Flashcards
Thoracic Cavity
Cards in this deck (35)
- 1Describe the general arrangement of the pleuraPleura covers each lung, reflects over itself around the root of the lung & covers the diaphragm & thoracic wall
- 2Define the term mediastinumThe space between the 2 pleural sacs, sternum, costal cartilages thoracic vertebra & diaphragm
- 3Describe the boundaries of the subdivisions fo the mediastinumSuperior mediastinum
- Behind the manubrium, between the thoracic inlet & the transverse plane of the the sternal angle i.e. T4/5
Inferior mediastinum
- Behind the sternal body, inferior to the transverse plane of the sternal angle to the diaphragm
- Divided into anterior, posterior & middle - 4List the contents of the anterior mediastinumThymus & internal mammary vessels
- 5List the contents of the middle mediastinumPericardium, heart, origin of the great vessel & the phrenic & vagus nerves
- 6List the contents of the posterior mediastinumThoracic aorta, sympathetic chain & ganglia, vertebral bodies, proximal costal segments & proximal intercostal nerve segments
- 7List the contents of the superior mediastinumArch of aorta (+ branches), SVC (+ branches), thymus, trachea, oesophagus & thoracic ducts
- 8What are the structures of the right of the mediastinum related to?R. atrium & veins
- SVC, IVC & arch of azygos - 9What are the structures of the left of the mediastinum related to?L. ventricle & arteries
- L. common carotid a., L. subclavian a., arch of aorta & thoracic aorta - 10What is the pericardium & what is its function?Fibro-serous sac which encloses the hear & the origin of the great vessel
Function - anchor the heart without compromising cardiac movement & prevent overfilling - 11Describe the fibrous pericardium attachmentsApex - fused with adventitia of great vessels
Anteriorly - sterna-pericardial lig. attaches it to the sternum & 3-6th c.c.
Posteriorly - pericardiovertebral lig. attaches it to T5-8
Inferiorly - pericardiophrenic lig. attaches it to the central tendon of the diaphragm - 12Describe the serous pericardium2 layers
Parietal layer - lines inner fibrous pericardium & reflects at the root of the great vessels to form visceral layer
Visceral layer - epicardium - 13Describe the pericardial cavityBetween the parietal & visceral layers of the serous pericardium
Filled with pericardial fluid which reduces the friction during systole - 14Describe the position of the transverse sinus of the serous pericardiumPosterior to the ascending aorta & pulmonary trunk
Anterior to the SVC - 15Describe the position of the oblique sinus of the serous pericardiumSurrounded by the reflection of the parietal serous pericardium around the right & left pulmonary veins & IVC
- 16Describe the nervous supply of the pericardium1- Phrenic nerve provides sensory supply
2- Vagus nerve provides vasomotor and parasympathetic supply
3- Cardiopulmonary splanchnic nerves provide sympathetic supply
4- Parasympathetic and sympathetic fibres join and form a plexus that supplies pericardium and heart - 17Describe the course and distribution of the right & left phrenic nervesFrom ventral rami of C3, 4 & 5
Pass anterior to scalene muscle, enter mediastinum between the subclavian artery & vein, the pass anterior to the root of the lung
Right passes lateral to the SVC then IVC then through the caval opening
Left crosses the aortic arch then over the LV & through the left crus independently - 18Describe why irritation of the phrenic nerve will result in referred pain to the shoulderLateral supraclavicular n. supplies the skin over the shoulder, which is the dermatome C4, as the phrenic nerve originates at C3, 4 & 5 (mainly C4) any structures with sensory supply via the phrenic n. may refer pain to the C4 deramtome via the lateral supraclavicular n.
- 19What may pose a threat of phrenic nerve injury?Cardiac surgey
Thoracic surgery
Lung tumours
Mediastial tumours
Polio
Radial incision in the diaphragm from costal margin to oesophageal opening - 20What is pericardial tamponade?Blood accumulating in the pericardial space, causing the heart to have difficult bumping or receiving blood
- 21Signs / Symptoms of pericardial tamponadeTachycardia
Hypotension (heart cannot pump out nor receive blood)
Tachypnea (organs not receiving oxygen or nutrients)
Distended and enlarged cervical veins (no venous return)
Shock - 22What is Beck's triad?Signs of pericardial tamponade
1- Distant heart sound
2- Decreased blood pressure
3- Distended jugular vein - 23Describe the position of the thymusBetween the manubrium, sternum & pericardium
It extends between the jugular notch & 4th costal cartilage - 24Describe the activity of the thymusActive in childhood
Regresses, with fibro-fatty infiltration with age, following puberty - 25Describe the division of the pulmonary trunkAt T4/5 inferior to aortic arch it divides into:
Right pulmonary a. - post. to the aorta & SVC
Left pulmonary a. - inferior to arch of aorta & ant. to thoracic aorta - 26State the posterior relations of the manubriumPosterior to:
1. Sternoclavicular joint - Brachiocephalic trunk divides into r. common carotid & r. subclavian & the internal jugular v. & subclavian veins join to form the brachiocephalic v.
2. 1st right c.c - SVC forms
3. 2nd right c.c. - azygos joins SVC
4. 3rd c.c. - SVC enters the RA - 27What are the visceral branches of the thoracic aorta?Oesophageal arteries - middle 1/3
Bronchial branches - 2 L & 1 R
Pericardial branches
Mediastinal branches
Superior phrneic a. - 28What are the 4 constrictions of the oesophagus?Upper oesophageal sphincter
Aortic arch
Left main bronchus
Diaphragm - 29Describe the divisions of the oesophagusUpper 1/3 - striated muscle to allow voluntary swallowing
Middle 1/3 - mixed striated & smooth muscle
Lower 1/3 - smooth muscle - 30Describe the venous drainage of the oesophagusUpper 2/3s drain to azygos, hemiazygos& accessory hemiazygos
Lower 1/3 drains to the left gastric vein - 31What is the porto-systemic anastomosis?An anastomosis with the vessel supplying the middle & lower oesophagus
- 32Describe the nerve supply of the oesophagus in the thoracic regionLeft vagus becomes anterior vagal trunk
Right vagus becomes posterior vagal trunk
Fibres from anterior & posterior vagal trunks as well as sympathetic fibres form the oesophageal plexus - 33Where are the mediastinal lymph nodes found?Arranged in groups around the carina
Tracheobronchial lymph nodes - clustered around the trachea & oesophagus
Anterior mediastinal lymph nodes - around brachiocephalic vein
Posterior mediastinal lymph nodes - behind the heart, adjacent to the oesophagus - 34How does lymph from the left & right return to systemic circulation?Right side - Thoracic duct to left brachiocephalic vein
Left side - Right lymphatic duct to right brachiocephalic vein - 35Describe the route of the thoracic ductDescribe the route of the thoracic duct.
- Starts at the cisterna chyli
- Lies between the aorta and the azygos vein in the posterior mediastinum
- At the level of T4/T5 it crosses behind the oesophagus and ascends on its left
- Arches over the apex of the left lung and its pleura
- Opens into/drains into the left brachiocephalic vein at Pirogoff's angle
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- MD3001 (Cardiovascular System) Flashcards on Thoracic Cavity, created by Lareyna Mcmenemy on 07/12/2018.
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- Lareyna Mcmenemy
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