Thoracic wall, Pleural Cavities, and Lungs

How many pairs of ribs are there?

12

Which ribs are true ribs?

1-7

Which ribs are false ribs?

8-10

Which ribs are floating ribs?

11-12

What are the boundaries of the superior thoracic aperture?

Manubrium, 1st pair of ribs, 1st thoracic vertebra

What are the boundaries of the inferior thoracic aperture?

Xiphisternal junction, costal margin and ribs 11+12, 12th thoracic vertebra

What innervates the diaphragm?

Phrenic nerve

What are the three dimensions of throacic cavity expansion?

Vertical, transverse, and sagittal

What happens during vertical expansion of the thoracic cavity?

Contraction (depression) of the diaphragm

What happens during transverse expansion of the thoracic cavity?

Elevation of the lateral ends of lower ribs (bucket handle movement)

What happens during anterior posterior expansion of the thoracic cavity?

Elevation of upper ribs, sternum moves anteriorly “pump handle movement”

What is the orientation of external intercostal muscles fibers?

Inferoanteriorly

When are the external intercostal muscles active?

During forced inspiration

When are the internal intercostal muscles active?

During forced expiration

What is the orientation of internal and innermost intercostal muscles fibers?

Inferoposteriorly

Where is the intercostal neurovascular bundle located?

In between internal and innermost intercostal muscles (runs in costal groove)

What are the branches of the internal thoracic artery?

Anterior intercostal arteries (1-6), musculophrenic artery, superior epigastric artery

What artery gives off the anterior intercostal arteries of the 7th-9th intercostal spaces?

Musculophrenic

Where do the posterior intercostal arteries of 3-11 rise from?

Thoracic aorta

Where do the posterior intercostal arteries of 1-2 rise from?

Subclavian system (supreme intercostal artery)

What is the name of the artery below rib 12?

Subcostal artery

What forms the intercostal nerves?

T1-T11 anterior rami

The T12 anterior ramus is known as the…?

Subcostal nerve

What are the branches of the intercostal nerves?

Lateral cutaneous, anterior cutaneous, muscular branches, collateral branch

What is the weakest point of the rib?

Anterior angle

What is a flail chest?

Three or more neighboring ribs break in at least two places, causing a section of the rib cage to detach and move independently from the rest of the chest wall

What is thoracic outlet syndrome?

Compression of the nerves, arteries, or veins in the space between the clavicle and 1st rib

What do the pulmonary cavities contain?

Lungs and pleura

What does the mediastinum contain?

Pericardium, heart, esophagus, vessels, and nerves

What are the two types of pleura?

Visceral and parietal

What is visceral pleura?

Membrane that adheres to lung surfaces

What is parietal pleura?

Membrane that adheres to thoracic wall, mediastinum, and diaphragm

What fills the pleural cavity?

Serous pleural fluid between visceral and parietal pleura

What are the named regions of the parietal pleura?

Cervical, costal, mediastinal, diaphragmatic

What innervates the parietal pleura?

Phrenic nerve and intercostal nerves

What are pleural recesses?

Areas where the lung does not completely fill the pulmonary cavity

What are the two types of pleural recesses?

Costodiaphragmatic and costomediastinal

What is pleural effusion?

Buildup of excess fluid between the two layers of the pleura

What is thoracentesis?

Insertion of a needle through the 9th intercostal space into the pleural cavity

What are the three surfaces of the lungs?

Costal, mediastinal, diaphragmatic

What is indicated by A?

Apex

What is indicated by B?

Anterior border

What is indicated by C?

Inferior border

What is indicated by D?

Costal surface

What is indicated by A?

Posterior border

What is indicated by B?

Mediastinal surface

What is indicated by C?

Diaphragmatic surface

How many lobes does the left lung have?

2

How many lobes does the right lung have?

3

What is indicated by A?

Horizontal fissure

What is indicated by B?

Superior lobe of right lung

What is indicated by C?

Middle lobe of right lung

What is indicated by D?

Inferior lobe of right lung

What is indicated by E?

Oblique fissure

What is indicated by F?

Oblique fissure

What is indicated by G?

Superior lobe of left lung

What is indicated by H?

Cardiac notch

What is indicated by I?

Inferior lobe of left lung

What is indicated by J?

Lingula

What is contained in the root of the lung?

Pulmonary veins, pulmonary arteries, primary bronchi, bronchial vessels, lymphatic, autonomic nerves

What is the hilum of the lung?

Area on the mediastinal surface where the root enter/exit

What is indicated by A?

Main bronchus of right lung

What is indicated by B?

Pulmonary artery of right lung

What is indicated by C?

Pulmonary veins of right lung

What is indicated by A?

Pulmonary artery of left lung

What is indicated by B?

Main bronchus of left lung

What is indicated by C?

Pulmonary veins of left lung

In the right lung, where is the pulmonary artery located in respect to the main bronchus?

Anterior

In the left lung, where is the pulmonary artery located in respect to the main bronchus?

Superior

What impressions are located on the mediastinal surface of the right lung?

Esophagus, superior vena cava, inferior vena cava, arch of azygos, cardiac (shallow)

What is indicated by A?

Superior vena cava

What is indicated by B?

Cardiac (shallow)

What is indicated by C?

Inferior vena cava

What is indicated by D?

Arch of azygos

What is indicated by E?

Esophagus

What impressions are located on the mediastinal surface of the left lung?

Arch of the aorta, descending aorta, left subclavian artery, esophagus, cardiac (deep)

What is indicated by A?

Arch of the aorta

What is indicated by B?

Descending aorta

What is indicated by C?

Left subclavian artery

What is indicated by D?

Cardiac (deep)

What is indicated by E?

Esophagus

What do pulmonary arteries carry?

Poorly oxygenated blood to the lungs

What do pulmonary veins carry?

Well oxygenated blood from the lungs back to the heart

What supplies the bronchial tree and lung parenchyma?

Bronchial arteries and veins

What is a pneumothorax?

Air in the pleural cavity

What is atelectasis?

Lung collapse

Where does the trachea start?

Vertebral level C6

What covers the outside of the trachea?

C-shaped rings of hyaline cartilage

What is the muscle located posteriorly to the trachea?

Trachealis

What is the carina?

Internal projection of the last ring of the trachea, separation between left and right lobes

Which main bronchus is more vertical, making it susceptible to foreign bodies?

Right

What is another name for secondary branches of bronchi?

Lobar

What are the groups of lympatic nodes in the lungs?

Intra pulmonary, bronchopulmonary (hilar), tracheobronchial, paratracheal

Where do the lymphatic nodes of the lungs drain?

Broncho-mediastinal trunk into subclavian vein