Term
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Definition
| 1-7, articulate directly with the coastal cartilage attaching to the sternum. |
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Term
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Definition
| 8-10, articulate with rib directly above. |
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Term
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Definition
| 11-12, posterior ribs that don't attach to anything anteriorly. |
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Term
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Definition
| Notch in the middle of the superior border of the manubrium. |
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Term
| Blood supply of the diaphragm |
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Definition
| Branches of the internal thoracic artery and thoracic aorta. |
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Term
| Nerve supply of the diaphragm |
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Definition
| Phrenic nerve. C3,4,5 keeps you alive. |
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Term
| Anterior surface markings for the diaphragm |
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Definition
1. Left dome is smaller, found on 5th rib.
2. Right dome is larger, curves up to the 4th intercostal space. |
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Term
| Accessory musculature for inspiration |
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Definition
1. Pectoralis major and minor
2. Serratus Anterior
3. Scalene
4. External intercostals |
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Term
| Accessory musculature for expiration |
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Definition
1. Internal intercostals
2. Innermost intercostals |
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Term
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Definition
Difficulty breathing creates heavy use of the accessory muscles for inspiration and expiration.
Patients prefer to sit up rather than lye down because gravity assists diaphragm flattening for inspiration. |
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Term
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Definition
12 pairs of nerves innervate the thorax.
T1-11 go along intercostal spaces with arteries and veins.
T12 is subcostal.
Mixed motor and sensory nerves. |
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Term
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Definition
Migration of of varicella-zoster virus (chickenpox) to the nervous system. Reactivation results in migration down the sensory neurons to the skin
Presents with burning pain/itching in dermatome supplied by involved sensory nerve and skin eruptions
Can be associated with weakness of muscles innervated by associated myotome
Treated with antivirals/steroids
Zostavax approved in 2006 for individuals over 60 |
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Term
| Blood supply of the thorax |
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Definition
1. Mostly supplied by te posterior intercostal arteries. Branch from the descending aorta and run along costal grooves of ribs between the internal and innermost intercostal muscles.
2. Anterior intercostal muscles: anastamos with posterior intercostal muscles.
Right and left subclavian->internal thoracic->anterior intercostals
Located just deep to the sternum. |
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Term
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Definition
Hypodermic needle is inserted into the intercostal space and pleural cavity to draw out fluid in the costodiaphragmatic recess.
Needle inserted superior to the rib to avoid damage to nerve, artery, and vein at the 9th intercostal (avoids inferior border of the lung). |
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Term
| Divisions of the mediastinum |
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Definition
Transverse thoracic plane divides the mediastinum into superior and inferior divisions.
The inferior division is further divided into anterior, middle, and posterior divisions. |
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Term
| Superior mediastinum components |
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Definition
1. Veins (SVC, R/L Brachiocephalic, R/L subclavian, R/L Jugular)
2. Arteries (Aorta, Brachiocephalic trunk, R/L carotid, R/L subclavian, R/L Internal Thoracic)
3. Nerves (R/L Vagus, R/L Phrenic, Sympathetic Trunk)
4. Trachea
5. Esophagus |
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Term
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Definition
| Radiographic visualization of the aorta through injection of contrast material. |
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Term
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Definition
Located in superior mediastinum.
Inclines to the right, ends at the sternum. |
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Term
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Definition
| Between the trachea and vertebral bodies, inclines to the left. Compressed by aortic arch and the root of the left lung. |
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Term
| Anterior mediastinum contents |
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Definition
Smallest subdivision
Contents:
Loose connective tissue
Fat
Lymphatic vessels
Branches of internal thoracic artery |
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Term
| Middle mediastinal contents |
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Definition
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Term
| Posterior Mediastinum Contents |
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Definition
1. Esophagus
2. Veins: Azygous system (Accessory hemiazygous is superior to hemiazygous, both drain to azygous)
3. Arteries: Thoracic descending aorta
4. Lymphatics: thoracic duct
5. Nerves: Posterior intercostal nerves, Sympathetic trunk, splanchic nerves, esophageal plexus |
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Term
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Definition
Part of the posterior mediastinum.
Branches:
1. Esophageal arteries (1 branch)
2. Bronchial arteries (paired branches)
3. Intercostal arteries (paired branches)
Posterior to root of the left lung, terminates at T12. |
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Term
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Definition
Located between azygous and descending aorta.
Begins with chyle cistern to go through the aortic hiatus.
Empties into the left subclavian vein at the junction of the internal jugular vein. |
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Term
| Sympathetic spinal cord segments |
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Definition
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Term
| Parasympathetic spinal cord segments |
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Definition
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Term
| Types of post-ganglionic cell bodies |
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Definition
1. Paravertebral: forms sympathetic trunk
2. Prevertebral: Located in esophgeal plexus around unpaired esophageal arteries. Splanchnic nerves synpase with prevertebral neurons. |
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Term
| Directions of nerve impulse in sympathetic trunk |
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Definition
Preganglionic nerve exits anterior rootlet along with somatic motor neurons, forms spinal nerve and passes via white rami communicates to sympathetic trunk where it:
1. Ascends to synapse higher in the trunk, goes to higher ganglia
2. Descends to synapse lower in the trunk, goes to lower ganglia
3. Synapses right in that ganglion, returns to spinal nerve via gray ramus communicates
4. Passes through without synapsing to reach a prevertebral ganglion (splanchnic)
Those nerves synapsing within the paravertebral ganglion rejoin the anterior spinal nerve rami via the grey rami communicantes |
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Term
| Openings in diaphragm surface |
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Definition
From superior to inferior:
1. Caval opening: IVC and lymphatics pass through, located at T8.
2. Esophageal hiatus: Esophagus vagal trunks, blood, and lymphatic vessels pass through (T10)
3. Aortic Hiatus: aorta, thoracic duct, and azygous system pass through, located at T12. |
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