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Anatomy Thorax
Cumulative Anatomy Final
53
Anatomy
Professional
05/02/2011

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Term
sternal angle
Definition
manubriuim::body of sternum
2nd rib::sternum
aortic arch begins/ends
inf border, sup mediastinum
IVDisk T4/T5
Term
Costvertebral Joint
Definition
head of rib with corresponding vert body and supra-adjacent vert body. Tubercle with corresponding Tverse process (except 11 and 12)
Term
sternocostal/costochondral joint type
Definition
synchondroses
Term
sternoclavicular join type
Definition
saddle-type synovial w/fibrocartilage articular surface and 2 separate synovial cavities
Term
intercostal nerves
Definition
primary rami of thoracic spinal nerves. Run in costal groove (VAN)
Term
internal intercostal branches
Definition
pericardiophrenic, anterior intercostals (2 @ each of first 6 spaces), ant perforating branches, musculophrenic and superior epigasrics
Term
thoracic lymph nodes
Definition
parasternal nodes (along int thoracic a), intercostal (heads of ribs; drain into cisterna chyli), phrenic nodes
Term
middle mediastinum contents
Definition
arch of the azygos v, main bronchi, phenic nerves, heart, pericardium, great vessel roots
Term
R vs L bronchi
Definition
R: wider, more vertical w/3 lobar (secondary) brochi (superior lobar = epartierial)
L = 2 lobar bronchi (upper and lower). Crossed anteriorly by aortic arch and pulm artery
Term
Pleura innervation/blood supply
Definition
parietal = pain sensitive (intercostal and phrenic nerves)

Visceral = supplied by bronchial arteries (from thoracic aorta), drained by pulm veins
Term
thoracentesis
Definition
between 7-9 intercostal space to avoid lung, liver, spleen, diaphragm
Term
R vs L lung
Definition
R = upper/middle/lower lobes via oblique and horizontal fissures. 3 2dnary (lobar) bronchi w/10 segmentals.

L = obliue fissure and upper/lower lobes. Lingula (at upper lobe)w/cardiac notch/impression and 2 lobar bronchi.
Term
bronchopulmonary segment
Definition
lung portion supplied by tertiary (lobular, segmental) bronchus, segmental artery (bronchial a), and intersegmental br of pulm vein.
Term
ligamentum arteriosum
Definition
fibrous remains fo ductus arteriosus.
connects L pulm artery to aortic arch
Term
Bronchial Veins
Definition
R: empty into azygos
L; into hemiazygos
Term
nerves @ lung root
Definition
phrenic = ant to root (runs between mediastinal pleura and pericardium).
vagus = post
Term
trachea/bronchi development
Definition
laryngotracheal groove @ pharygeal foregut envaginates to form laryngotracheal diverticulum, which is separated from foregut by tracheoesophageal septum, whcih divides forgut into ventral (laryngotrach tube), and dorsal (oropharynx/esoph). Lung buds develop at diverticulum.
Term
transverse sinus
Definition
subdivision of pericardial sac. Is posterior to ascending aorta and pulm trunk, anterior to SVC, sup to Latrium and pulm veins
Term
pericardiocentesis
Definition
insert needle @ 5th IC space just to left of sternum (miss lung via cardiac notch)
Term
heart borders
Definition
base = posterior = Latrium
Right = acute = SVC, RA, IVC
L = obtuse = LV
Term
cardiac silhouette
Definition
PI radiograph.
R = SVC, RA, IVC
L = aortic arch (knob), pulm trunk, Lauricle, LV
*LA shows no border*
Term
sinus venarum
Definition
in RA. Receives SVC, IVC, coronary sinus, anterior cardiac veins. Develops from sinus venosus. Is separated from rest of RA by crista terminalis
Term
pectinate m
Definition
ridges of atrial myocardium
Term
Fossa Ovalis
Definition
remains of fossa ovale = embryonic route from RA to LA
Term
LA location
Definition
post to RA
Term
Right Ventricle muscles
Definition
trabeculae= muscular ridges. Moderator band connects IV septum and papillary m.
Papillary m, from ventricular walls to chordae tendinae @ tricuspid.
Term
heart sound locations
Definition
pulm valve = L 2nd IC space, lat to sternum
Aortic valve = R 2nd IC space lat to sternum (DUB)
Tricuspid = right lower part, sternum
Bicuspid (mitral) = L 5th IC space, midclav line
Term
heart sounds
Definition
LUB = AV valves close @ systole onset
DUB = aortic/pulmonary @ diastole onset
Term
Moderator band
Definition
RV muscle band. Connects IV septum to papillary muscle (thus to chordae tendianae and tricuspid). Carries R limb of AV bundle (purkinje fibers)
Term
SA/AV nodes
Definition
SA @ RA myocardium
AV @ IA septum
Blood from R coronary a.
Term
AV bundle
Definition
runs im membranous part, IV septum
Term
coronary arteries
Definition
both from ascending aorta. max flow during diastole.
R: SA/AV nodal a, marginal a, post descending,
L: LAD (to IV septum, apex), Cicumflex (in coronary sulcus: gives off L marginal a.)
Term
cardiac veins
Definition
coronary siuns receives:
Great cardiac v (w/LAD)
Middle cardiac v (w/ post IV a)
Small caridac v (w marginal a)
oblique v of LA
Term
azygos entry
Definition
@ SVC
Term
conus ateriosus
Definition
RV origin of pulm trunk
Term
primitive heart tube
Definition
2 fused endocardial heart tubes. Mesodermal origin. gives rise to endocardium. surrounding splanchnic mesoderm gives rise to myo and epicardium.
Term
ASD
Definition
septum primum or secundum abnormality. Blood clot route to brain
Term
aortic arch derivatives
Definition
aortic arch 4 = aortic arch and brachiocephalic a/subclavian a
Term
fetal circulation
Definition
foramen ovale: in septum secundum. shunt from RA-->LA (lung bypass)
ductus arteriosus: pulm trunk-->aorta for lung bypass
ductus venosus: O2 blood from umbilical vein --> IVC (bypass liver)
Term
umbiical a/v
Definition
a: carry blood to placenta for O2genation. become medial umbilical lig
v: O2 blood from placenta to fetus
Term
ligamentum teres hepatis
Definition
from obliterated L umbilical vein
Term
esophageal constrictions
Definition
C6 (where it starts)

@ L main bronchus crossing

@ T10 (pierces diaphragm)
Term
posterior intercostal aa
Definition
1st 2 from costocervical trunk, rest from thoracic aorta.

collateral branches run at sup border of rib below
Term
collateral ciculation: thorax
Definition
ant/post intercostals
inf/sup epigastrics
sup ICa Costocerv tr)/3rd post ICa
post ICa/dorsal scap-->supra/cirucmflex scap aa
Term
azygos
Definition
enters thorax w/aorta. Receives RsupICv, hemiazygos, accessory azygos. Arches over R lung root, enters SVC
Term
hemiazygos vs accessory hemiazygos tributaries
Definition
hemi: 9-11th postIVc (left)
accessory: 4/5-8th ICv
Term
superior intercostal veins
Definition
= 2nd, 3rd, (4th) post IC veins. drain into azygos. (1st drains into brachiocephalic, lower into hemi/accessory hemiazygos)
Term
thoracic duct
Definition
from cisterna chyli in abdomen. passes to thorax w/aorta. drains all but Right side of thorax/head and R upper limb. Empties into L venous angle
Term
sympathetic NS organization
Definition
lateral horn (interomedial cell column), T1-L2.
white rami = into symp trunk.
gray rami = leave trunk, join spinal nerve
supply BV, hair follicle, sweat glands
Term
stellate block
Definition
block of stellate ganglion (inf cerv gang + sup thoracic gang). insert needle near neck of 1st rib).
Term
gray vs white rami contents
Definition
gray: postgang GVE (cell bodies in symp chain ganglia)
white: pregang GVE and GVA
Term
thoracic splanchnics
Definition
sympathetic pregang GVE and GVA.
greater = 5th-9th thoracic gang
lesser = 10th-11th thoracic gang
least = 12th thoracic gang
Term
parasymp organization
Definition
CN 3,7,9,10 = pregang
Vagus stops at descending colon (pelvic splanchnic nerves take over S2-S4). Also contains GVA from nodose ganglion.
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