior (dorsal) root: Nerve fibers carrying information __ the spinal cord (__)
---Contains a __ that contains the cell bodies of the sensory neurons (__) |
|
Definition
- spinal nerves
-- away; (efferent, motor fibers)
-- toward; (afferent, sensory fibers)
--- ganglion; (dorsal root ganglion) |
|
|
Term
-Spinal nerves are __ nerves
--Contain both __ and __ fibers
-After exiting the vertebral canal they divide into __ (__)
--__ is smaller: Innervates __ and __
--__ is larger: Innervates __ and muscles of __ and __ as well as __ |
|
Definition
- mixed nerves
-- motor; sensory
- two branches (both mixed nerves)
-- posterior ramus; skin; deep muscles of the back
-- anterior ramus; skin; limbs; anterolateral trunk; superficial muscles of the back |
|
|
Term
- there are __ pairs of spinal nerves that arise sequentially from the spinal cord segments
-- give the breakdown: |
|
Definition
- 31 pairs
-- 8 cervical
12 thoracic
5 lumbar
5 sacral
1 coccygeal |
|
|
Term
- spinal nerves are named by the __ where they leave the __
--__: Exit superior to the vertebra for which they are named
--__: Exits between C7 and T1 vertebrae
--__: Exit inferior to the vertebra |
|
Definition
- vertebra; vertebral canal
-- C1-C7
-- C8
-- T1 and below |
|
|
Term
- __: Area of skin innervated by the sensory fibers of a given spinal nerve
--__ from a single spinal nerve usually reach the skin in more than one __
--__ usually contain sensory fibers from more than one __ |
|
Definition
- dermatome
-- sensory fibers; cutaneous nerve
-- cutaneous nerve; spinal nerve |
|
|
Term
-Spinal cord is covered by __
-The meninges are 3 connective tissue membranes: __, __, and __ |
|
Definition
- meninges
- dura mater; arachnoid (mater); pia mater |
|
|
Term
Dura Mater
-Dense, strong fibrous sheet that forms a loose sac around the __ and __
-Continuous above at the __ with the __
-Inferiorly the __ terminates blindly at the __ level |
|
Definition
- spinal cord; cauda equina
- foramen magnum; dura of the brain
- dural sac; S2 vertebral level |
|
|
Term
-Upper part of __ is within the dural sac (__)
-__ passes out of the dural sac where it picks up an investment of __ and continues to its attachment to the __ (__ or __) |
|
Definition
- filum terminale; (filum terminale internum)
- filum terminale; dura mater; coccyx (filum terminale externum or coccygeal ligament) |
|
|
Term
-The dura mater is separated from the vertebrae by the __
-The epidural space contains __, __ and the __ |
|
Definition
- epidural space
- fat; loose connective tissue; internal vertebral venous plexus |
|
|
Term
-The dura mater forms a __ around the __ of each spinal nerve and fuses with the __ of the __ at the __
-- __: connective tissue of a nerve |
|
Definition
- sleave; roots; epineurium; spinal nerve; intervertebral foramen
-- epineurium |
|
|
Term
- __: Delicate membrane that lines the internal surface of the dura mater
--Continuous with the __
--Extends the full length of the __
--Lines the __ around the spinal nerve roots
--__: Potential space between dura mater and arachnoid |
|
Definition
-arachnoid
-- cranial arachnoid
-- dural sac
-- dural sleeves
-- subdural space |
|
|
Term
-__: Real space between arachnoid and pia mater
--Filled with __
--Continuous with __ around the __
-- Extends inferiorly to __ vertebral level
--Extends into spinal nerve __ |
|
Definition
- subarachnoid space
-- cerebrospinal fluid (CSF)
-- subarachnoid space; brain
-- S2
-- spinal nerve root sleeves |
|
|
Term
Subarachnoid space
-__: The part of the subarachnoid space inferior to the conus medullaris
--__ filled and contains the anterior and posterior nerve roots of the __ and the __
-Lumbar Puncture (LP or spinal tap): Introduction of a needle into the __, usually between the __ or __ , most commonly to obtain a __ sample |
|
Definition
- lumbar cistern
-- CSF; cauda equina; filum terminale internum
-- lumbar cistern; L3/L4; L4/L5 vertebral arches; csf |
|
|
Term
- __: Vascular membrane that intimately follows the surface of the spinal cord and nerve roots within the arachnoid
--Continuous with the pia mater covering the medulla oblongata
--Part of the filum terminale is derived from the pia mater |
|
Definition
- pia mater
-- pia mater; medulla oblongata
-- filum terminale |
|
|
Term
-__:Extension of the pia mater in a coronal plane that helps to stabilize the spinal cord in the dural sac
--Located at the lateral edges of the spinal cord between the __ and __
--Extends across the __ and attaches laterally to the __ by 20-21 tooth-like projections (denticulations) that penetrate the arachnoid |
|
Definition
- denticulate ligament
-- anterior; posterior roots
-- subarachnoid space; dura mater |
|
|
Term
thoracic cavity
-__: Contains thymus, heart within pericardial sac, large blood vessels that enter or leave heart, trachea, esophagus, azygos venous system, thoracic duct, lymph nodes, vagus and phrenic nerves, sympathetic trunks
-Two pleural cavities: __ and __ |
|
Definition
- mediastinum
- lungs; pleural membrane |
|
|
Term
trachea
-Begins in neck at inferior border of __ of __ (at level of body of __)
-Ends inferiorly, in the __ , at level of __ (corresponds with lower border of body of __ or __)
--Ends by dividing into __ and __
--Division is marked internally by a ridge (carina) |
|
Definition
- cricoid cartilage; larynx; (C6)
- mediastinum; sternal angle; T4; T4/T5 intervertebral disc
-- right; left principal (main) bronchi
-- ridge (carina) |
|
|
Term
Tracheal cartilages
-__ to __ in number
-Help to keep __
-__-shaped or __-shaped bars of __ deficient posteriorly
-Posterior wall of trachea is __ and composed of a __ |
|
Definition
- 16; 20
- tracheal lumen patent
- u; c; hyaline cartilage
- flat; fibromuscular membrane (membranous wall) |
|
|
Term
Anatomical relations in thorax
-Anterior:
-Posterior:
-Right:
-Left:
--__ ascends in groove between trachea and __ on left side |
|
Definition
Anatomical relations in thorax
-Anterior: thymus, arch of aorta, brachiocephalic trunk (artery), left brachiocephalic vein
-Posterior: esophagus
-Right: arch of azygos vein, right vagus nerve, right pleura and lung
-Left: arch of aorta, left common carotid and left subclavian arteries
--Left recurrent laryngeal nerve ascends in groove between trachea and esophagus on left side |
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Term
Right principal bronchus
-__, __, and more __ than left principal bronchus
--Foreign bodies enter right principal bronchus more often than left principal bronchus
-Located inferior to __
-Gives off __ (for corresponding lobes of right lung) |
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Definition
- wider; shorter; vertical
-- foreign bodies
- arch of azygos vein
- super; middle; and inferior lobar (secondary) bronchi |
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Term
Left principal bronchus
-__, __, and less __ than right principal bronchus
-Located inferior to __
-Gives off __ lobar bronchi |
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Definition
- narrower; longer; vertical
- arch of aorta
- superior and inferior lobar bronchi |
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Term
lungs
-Each lung is conical in shape, covered with __, and attached to __ by a __, __ and __ vessels, and __ |
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Definition
| - visceral pleura; mediastinum; bronchus; blood; lymph vessels; nerves |
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Term
parts of lungs
-__: projects upward through superior thoracic aperture into root of neck (about 2-3 cm above medial third of clavicle, at level of neck of 1st rib)
-__: directed inferiorly, concave, related to diaphragm
-__: convex, related to ribs, costal cartilages, and intercostal spaces
-__: faces medially, related to mediastinal structures |
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Definition
- apex
- diaphragmatic surface (base)
- costal surface
- mediastinal surface |
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Term
Borders of lung
-Anterior border
--__ and __, overlaps __
--Separates __ and __ surfaces anteriorly
--On __, it has an indentation (__) limited inferiorly by a tongue-like process of superior lobe (__)
-Inferior border
--Surrounds __
--Thin and sharp where it separates __ from __
--Rounded where it separates __ from __ |
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Definition
-- thin; sharp; pericardium
-- costal; mediastinal
-- left lung; (cardiac notch); (lingula)
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-- base
-- base; costal surface
-- base; mediastinal surface |
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Term
lungs
-No well defined border between __ and __
-__: Depression on mediastinal surface through which bronchi, blood and lymph vessels, and nerves enter or leave lung (structures that enter or leave lung, as a group, are referred to as __) |
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Definition
- costal; mediastinal surfaces posteriorly
- hilum; (root of lung) |
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Term
Lobes and fissures
-__ lung is slightly larger than __ lung
-Right lung is divided into __ lobes (__) by __ fissures (__)
-Left lung is divided into __ lobes (__) by __ |
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Definition
Lobes and fissures
-Right lung is slightly larger than left lung
-Right lung is divided into 3 lobes (superior, middle, and inferior) by two fissures (oblique and horizontal)
-Left lung is divided into 2 lobes (superior and inferior) by oblique fissure |
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Term
Impressions on mediastinal surface of lungs
Right lung:
Left lung: |
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Definition
Impressions on mediastinal surface of lungs
-Right lung: cardiac impression, grooves for superior vena cava, arch of azygos vein, and esophagus
-Left lung: cardiac impression (bigger than on right lung), grooves for aortic arch and descending thoracic aorta |
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Term
-Each lobar bronchus gives off branches called __
-Each __ supplies a section of a lobe called __ |
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Definition
-Each lobar bronchus gives off branches called segmental (tertiary, 3rd order) bronchi
-Each segmental bronchus supplies a section of a lobe called bronchopulmonary segment |
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Term
bronchopulmonary segment
-__ in shape (apex directed toward __, base directed toward __)
-Surrounded by __
-Has a __ and a segmental branch of __
-__ are intersegmental (lie in connective tissue between segments)
-A diseased segment can be removed __ |
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Definition
-Pyramidal in shape (apex directed toward hilum, base directed toward surface of lung)
-Surrounded by connective tissue
-Has a segmental bronchus and a segmental branch of pulmonary artery
-Veins are intersegmental (lie in connective tissue between segments)
-A diseased segment can be removed surgically |
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Term
- __: Formed by structures that enter or leave lung
-Surrounded by a __ of __
--__ hangs loose inferior to __ |
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Definition
- root of lung: Formed by structures that enter or leave lung
-Surrounded by a tubular sheath of pleura
--Pleural sheath hangs loose inferior to root of lung (pulmonary ligament) |
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Term
root of lung
- components:
- right lung: pulmonary artery lies __
- left lung: pulmonary artery lies __ |
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Definition
root of lung
-Components:
Principal (main) bronchus (1 per lung)
Pulmonary artery (1 per lung)
Pulmonary veins (2 per lung, superior and inferior)
Bronchial vessels (arteries and veins)
Lymph nodes and lymph vessels
Autonomic nerves (anterior and posterior pulmonary plexuses)
-Right lung: pulmonary artery lies anterior to principal bronchus
-Left lung: pulmonary artery lies superior to principal bronchus |
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Term
blood supply of lungs
-Lungs have __ functionally different circulatory pathways
-Pulmonary vessels
--Pulmonary arteries convey __ to lungs from __
--Pulmonary veins drain __ from lungs and carry it to __ |
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Definition
-Lungs have 2 functionally different circulatory pathways
-Pulmonary vessels
--Pulmonary arteries convey deoxygenated blood to lungs from right ventricle of heart
--Pulmonary veins drain oxygenated blood from lungs and carry it to left atrium of heart |
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Term
-__: Supply oxygenated blood to lung tissues with no close access to atmospheric oxygen (bronchi and large bronchioles)
-Left bronchial arteries (usually __) originate from __
-Right bronchial artery (usually __) originates from a __ (usually the __) or from a __
-Bronchial veins
--Do not receive all blood conveyed by __ (some of it is drained by __)
--Drain into __ (on the right) and __ (on the left) |
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Definition
- bronchial vessels
- (2); descending thoracic aorta
- (1); right posterior intercostal artery (usually the 3rd); left bronchial artery
-- bronchial arteries; (pulmonary veins)
-- azygos vein; accessory hemiazygos |
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Term
lymphatic drainage of the lung
- the lung includes the __ and __ lymphatic plexuses |
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Definition
| - superficial lymphatic; deep lymphatic |
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Term
-Superficial lymphatic plexus
--Lies underneath __
--Drains over lung surface toward __ (in __)
-Deep lymphatic plexus
--Travels along bronchi and pulmonary vessels toward __ (some lymph passes through __ located within lung substance)
--As lymph reaches __, it also enters __ |
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Definition
-Superficial lymphatic plexus
--Lies underneath visceral pleura
--Drains over lung surface toward bronchopulmonary lymph nodes (in hilum)
-Deep lymphatic plexus
--Travels along bronchi and pulmonary vessels toward hilum (some lymph passes through pulmonary nodes located within lung substance)
--As lymph reaches hilum, it also enters bronchopulmonary nodes |
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Term
lymphatic drainage of lungs
-From bronchopulmonary nodes lymph passes through __ (located around bifurcation of __) and __ (located along sides of __) |
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Definition
| -From bronchopulmonary nodes lymph passes through tracheobronchial nodes (located around bifurcation of trachea) and paratracheal nodes (located along sides of trachea) |
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Term
lymphatic drainage of lungs
-Paratracheal nodes drain into __ and __, which in turn drain into __ and __ or directly into ___ (union of __ and __ at __)
-Some lymph from inferior lobe of left lung is drained by __ |
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Definition
-Paratracheal nodes drain into right and left bronchomediastinal lymph trunks, which in turn drain into thoracic duct (left) and right lymphatic duct (right) or directly into jugulosubclavian junction (union of subclavian and internal jugular veins at root of neck)
-Some lymph from inferior lobe of left lung is drained by right bronchomediastinal lymph trunk |
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Term
-__ and __ contain sensory and motor autonomic nerve fibers
-Plexuses are formed by branches of __ and __
-Sympathetic motor fibers cause __ and __
-Parasympathetic motor fibers cause __ and __
-Plexus also contains sensory fibers from __ and __ |
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Definition
-Anterior and posterior pulmonary plexuses contain sensory and motor autonomic nerve fibers
-Plexuses are formed by branches of upper thoracic sympathetic trunks and vagus nerves
-Sympathetic motor fibers cause bronchodilation and decreased glandular secretion
-Parasympathetic motor fibers cause bronchoconstriction and increased glandular secretion
-Plexus also contains sensory fibers from bronchial mucous membrane and alveoli |
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Term
-__: Serous membrane that is arranged like a closed, invaginated sac
-During development, each __ invaginates into the __ and grows to fill most of pleural cavity
-- pleura includes __ that surrounds lung and __ that lines inner thoracic cavity |
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Definition
- pleura
- lung bud; pleural sac
-- visceral pleura; parietal pleura |
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Term
Each pleura has 2 parts
-Visceral layer: Covers outer surface of __ and extends into __
-Parietal layer: Covers internal surface of __, superior surface of __, lateral surface of __, and extends into __
-Visceral and parietal layers are continuous with each other by cuff of pleura that surrounds __ |
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Definition
- lung; interlobar fissures
- thoracic wall; diaphragm; mediastinum; root of neck
- root of lung |
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Term
-__: Slit-like space (potential space) separating the parietal and visceral layers
-Contains small amount of __ that allows 2 layers to move on each other with minimal friction
-Pleural cavity becomes a real space in __ conditions |
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Definition
- pleural space
- fluid
- pathological |
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Term
parts of parietal pleura
-__: Lines inner surfaces of ribs, costal cartilages, intercostal spaces, and sternum
-__ : Covers superior surface of diaphragm
-__: Covers lateral surface of mediastinum
-__:Extends up into root of neck over apex of lung
--Extends 2-3 cm above medial third of __ (lung and pleura may be injured in wounds to root of neck or central line placement causing pneumothorax) |
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Definition
- costal pleura
- diaphragmatic pleura
- mediastinal pleura
- cervical pleura (pleural cupula)
-- clavicle |
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Term
Pleura recesses
-__: Lowest part of pleural cavity, below inferior border of lung, into which lung expands on deep __
--Located between costal and diaphragmatic parts of __
-__: Located close to anterior border of lung, between costal and mediastinal parts of __
--During inspiration and expiration anterior border of lung slides in and out of this recess |
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Definition
- costodiaphragmatic recess; inspiration; --parietal pleura
- costomediastinal recess; parietal |
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Term
nerve supply of pleura
-Parietal pleura
--Costal pleura: __
--Mediastinal pleura: __
--Diaphragmatic pleura: __ nerve (peripheral part) and __ nerve (central part)
-Visceral pleura
--__ via __
-Once a disease process involves __, pain becomes a prominent feature |
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Definition
-- intercostal nerves
-- phrenic nerve
-- intercostal nerves (peripheral part); phrenic nerve (central part)
-- visceral sensory fibers; pulmonary plexus
- parietal pleura |
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Term
- __: Fibro-serous sac that surrounds heart and roots of great vessels that enter or leave heart
- parts: __ and __ |
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Definition
- pericardium
- fibrous pericardium; serous pericardium |
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Term
-__: Strong, fibrous outer part of pericardial sac
--Firmly attached inferiorly to __
--Superiorly becomes continuous with __ passing through it |
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Definition
- fibrous pericardium
-- central tendon of diaphragm
-- outer layer (adventitia) of great vessels |
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Term
- serous pericardium lies deep to the __
--Arrangement similar to __
--Two layers: __ and __
--Parietal layer
---Lines internal aspect of __
---Reflected around roots of great vessels to become continuous with __
--Visceral layer
---Closely applied to __
--Epicardium: Visceral layer of __ + __ and __ under it |
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Definition
- fibrous pericardium
-- pleura
-- parietal; visceral
--
--- fibrous pericardium
--- visceral layer
--
--- surface of heart
-- serous pericardium; connective tissue; fat |
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Term
- __: Slit-like space between parietal and visceral layers of serous pericardium
- A potential space
-Contains only a small amount of __ that acts as a lubricant between layers
-Only becomes a real space under __ |
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Definition
- pericardial cavity
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- fluid
- pathological conditions |
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Term
Transverse sinus
-Passage from right to left sides of __ - located __ to __ and __
-Right end is located between __ and __
-Left end is located __ to left margin of __
Oblique sinus
-__, rather than a passage
-Located posterior to __
-Can be explored by elevating a__ and sliding fingers behind __
-__ lies posterior to oblique sinus (outside __) |
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Definition
- pericardial cavity
- posterior; ascending aorta; pulmonary trunk
- superior vena cava; ascending aorta
oblique sinus
- cul-de-sac
- left atrium
- apex of heart; left atrium
- esophagus; (pericardial sac) |
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Term
Blood supply of pericardium
-__ and __ layer of serous pericardium
--__ artery (branch of __ artery that travels with __)
---Smaller contributions are provided by __ and small pericardial branches of __
--__ vein (drains into __ or __ veins)
Some small veins drain into azygos venous system
-Visceral layer of serous pericardium: __ arteries and __ veins |
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Definition
- fibrous pericardium; parietal
-- pericardiacophrenic (internal thoracic; phrenic nerve)
--- musculophrenic artery; descending thoracic aorta
-- pericardiacophrenic vein (internal thoracic; brachiocephalic)
- coronary; cardiac veins |
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Term
nerve supply of pericardium
-Fibrous pericardium and parietal layer of serous pericardium are supplied by __
-Visceral layer of serous pericardium receives autonomic innervation via __ (autonomic plexus that supplies heart) |
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Definition
- phrenic nerves
- cardiac plexus |
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Term
- __: Hollow muscular organ somewhat pyramidal or conical in shape
-Located within __ in middle __
-Rests on one of its __, not on its __
-Long axis of heart (running from base to apex) is directed __, __, and to the __ |
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Definition
- heart
- pericardial sac; middle mediastinum
- sides; base
- anteriorly; inferiorly; left |
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Term
heart
- the four chambers are:
-Atria receive blood from __ (__, __, and __ drain into right atrium; __ drain into left atrium)
-Ventricles pump blood into __ (right ventricle pumps blood into __, left ventricle pumps blood into __) |
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Definition
- two atria (right and left); two ventricles (right and left)
- veins; (superior vena cava; inferior vena cava; coronary sinus; 4 pulmonary veins)
- arteries; (pulmonary artery/trunk; aorta) |
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Term
heart
-Functionally, heart consists of two pumps working together (__ and __)
-Right heart (RA and RV)
--Pumps blood poor in __
--RA receives __ from whole body (including heart)
--Blood passes to from __ to __
--RV pumps blood into __, which carries blood to lungs for __ |
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Definition
- right heart; left heart
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-- oxygen
-- poorly oxygenated blood
-- ra; rv
-- pulmonary trunk; oxygenation |
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Term
heart
-Left heart (LA and LV)
--Pumps blood rich in __
--LA receives __ from lungs via __
--Blood passes from __ to __
--LV pumps blood into __, which distributes oxygenated blood to all tissues and organs of body via its branches |
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Definition
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-- oxygen
-- oxygenated blood; pulmonary veins
-- LA; LV
-- aorta |
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Term
external features of heart
- parts: |
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Definition
-Parts:
Base
Apex
Sternocostal (anterior) surface
Diaphragmatic (inferior) surface
Right and left pulmonary surfaces |
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Term
Sternocostal surface
-Faces __
-Major component: __
-Minor components: __ with its __, __, and __
-Coronary (atrioventricular) sulcus
--Encircles heart between __ and __
--On sternocostal surface it can be seen mostly between __ and __
-Anterior interventricular sulcus
--Boundary between __ and __ on sternocostal surface
--Indicates position of __ on sternocostal surface |
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Definition
-Faces anteriorly
-Major component: RV
-Minor components: RA with its auricle, LV, and left auricle
-Coronary (atrioventricular) sulcus
--Encircles heart between atria and ventricles
--On sternocostal surface it can be seen mostly between RA and RV
-Anterior interventricular sulcus
--Boundary between RV and LV on sternocostal surface
--Indicates position of interventricular septum on sternocostal surface |
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Term
apex of heart
-Formed by __
-Lies at level of __, about 9 cm from midline (just medial to __)
-Apex beat can usually be __ and often seen in living subjects |
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Definition
-Formed by LV
-Lies at level of 5th left intercostal space, about 9 cm from midline (just medial to midclavicular line)
-Apex beat can usually be palpated and often seen in living subjects |
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Term
base of heart
-Lies opposite __
-Faces posteriorly, toward bodies of __ (separated from them by pericardium, esophagus, and descending thoracic aorta)
-Formed mostly by __ with narrow portion of __
-Four __ open into __
--Two right (superior and inferior) and two left (superior and inferior) |
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Definition
-Lies opposite apex
-Faces posteriorly, toward bodies of T6-T9 vertebrae (separated from them by pericardium, esophagus, and descending thoracic aorta)
-Formed mostly by LA with narrow portion of RA
-Four pulmonary veins open into LA
--Two right (superior and inferior) and two left (superior and inferior) |
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Term
base of heart
-__ opens into upper part of RA
--Drains blood from __ of body (above diaphragm)
-__ opens into lower part of RA
--Drains blood from __ of body (below diaphragm)
-Coronary (atrioventricular) sulcus
--Separates __ from __
--Its left part (between __ and __), contains __, which collects most venous blood from heart and drains into __ |
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Definition
-Superior vena cava opens into upper part of RA
--Drains blood from upper parts of body (above diaphragm)
-Inferior vena cava opens into lower part of RA
--Drains blood from lower parts of body (below diaphragm)
-Coronary (atrioventricular) sulcus
--Separates base from diaphragmatic surface
--Its left part (between LA and LV), contains coronary sinus, which collects most venous blood from heart and drains into RA |
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Term
diaphagmatic surface
-Formed largely by __ with smaller contribution of __
-contains __
--Runs from __ toward __
--Forms boundary between __ and __ on diaphragmatic surface (indicates position of __ on diaphragmatic surface) |
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Definition
-Formed largely by LV with smaller contribution of RV
-contains Posterior interventricular sulcus
--Runs from coronary sulcus toward apex
--Forms boundary between RV and LV on diaphragmatic surface (indicates position of interventricular septum on diaphragmatic surface) |
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Term
pulmonary surfaces
-Related to __ of right and left lungs (__ and __ lie in between)
-Left pulmonary surface is formed largely by __ (__ and __ make small contribution)
-Right pulmonary surface is formed by __ |
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Definition
-Related to cardiac impressions of right and left lungs (pericardium and mediastinal pleura lie in between)
-Left pulmonary surface is formed largely by LV (left atrium and left auricle make small contribution)
-Right pulmonary surface is formed by right atrium |
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Term
right coronary artery
-Originates from __
--Descends in __ on sternocostal surface, between __ and __
--Turns around inferior border of heart and continues in posterior part of __
--Toward its end, it gives off __, which runs in __ toward apex of heart |
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Definition
-Originates from right aortic sinus
--Descends in coronary sulcus on sternocostal surface, between RA and RV
--Turns around inferior border of heart and continues in posterior part of coronary sulcus
--Toward its end, it gives off posterior interventricular artery, which runs in posterior interventricular sulcus toward apex of heart |
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Term
right coronary artery
- main branches:
-Dominance of coronary arterial system is determined by which artery gives off __ (RCA 67%, LCA 15%, co-dominance 18%) |
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Definition
Main branches: Sinuatrial nodal branch Right marginal branch,
Atrioventricular nodal branch
Posterior interventricular branch
-Dominance of coronary arterial system is determined by which artery gives off posterior interventricular branch (RCA 67%, LCA 15%, co-dominance 18% |
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Term
right coronary artery
Right coronary artery typically supplies
-Most of __ (except small area right of __)
- Part of __ surface of __ (just left of __)
-Posterior 1/3 of __
-__ and __
-__ node (60% of people) and __ node (80% of people |
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Definition
Right coronary artery typically supplies
-Most of RV (except small area right of anterior interventricular sulcus)
-Part of diaphragmatic surface of LV (just left of posterior interventricular sulcus)
-Posterior 1/3 of interventricular septum
-RA;Interatrial septum
-SA node (60% of people)
-AV node (80% of people |
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Term
left coronary artery
-Originates from __
-Runs posterior to __ and divides into two branches: __ and __ |
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Definition
-Originates from left aortic sinus
-Runs posterior to pulmonary trunk and divides into two branches:
--Anterior interventricular artery
--Circumflex artery |
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Term
-Anterior interventricular artery (left anterior descending artery)
--Descends toward __ of heart in __
--Turns around __ border of heart and __ with terminal branches of __ (usually a branch of __)
--Usually gives rise to a __ branch that descends on anterior surface of LV |
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Definition
-Anterior interventricular artery (left anterior descending artery)
--Descends toward apex of heart in anterior interventricular sulcus
--Turns around inferior border of heart and anastomoses with terminal branches of posterior interventricular artery (usually a branch of right coronary artery)
--Usually gives rise to a lateral (diagonal) branch that descends on anterior surface of LV |
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Term
lca: circumflex artery
-Curves around __ aspect of heart in __
-Gives off __
-Terminal branches of circumflex artery __ with terminal branches of __ |
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Definition
- left; coronary sulcus
- left marginal artery
- anatomose; right coronary artery |
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Term
-Left coronary artery typically supplies
--Most of __ (except part of its __, just left of __)
--Small part of __ (just right of __)
--Anterior 2/3 of __ and __
-- __ and its right and left bundle branches
--__ node (40% of people) and __ node (20% of people) |
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Definition
Left coronary artery typically supplies
--Most of LV (except part of its diaphragmatic surface, just left of posterior interventricular sulcus)
--Small part of RV (just right of anterior interventricular sulcus)
--Anterior 2/3 of interventricular septum
LA
--AV bundle and its right and left bundle branches
-SA node (40% of people) and AV node (20% of people) |
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Term
venous drainage of heart
-Most venous blood from heart is collected by __
--Runs from left to right in posterior part of __ (between __ and __) and drains into __
-Tributaries of coronary sinus
--__ vein
---Ascends in __ with __
---When it reaches __, it turns left and accompanies __
---Becomes continuous with __ |
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Definition
-Most venous blood from heart is collected by coronary sinus
--Runs from left to right in posterior part of coronary sulcus (between LA and LV) and drains into RA
-Tributaries of coronary sinus
--Great cardiac vein
---Ascends in anterior interventricular sulcus with anterior interventricular artery
---When it reaches coronary sulcus, it turns left and accompanies circumflex artery
---Becomes continuous with coronary sinus |
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Term
venous drainage
-Middle cardiac vein
--Runs in __ with __
-Small cardiac vein
--Runs first with __ and then with __ in __
-Posterior vein of LV
--Drains __ |
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Definition
-Middle cardiac vein
--Runs in posterior interventricular sulcus with posterior interventricular artery
-Small cardiac vein
--Runs first with right marginal artery and then with right coronary artery in coronary sulcus
-Posterior vein of LV
--Drains diaphragmatic surface of LV |
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Term
Other cardiac veins that do not drain into coronary sinus
-Anterior cardiac veins
--Originate from anterior surface of __
--Pass over __
--Open directly into __
-Smallest cardiac veins
--Very small veins located within __ of __
--Open directly into __ (numerous in __ and __, occasional and often absent in __ and __) |
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Definition
Other cardiac veins that do not drain into coronary sinus
-Anterior cardiac veins
--Originate from anterior surface of RV
--Pass over right coronary artery
--Open directly into RA
-Smallest cardiac veins
--Very small veins located within muscular walls of heart
--Open directly into heart chambers (numerous in RA and RV, occasional and often absent in LA and LV |
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Term
right atrium internal features
- two parts: __ and __
-- __: smooth walls
-- right auricle: contains __ which are trabeculated bundles of muscle on walls
-__ marks the division between the two parts
--Ridge on internal aspect of lateral wall |
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Definition
- sinus venarum (main cavity); right auricle
-- sinus venarum
-- pectinate muscles
- crista terminalis |
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Term
openings into right atrium
- the two are __ and __
-- superior vena cava opens into __ and has __
-- inferior vena caa opens into __ and has __ |
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Definition
- superior vena cava; inferior vena cava
-- upper part of RA; no valve
-- lower part of RA; a rudimentary valve |
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Term
RA
- __:Opens into RA between opening of IVC and right atrioventricular orifice
--Rudimentary __
- __:Communication with RV
--Lies anterior to openings of __ and __
--__ (right atrioventricular) valve
---3 cusps: __ |
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Definition
- coronary sinus
-- valve
- right atrioventricular orifice
-- IVC; coronary sinus
-- tricuspid (right atv)
--- anterior; posterior; septal |
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Term
Right atrium
-___: Shallow depression on right side of interatrial septum,
Indicates site of __ during intra-uterine life
-__: Upper border of fossa ovalis |
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Definition
- fossa ovalis; foramen ovale
- limbus of fossa ovalis |
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Term
right atrium
-__: Communication between RA and LA during intra-uterine life
--Blood passes from __ to __ (right-to-left shunt)
--__ at birth
-Patent foramen ovale after birth constitutes an __
--Blood passes from __ to __ (left-to-right shunt) |
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Definition
- foramen ovale
-- ra; la
-- closes
- atrial septal defect
-- la; ra |
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Term
right ventricle
-Communicates with RA via __
-Communicates with pulmonary trunk via __
--Guarded by __
-Below pulmonary orifice, cavity of RV is funnel-shaped and has smooth walls (__)
-Below conus arteriosus RV walls have __ |
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Definition
- right atrioventricular orifice
- pulmonary orifice
-- pulmonary valve
- (infundibulum/conus arteriosus)
- muscular ridges (trabeculae carneae) |
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Term
right ventricle
- __: Muscular structures, roughly cone-shaped, that project into lumen of ventricles
--Attached by their bases to ventricular wall
--Apices are connected to cusps of atrioventricular valves by __
--RV has 3 sets of __: |
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Definition
- papillary muscles
-- ventricular wall
-- chordae tenineae/tendinous cords
-- papillary muscles: anterior (largest); posterior; septal (smallest) |
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Term
right ventricle
-Ventricular contraction increases intraventricular pressure
-Papillary muscles contract Via __ they hold down cusps of atrioventricular valves and prevent them from being forced into atria (prevent backflow of blood from ventricles into atria during ventricular __) |
|
Definition
- intraventricular pressure
-- chordae tendineae; (systole) |
|
|
Term
right ventricle
- __: Muscular ridge that extends from right side of interventricular septum to anterior wall of RV (base of __)
--Conveys right branch of __ (part of conducting system of heart) |
|
Definition
- septomarginal trabecula (moderator band); (anterior papillary muscle)
-- av bundle |
|
|
Term
right ventricle
-__ guards pulmonary orifice
--Consists of __
-__: Pocket-like spaces between cusps of pulmonary valve and wall of pulmonary trunk
-During ventricular __, cusps of pulmonary valve are pressed against wall of pulmonary trunk by outrushing blood
-During ventricular __, blood flows back toward heart and fills __
--Valve cusps come into apposition and close __ (prevents backflow of blood from pulmonary artery to RV during ventricular diastole) |
|
Definition
- pulmonary valve
-- 3 semilunar cusps (anterior, left, and right)
- pulmonary sinuses
- systole
- diastole; pulmonary sinuses
-- pulmonary orifice |
|
|
Term
left atrium
- __ has smooth walls
- __ has trabeculated walls
-- __ muscles |
|
Definition
- main cavity
- left auricle
-- pectinate |
|
|
Term
left atrium
Openings
-Openings of four __ in posterior wall (no valves)
-Left atrioventricular orifice
--Communication between __ and __
--Guarded by __
---Two cusps: __
-Depression on left side of interatrial septum marks location of __
--Bounded inferiorly by a __ |
|
Definition
- pulmonary veins
-
-- la; lv
-- mitral (bicuspid/ left av) valve
--- anterior; posterior
- fossa ovalis
-- crescent shaped ridge (valve of foramen ovale) |
|
|
Term
left ventricle
-__ walls are thicker than __ walls (pressure inside __ > pressure inside __)
-Communicates with LA via __
-Communicates with __ via __
--Guarded by __
-Part of LV below aortic orifice is known as __ ( has __) |
|
Definition
- lv; rv; lv; rv
- left atrioventricular orifice
- aorta; aortic orifice
-- aortic valve
- aortic vestibule (smooth walls) |
|
|
Term
left ventricle
-Remainder of LV has irregular walls due to presence of __
-Two __ (anterior and posterior)
--Attached by their __ to wall of LV
--Apices are connected to cusps of mitral valve via __ |
|
Definition
- muscular ridges (trabeculae carneae)
- papillary muscles
-- bases
-- chordae tendineae |
|
|
Term
left ventricle
-__ guards aortic orifice
--Three __
-__: Pocket-like spaces between cusps of aortic valve and wall of aorta
-Orifices of right and left __ are located in right and left __ |
|
Definition
- aortic valve
-- three semilunar (right; left; posterior)
- aortic sinuses
- coronary arteries; aortic sinuses |
|
|
Term
-__: seperates rv from lv
-- placed obliquely
--One surface faces __ and __, other surface faces __
-- bulges toward __
-Position indicated on surface of heart by anterior and posterior __ |
|
Definition
- interventricular septum
-- anteriorly; righly; posteriorly left
-- RV
- interventricular sulci |
|
|
Term
parts of interventricular septum
- __: forms most of septum
- __: thin (devoid of muscle), small part of interventricular septum, located close to __
-Ventricular septal defects usually involve __ of interventricular septum
-- allows blood to pass from __ to __ |
|
Definition
- muscular part
- membranous part; atrioventricular orifices
-membranous parts
-- lv; rv |
|
|
Term
outline of heart on anterior chest
-__: Curved line drawn from inferior border of __ left costal cartilage, about 1 cm from sternal margin, to superior border of __ right costal cartilage, about 1 cm from sternal margin
-__: Curved line drawn from upper border of __ right costal cartilage, about 1 cm from sternal margin, to __ right costal cartilage, close to its sternal end
-__: Line drawn from lower end of right border to apex beat ( ___ intercostal space, just medial to midclavicular line)
-__: Curved line drawn from apex beat to inferior border of __ costal cartilage, about 1 cm from sternal margin |
|
Definition
- superior border; 2nd; 3rd
- right border; 3rd; 6th
- inferior border; 5th left
- left border; 2nd left |
|
|
Term
auscultation of heart valves: two sounds
- first sound:Closure of __ and __ valves (beginning of ventricular __)
- second sound:Closure of __ and __ valves (beginning of ventricular __) |
|
Definition
- tricuspid; mitral; (systole)
- aortic; pulmonary; (diastole) |
|
|
Term
Places where valve sounds can be best heard
-Tricuspid valve: Just to the __ of lower part of body of __, at level of __
-Mitral valve: __ (5th left intercostal space, just medial to midclavicular line)
-Pulmonary valve: Medial end of __
-Aortic valve: Medial end of __ |
|
Definition
- left; sternum; 5th intercostal space
- apex beat
- 2nd left intercostal space
- 2nd right intercostal space |
|
|
Term
- __: Extra sounds heard during systole or diastole
--Frequently indicate underlying __
- Caused by some disruption in __
-Diseased __ are a common cause of murmurs
--__: When valve cusps are thickened and passage through valve is narrowed, forward blood flow (normal direction) is restricted
-__: When valves lose competency and their cusps do not close tight enough, they allow backflow of blood (abnormal direction) |
|
Definition
- heart murmurs
-- pathology
- blood flow
- valves
-- stenosis
-- regurgitation |
|
|
Term
heart murmurs
-__: diastolic murmur
-__: systolic murmur
-__: systolic murmur
-__: diastolic murmur |
|
Definition
- tricuspid and mitral stenosis
- tricuspid and mitral regurgitation
- pulmonary and aortic stenosis
- pulmonary and aortic regurgitation |
|
|
Term
fibrous skeleton of heart
- consists of:
--Four __ (surround 2 atrioventricular orifices and pulmonary and aortic orifices)
--Right and left fibrous __ (formed by connections between rings)
--Membranous part of __ |
|
Definition
- four fibrous rings
- trigones
- interventricular septum |
|
|
Term
functions of fibrous skeleton of heart
-Separate myocardium of __ from myocardium of __ (__)
--Electrical impulses can pass from atria to ventricles only through __
--There is only one opening in fibrous skeleton (in __) which transmits __
-Give attachment to atrial and ventricular muscle fibers and to cusps of atrioventricular, aortic, and pulmonary valves
-Support __ of valves
-Prevents them from __ and becoming __ |
|
Definition
- atria; ventricles; (electrical insulation)
-- av bundle (of his)
-- right fibrous trigone; av bundle
-
- bases
- stretching; incompetent |
|
|
Term
conducting system of heart
-Consists of specialized __ responsible for generating and conducting electrical impulses to all parts of heart
--Regulates rhythmical contraction of __ and __
-During each cardiac cycle, __ contract first and together, then __ contract, also together |
|
Definition
- cardiac muscle cells
-- atria; ventricles
- atria; ventricles |
|
|
Term
conducting system of heart
- components: |
|
Definition
- sinuatrial node
- av node
- av bundle (of his) with its left and right branches
- subendocardial plexus of purkinje fibers |
|
|
Term
SA node
-Located in __, just right of opening of __, at upper end of __
-__ of heart
--Spontaneously gives origin to rhythmical electrical impulses (about 70/min) that travel through __
AV node
-Located in lower part of __, above attachment of __ of __ |
|
Definition
- ra; svc; crista terminalis
- pacemaker
-- atrial myocardium
- interatrial septum; septal cusp; tricuspid valve |
|
|
Term
AV bundle (of his)
-Begins as a continuation of __
-Pierces __ of heart (__) to reach myocardium of __ (only conductive path between __ of atria and ventricles)
-At upper border of muscular part of __, it divides into right and left branches (one for each ventricle) |
|
Definition
- av node
- skeleton; (right trigone); ventricles; myocardium
- interventricular septum |
|
|
Term
conducting system of heart
-Right and left bundle branches run toward __ under __
-Right bundle branch crosses from right side of __ to anterior wall of __ in __
-Becomes continuous with __ of __ |
|
Definition
- apex of heart; endocardium of septum
- interventricular septum; RV (base of anterior papillary muscle); septomarginal trabecula
- subendocardial plexus; purkinje fibers |
|
|
Term
conducting system of heart
-Left bundle branch descends on left side of __
-Divides into branches which reach __ wall along several __
-Become continuous with __ of __ |
|
Definition
- interventricular septum
- lv; trabeculae carneae
- subendocardial plexus; purkinje fibers |
|
|
Term
nerve supply of heart
-Innervated by sympathetic and parasympathetic fibers via __
--Located anterior to bifurcation of __ and posterior to __
-Sympathetic innervation arises from __ and __ parts of __
-Parasympathetic innervation comes from __ |
|
Definition
- cardiac plexus
-- trachea; ascending aorta
- cervical; upper thoracic; sympathetic trunks
- vagus nerves |
|
|
Term
nerve supply of heart
- Sympathetic stimulation: Causes __ heart rate and force of __ and __ of coronary arteries
-Parasympathetic stimulation: Causes __ of heart rate and force of contraction and constriction of coronary arteries |
|
Definition
- increased; contraction; dilation
- reduction |
|
|
Term
nerve supply of heart
-Visceral sensory fibers running with vagus nerves are concerned with __
-Visceral sensory fibers running with sympathetic nerves conduct __ from __
--Terminate in spinal cord segments __
--Pain from heart is referred to __ supplied by same __ (usually on left side) |
|
Definition
- cardiac reflexes
- pain sensation; heart
-- T1-T4
-- cutaneous areas; spinal cord segments |
|
|
Term
-__:Central compartment of thoracic cavity located between lungs and pleural sacs
- boundaries:
-- superior:
-- inferior:
-- anterior:
-- posterior:
-- lateral: |
|
Definition
- mediastinum
-
--Superior: superior thoracic aperture
--Inferior: diaphragm
--Anterior: sternum
--Posterior: thoracic vertebral column
--Lateral: mediastinal pleura |
|
|
Term
mediastinum subdivisions
-Superior and Inferior
--Horizontal plane passing from __ to inferior border of body of __ (or __) divides mediastinum into superior and inferior parts
-Inferior mediastinum is further subdivided into __, __, and __ parts |
|
Definition
-
-- sternal angle; (T4; T4/T5 intervertebral disc)
- anterior; middle; posterior |
|
|
Term
inferior mediastinum
-Middle mediastinum: __ with heart and roots of great vessels, Structures that form __
-Anterior mediastinum: Between __ and __
-Posterior mediastinum: Limited anteriorly by roots of __ and __ and posteriorly by __ (T5 to T12 vertebrae |
|
Definition
- pericardial sac; roots of lungs
- sternum; pericardial sac
- lungs; pericardial sac; vertebral column |
|
|
Term
- __:Located superficially (anteriorly) in superior and anterior parts of mediastinum, Primary lymphoid organ.
--Produces __
- __ varies considerably with age
---__ in early part of life (up to about 15 years)
---Progressively involutes thereafter, and is largely replaced by __ and __ |
|
Definition
- thymus
-- immunocompetent T lymphocytes
-- appearance
--- largest
--- fat; connective tissue |
|
|
Term
Thymus
-Consists of __ held together by connective tissue
-Anterior relations: Sternum and adjacent parts of upper 3 costal cartilages
-__ relations: Pericardial sac, left brachiocephalic vein, aortic arch and its branches, trachea |
|
Definition
- two lobes
- sternum; 3 costal cartilages
- posterior |
|
|
Term
brachiocephalic veins
-Formed by union of __ and __ on each side, at root of neck (posterior to sternoclavicular joints)
-Right brachiocephalic vein is __ and __
--Joins __ posterior to __ right costal cartilage to form __
-Left brachiocephalic vein is __ and __
--Runs inferiorly and right, posterior to __ of sternum, to join __
-Major tributaries
--From neck:
--From thorax: |
|
Definition
- subclavian; internal jugular veins
- short; vertical
-- left brachiocephalic vein; 1st; svc
- longer; oblique
-- manubrium; right brachiocephalic vein
-
-- vertebral and inferior thyroid veins
-- internal thoracic vein |
|
|
Term
-__: Returns venous blood from upper half of body to the heart
--Head and neck, upper limbs, thoracic wall, and some thoracic organs (esophagus, trachea, bronchi, etc)
-Formed by union of __ posterior to __ costal cartilage
-Descends vertically, terminates in upper part of __, posterior to __ costal cartilage
-Upper part is located in __
-Lower part is located within __, in __
-Receives only one tributary: __ which joins SVC just before SVC enters __ |
|
Definition
- superior vena cava
--
- right and left brachiocephalic veins; 1st right
- RA; 3rd right
- superior mediastinum
- pericardial sac; middle mediastinum
- azygos vein; pericardial sac |
|
|
Term
-__:Returns venous blood from lower half of body to the heart
--Abdomen, pelvis, and lower limbs
-Very short course in __
--Pierces __ at level of __
--Almost immediately terminates in lower part of __ |
|
Definition
- inferior vena cava
--
- middle mediastinum
-- central tendon of diaphragm; T8
-- RA |
|
|
Term
|
Definition
1.ascending aorta
2. arch of aorta
3. descending aorta: divided by diaphragm into thoracic and abdominal parta |
|
|
Term
ascending aorta
-Begins at aortic orifice of __
--Runs superiorly and right
-Terminates at level of __, where it becomes continuous with __
-Lies within __, in __
-Branches: |
|
Definition
- LV
--
- sternal angle; aortic arch
- pericardial sac; middle mediastinum
- right and left coronary arteries |
|
|
Term
arch of aorta
-Begins at level of __, as a continuation of ascending aorta
--Passes posteriorly and left, forming a superiorly convex arch
-Terminates at lower border of body of __ (on left), where it becomes continuous with __
-Located in __
-Arches over root of __
- three branches of the arch of aorta: |
|
Definition
- sternal angle
--
- T4; descending thoracic aorta
- superior mediastinum
- left lung
- brachiocephalic artery/trunk; left common carotid artery; left subclavian artery |
|
|
Term
arch of aorta
-Brachiocephalic artery (trunk)
--Passes superiorly and right
--Divides into __ and __ posterior to right sternoclavicular joint
-Left common carotid artery
--Passes through __ to reach root of neck
-Left subclavian artery
--Passes through __ to reach root of neck
--Arches over apex of __ and left __ toward left __ |
|
Definition
-
--
-- right subclavian; right common carotid arteries
-
-- superior thoracic aperture
-
-- superior thoracic aperture
-- left lung; 1st rib; upper limb |
|
|
Term
arch of aorta
-__: Fibrous band connecting bifurcation of pulmonary trunk (or initial segment of left pulmonary artery) to lower surface of aortic arch
--Remnant of __
-__: During intra-uterine life carries blood from pulmonary trunk to aorta, bypassing lungs
--After birth it closes and becomes __
-__: When ductus arteriosus does not close after birth
--Carries blood from __ to __ (left-to-right shunt) |
|
Definition
- ligamentum arteriosum
-- ductus arteriosus
- ductus arteriosus
-- ligamentum arteriosum
- patent ductus arteriosus
-- aorta; pulmonary trunk |
|
|
Term
descending thoracic aorta
-Begins at lower border of body of __ (on left), as a continuation of aortic arch
--Passes inferiorly and slightly medially in __
--At level of __ it passes through aortic opening (hiatus) of diaphragm and becomes continuous with __
-Branches
--__: for lower 9 intercostal spaces
--__: run along lower borders of 12th ribs
--__, __, __ branches
--__: supply posterior part of superior surface of diaphragm |
|
Definition
- T4
-- posterior mediastinum
-- T12; abdominal aorta
-
-- posterior intercostal arteries
-- subcostal arteries
-- esophageal, bronchial, pericardial
-- superior phrenic arteries |
|
|
Term
phrenic nerve
-Branch of __
--Contains fibers from ventral rami of __ spinal nerves
-Right phrenic nerve
--Descends along __ of right brachiocephalic vein and SVC
--Passes __ to root of right lung
--Descends between __ (which separates it from RA) and __
--Reaches diaphragm on __ side of __ |
|
Definition
- cervical plexus (ie it originates from cervical plexus)
-- c3, c4, c5
-
-- right side
-- anterior***
-- pericardial sac; mediastinal pleura
-- right; ivc |
|
|
Term
phrenic nerve
- left phrenic nerve
--Crosses __ side of aortic arch
--Passes __ to root of left lung
--Descends between __ (which separates it from LV) and __
--Reaches diaphragm close to __
-Terminal branches of both phrenic nerves pierce the __ and supply __ on undersurface of diaphragm
-Phrenic nerves are accompanied by __ vessels |
|
Definition
-
-- left
-- anterior
-- pericardial sac; mediastinal pleura
-- apex of heart
- diaphragm; parietal peritoneum
- pericardiacophrenic |
|
|
Term
phrenic nerve
- innervation
-- motor fibers:
-- sensory fibers:__, __, __
- Pain caused by irritation of structures receiving sensory nerve supply from phrenic nerve is referred to __ |
|
Definition
-
-- diaphragm
--Pericardium (fibrous and parietal layer of serous);
Mediastinal pleura and central part of diaphragmatic pleura;
Parietal peritoneum on undersurface of diaphragm
- shoulder region (c3-c5 dermatomes) |
|
|
Term
vagus nerve
-Both nerves (R and L) pass __ to 1st part of __ before they enter superior mediastinum
-Right vagus nerve
--Descends in thorax __ to right brachiocephalic vein
--Passes __ to trachea and __ to arch of azygos vein
--Passes __ to root of right lung and gives branches to __
--Passes onto __ and takes part in ___ (branches of right vagus are distributed primarily on posterior surface of esophagus) |
|
Definition
- anterior; subclavian artery
-
-- posterior
-- lateral; medial
-- posterior; pulmonary plexuses
-- esophagus; esophageal plexus |
|
|
Term
left vagus nerve
-Descends in thorax between __ and __
-Crosses left surface of __
-Passes __ to root of left lung and gives branches to __
-Passes onto __ and takes part in __ (branches of left vagus are distributed primarily on anterior surface of esophagus) |
|
Definition
- left common carotid; left subclavian arteries
-- aortic arch
-- posterior; pulmonary plexuses
-- esophagus; esophageal plexus |
|
|
Term
Vagus nerve
-Close to __, esophageal plexus forms two trunks (anterior and posterior vagal trunks)
--Which pass through __, together with esophagus, to enter abdomen
Thoracic branches
-Branches that carry __ and __ fibers to esophagus, trachea, bronchi, lungs, and heart |
|
Definition
- diaphragm
-- esophageal opening (hiatus) of diaphragm
-
-- visceral motor (pym); visceral sensory |
|
|
Term
Left recurrent laryngeal nerve
--Originates from __ nerve as it crosses left side of __
--Curves around __ and inferior aspect of __
-Ascends toward __ in groove between trachea and esophagus, on left side
-Gives branches to __ and __
-Terminates supplying motor and sensory fibers to __ (innervates most laryngeal muscles on left side)
-Lesion causes paralysis of most of left laryngeal muscles, which results in __ |
|
Definition
-- left vagus; aortic arch
-- ligamentum arteriosum; aortic arch
-- larynx
-- trachea; esophagus
-- larynx
-- hoarseness |
|
|
Term
right recurrent laryngeal nerve
-Originates from ___ in root of neck
-Curves around inferior aspect of __ (very close to its origin from brachiocephalic trunk)
-Ascends to __ |
|
Definition
- right vagus nerve
- right subclavian artery
- larynx |
|
|
Term
-__: muscular tube that connects pharynx to stomach
--Begins in neck, at level of __, as a continuation of __
--Passes through __
--Runs through superior and posterior parts of __
--Passes through __ of diaphragm at level of __ (slightly left of median plane)
--After short course in abdomen becomes continuous with __ |
|
Definition
-esophagus
-- c6; pharynx
-- superior thoracic aperture
-- mediastinum
-- esophageal opening (hiatus); T10
-- stomach |
|
|
Term
esophagus
- parts:
- relations in superior mediastinum: lies posterior to __ and anterior to __
- relations in posterior mediastinum: lies posterior to __ and anterior to __
-- descends first along right side of __, and the anterior to it |
|
Definition
- parts: cervical, thoracic, abdominal
- trachea; vertebral column
- pericardial sac; vertebral column
-- descending thoracic aorta |
|
|
Term
azygous venous system
-Azygos means __, lacking a mate
--Vessels of right and left sides are __
-Functions
--Drain blood from body walls of __ and __
--Also receives venous blood from some __ (bronchi, esophagus, pericardium)
--Important channel for collateral venous circulation if __ or __ are obstructed
-Blood in azygos system drains into SVC
-Large number of anatomic variations in this venous system |
|
Definition
- unpaired
-- axymmetric
-
-- thorax; abdomen
-- thoracic viscera
-- svc; ivc
- |
|
|
Term
azygos venous system
-Consists of __ longitudinal venous channels
--One on each side of vertebral column
--Receive veins from body wall and are interconnected with each other across vertebral column
-__: channel on right side
--__(previous) is formed by union of ascending __ and __ on right side
---__: vertically oriented vein that interconnects and receives blood from lumbar veins (in posterior abdominal wall)
-__ (inferiorly) and __ (superiorly): channel on left side
--These veins are connected to each other, and both empty into the __ |
|
Definition
- two
--
--
- azygos vein
-- azygos vein; lumbar; subcostal veins
--- ascending lumbar vein
- hemiazygos vein; accessory hemiazygous vein
-- azygos vein |
|
|
Term
azygos venous system
-Azygos vein
--Ascends in __ to level of __
--Arches forward over root of __
--Terminates in __
-Tributaries of azygos vein
--Right __ (except 1st, which drains into __)
--Posterior intercostal veins of 2nd, 3rd, and 4th spaces usually join to form a single vein (__), which drains into __
-__ posterior intercostal veins drain directly, and usually independently, into azygos vein
-Hemiazygos and accessory hemiazygos veins
-Visceral tributaries (e.g.: esophageal and bronchial veins) |
|
Definition
-
-- posterior mediastinum; T4
-- right lung
-- svc
-
-- posterior intercostal veins; (right brachiocephalic vein)
--- (right superior intercostal vein); azygos vein
- 5th- 11th
-
- |
|
|
Term
-__: Transabdominal or transvaginal needle inserted into placental mass; tissue aspirated (5-30 mg)
--2x risk of amniocentesis
--Can be done earlier
--Higher numbers of rapidly dividing cells obtained
---Some results faster |
|
Definition
- chorionic villus sampling
-- amniocentesis |
|
|
Term
azygos venous system
-Hemiazygos (inferior hemiazygos) vein
--Formed by union of __ and __ on left side
--Ascends on left side of __
--Usually receives __ posterior intercostal veins on left
--Crosses to right to end in __
-Accessory hemiazygos (superior hemiazygos) vein
--Descends on left side of __
--Receives left posterior intercostal veins from __ (usually)
--Crosses to right to drain into __
-Posterior intercostal veins of __ spaces on left side usually join to form a single vein (__), which drains into __ |
|
Definition
-
-- ascending lumbar; subcostal veins
-- lower thoracic spine
-- 9th-11th
-- azygos vein
-
-- thoracic spine
-- 4th-8th spaces
-- azygos vein
- 1st-3rd; (left superior intercostal vein); left brachiocephalic vein |
|
|
Term
thoracic duct
-Begins in upper part of __ (L1-L2 level)
--Sometimes as a dilated sac (__)
--More often by direct confluence of lumbar and intestinal lymph trunks
---Collect lymph from lower limbs, pelvis, and abdomen
-Passes through __ of __
-Ascends behind __ in posterior mediastinum
--__ vein to its right
--__ to its left
-Ascends along left border of __ to __ in superior mediastinum |
|
Definition
- posterior abdominal wall
-- (cisterna chyli)
-- lumbar; intestinal lymph trucks
---
- aortic hiatus; diaphragm
- esophagus
-- azygos vein
-- descending thoracic aorta
- esophagus; superior thoracic aperture |
|
|
Term
thoracic duct
-Arches left, posterior to __ and __ in root of neck
-Terminates at union of __ and __
-Close to its termination it receives __, __, and __ (they may drain directly into adjacent large veins)
-Thoracic duct conveys to venous circulation all lymph from lower limbs, pelvis, abdomen, left side of thorax, left side of head and neck, and left upper limb |
|
Definition
- left common carotid artery; left internal jugular vein
- left subclavian; left internal jugular veins
- left jugular; left subclavian; left bronchomediastinal lymph trunks |
|
|
Term
right lymphatic duct
-__, __, and __ may join to form a short vessel (right lymphatic duct)
--Terminates at union of __ and __
--Drains lymph from right side of thorax, right side of head and neck, and right upper limb
-The three trunks may open independently into adjacent large veins |
|
Definition
- right jugular; right subclavian; right bronchomediastinal lymph trunks
-- right subclavian; right internal jugular
--
- |
|
|
Term
thoracic sympathetic trunk
-Continuous above with __ and below with __ parts of sympathetic trunk
-Consists of __ segmentally arranged __
--First thoracic ganglion often fuses with inferior cervical ganglion to form __
-Connected to each other in a chain
--Descends on heads of __ (upper thoracic levels) and on sides of __ (lower thoracic levels)
-Lies posterior to __ along its whole course |
|
Definition
- cervical; lumbar
- 10-11; ganglia
-- cervicothoracic (stellate) ganglion
-
-- ribs; vertebral bodies
- parietal pleura |
|
|
Term
thoracic sympathetic trunk: branches
-All ganglia are connected to corresponding intercostal nerves by __ and __
-__ (usually upper __) give off postganglionic fibers to thoracic viscera (heart, aorta, lungs, esophagus) |
|
Definition
- white; gray communicating rami
- upper ganglia (4) |
|
|
Term
- thoracic sympathetic trunk contains three __
--Originate from lower part of thoracic sympathetic trunk (__ and below)
--Pierce __ and terminate in __
--Contain __ (terminate in prevertebral ganglia in abdomen) and __ (carry pain sensation from abdominal organs)
--Greater splanchnic nerve originates from ganglia __
--Lesser splanchnic nerve originates from ganglia __ or __
--Lowest/least splanchnic nerve originates from __ |
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Definition
- splanchnic nerves
-- (5th ganglion)
-- diaphragm; abdomen
-- preganglionic sympathetic fibers; visceral sensory fivers
-- 5-9
-- 9-10; 10-11
-- lowest thoracic ganglion |
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