SEM 2: Thorax II

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what is the mediastinum and how many divisions does it have
the central compartment of the thorax - contains two parts: superior and inferior. inferior subdivides into: anterior, posterior and middle
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what are the boundaries of the superior mediastinum
sup: superior thoracic apature, inf: continuous with inferior mediastinum at the level of the sternal angle, ant. manubrium, post. vertebral bodies T1-T4, lat: pleura of lungs
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what are the contents of the superior mediastinum
aortic arch (branches into brachiocephalic, left common carotid and left subclavian), svc (receives brachiocephalic which receives the left superior intercostal v., supreme intercostal v. and azygous v.), vagus n. and phrenic n., thymus
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what are the boundaries of the anterior mediastinum
sup:continuous with the superior mediastinum at the level of the sternal angle , inf: diaphragm, ant. sternal body, post. pericardium, lat: mediastinal pleura
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what are the contents of the anterior mediastinum
loose connective tissue, fat, lymph vessels and thymus (in infants)
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what are the boundaries of the posterior mediastinum
sup: the level of the sternal angle and T4 vertebral body, inf: diaphragm, ant. pericardium, post. T5-T12 , lat: mediastinal pleura
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what are the contents of the posterior mediastinum
descending aorta ( branching into posterior intercostal a., bronchial, oesophageal and superior phrenic) passing through aortic hiatus , oesophagus passing through oesophageal hiatus, thoracic duct passing through aortic hiatus, azygous venous system, sy
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what are the boundaries of the middle mediastinum
sup: the level of the sternal angle and T4 vertebral body, inf: superior diaphragm, ant. anterior margin of pericardium, post. posterior margin of pericardium , lat: mediastinal pleura
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what are the contents of the middle mediastinum
heart, pericardium, tracheal bifurcation, ascending aorta, pulmonary trunk , svc, cardiac plexus and phrenic n., traechobronchial lymph nodes
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how are the lobes of the lungs distributed?
left: superior and inferior lobe, right:superior, inferior and middle lobes
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how are the fissures of the lungs distributed?
left: oblique fissure, right: oblique fissure and horizontal fissure
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what are the relations of the left lung?
heart, arch of aorta, thoracic aorta, oesophagus
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what are the relations of the right lung?
heart, svc, ivc, azygous vein, oesophagus
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what are the surfaces of the lungs
mediastinal, diaphragmatic and costal
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what are the borders of the lungs
anterior, inferior and posterior
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what is the order of structures in the hilum
pulmonary arteries sup., pulmonary veins inf., bronchi post. (divided on right)
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where is the cardiac notch
anterior border of left lung
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what is the lingula
a tongue like projection bellow the cardiac notch in the left lung
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what is a bronchopulmonary segment
an area of the lung supplied by a segmental/tertiary bronchus and accompanying pulmonary arterial branch
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what is clinically relevant about bronchopulmonary segments
smallest area that can be isolated and removed without affecting adjacent regions
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what is the order of the bronchial tree
trachea -> principle bronchi -> lobar bronchi -> segmental bronchi ->->terminal/respiratory bronchioles
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what is the carina
when the trachea divides into the principle bronchi behind the arch of aorta at the level of the sternal angle
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what is clinically relevant about the carina
the right bronchus is wider and at less of an angle, therefore aspirated material is most likely to be found here
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what is the trachealis
posterior free ends of the trachea that are connected to smooth muscle, allowing the oesophagus to bulge in swallowing
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what is the function of hyaline cartilage in the trachea
to keep the fibroelastic tube patent
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what is the parietal pleura
a smooth membrane that lines the body wall and is split into: mediastinal, cervical, costal and diaphragmatic
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what is the visceral pleura
a smooth membrane that lines the lung
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what is the function of the pleural cavity
lubricated space allowing the two pleura to slide along one another; creates surface tension, allowing the expansion of the thoracic cage to expand the lungs
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what are the pleural recesses
costodiaphragmatic (between the costal parietal pleura and diaphragmatic parietal pleura) and costomedialstinal (between the costal parietal pleura and mediastinal parietal pleura)
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how do the lungs develop
laryngotracheal tube grows lung buds that push laterally into membrane lining the coelomic cavity
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what is clinically relevant about the costodiaphragmatic recess
doesn't fill in quiet inspiration but does in forced, most likely place for fluid to accumulate
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what is clinically relevant about the costodiaphragmatic recess
fills in quiet (deep) inspiration, most likely place for fluid to accumulate
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what is the pulmonary ligament
a reflection of the mediastinal pleura that attaches to the inferior lobe to provide stability to the lung
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what is the blood supply to the bronchi
left: descending thoracic aorta -> superior and inferior bronchial arteries. right: 3rd posterior intercostal a. -> right bronchial. bronchial arteries follow bronchi until they reach respiratory bronchioles where they anastamose with the pulmonary arteri
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what is the venous drainage of the bronchi
left: bronchial veins -> accessory hemiazygous -> azygous -> svc. right: bronchial veins -> azygous -> svc.
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what are the lymphatics of the lungs
trachebronchial lymph nodes: pretracheal and paratracheal (anterior and along sides of trachea), superior trachebronchial (superior border of carina), bronchopulmonary/hilar (hilum of lung), pulmonary/intrapulmonary (deep to hilum, around bronchi), inferi
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what is the pericardium
a fibroserous sac that functions to restrict excessive movement of the heart and act as a lubricted container for heart contractions
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what is the fibrous pericardium
a strong fibrous and inflexible sac that fuses with the great vessels. attached to the central tendon of the diaphragm and the sternum via sternopericardial ligaments
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what is the structure of the serous pericardium
two layers of pericardium called parietal and visceral. visceral is next to the heart, parietal is in the middle.
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what is pericardial effusion
the pericardium is inflexible due to fibrosis, causing excess fluid on the heart which compresses it.
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what is the order of the pericardial layers
fibrous, parietal, serous fluid, visceral
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what are the pericardial sinuses
reflections of the pericardium around great vessels, called: transverse and oblique
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why is the transverse sinus clinically relevant
allows surgeons to isolate the pulmonary trunk and aorta for clamping during coronary bypass grafting
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what are the relations of the pulmonary trunk
bifurcates at T5-6, left is inf. to aortic arch, right is post. to aortic arch and SVC
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what are the relations of the aorta
ascending within pericardium, arch in mediastinum, post. to manubrium, ant. to trachea. descending at sternal angle
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what is the ligament arteriosum
an embryological remnant connecting the aorta to the bifurcation of the pulmonary trunk
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what are the relations for the SVC
inferior half in pericardium. passes through fibrous pericardium at the 2nd costal cartilage
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what are the relations for the IVC
passes through diaphragm at T8, has a small portion in the fibrous pericardium
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what structures are found in the right atrium
coronary sinus, right auricle, Cristae terminalis, fossa ovalae
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what structures are found in the right auricle
musculi pectinate
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what structures are found in the left atrium
coronary sinus, left auricle, fossa ovalae
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what structures are found in the left ventricle
trabecular carnae, papillary muscles, chordae tendae
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what structures are found in the right ventricle
trabecular carnae, papillary muscles, moderator band
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what areas of the heart does the left coronary artery supply
left atrium, left ventricle, right ventricle, inter ventricular septum, SAN and AVN
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what areas of the heart does the right coronary artery supply
right atrium, right ventricle, diaphragmatic left ventricle, posterior inter ventricular septum, and SAN
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what is the cristae terminalis
ridge separating auricles and atrium
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what is the fossa ovalae
embryological remnant of a valve between the atriums
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what is the musculi pectinati
the rough wall of the auricles
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what is the moderator band
a bridge between the lower inter-ventricular and base of the anterior papillary muscle, carrying part of the cardiac conduction system to the RV
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Card 2

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what are the boundaries of the superior mediastinum

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sup: superior thoracic apature, inf: continuous with inferior mediastinum at the level of the sternal angle, ant. manubrium, post. vertebral bodies T1-T4, lat: pleura of lungs

Card 3

Front

what are the contents of the superior mediastinum

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Preview of the front of card 3

Card 4

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what are the boundaries of the anterior mediastinum

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Card 5

Front

what are the contents of the anterior mediastinum

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