Anatomy of Chest Wall and Lungs

What bones make up the sternum?
1 – manubrium sterni
2 – body of sternum
3 – xhiphisternum
are bones that make up this structure

what are the false ribs?
these are ribs 8-12

what are the floating ribs?
these are ribs 11 and 12

which vertebrae articulate with ribs?
the thoracic vertebrae articulate with these

which are the true ribs?
these are ribs 1 – 7

What is the manubriosternal joint?
this is the joint between the manubrium and the body of the sternum

what is the costal cartilage?
this is the cartilage that joins the anterior portion of the ribs with the sternum?

the costal cartilage of which rib articulates with the manubrium sterni?
the costal cartilage of the first rib articulates with this structure

what rib articulates with the manubriosternal joint?
the second rib articulates with this structure?

what is another name for the manubriosternal joint?
This is also called the sternal angle of Louis

what type of joint is the manubriosternal joint?
this is a secondary fibrocartilagenous joint of the thoracic cage

Where should one always start counting ribs?
this should always be done from the sternal angle

what is the clavicle
this bone connects the manubrium and the acromion

how do the 8th, 9th, and 10th ribs articulate with the sternum?
these connect to the costal cartilage of the 7th rib to articulate with the sternum

what are the typical ribs?
these are ribs 3 – 9

what is the upper articular facet of the rib?
this is the part of the typical rib that articulates with the body of vertebra above

what is the lower articular facet of the rib?
this is the part of the typical rib that articulates with the body of corresponding vertebra

what is the neck of the typical rib?
this connects the articular facets for body of vertebrae with the articular facet for transverse process of vertebra

what is the tubercle of a typical rib?
this is a bony process on the rib that contains facets that articulate with the transverse processes of thoracic vertebrae

what is the articular facet for transverse process of vertebrae?
these are surfaces on ribs that articulate with the transverse process of vertebrae?

what is the angle of typical rib?
this gives attachment to the tendons of the illiocostalis

What is the costal groove?
this is between the ridge of the internal surface of the rib and the inferior border

What lies in the costal groove?
these contains the intercostal vessels and intercostal nerve

what is the order of the contents of the costal groove?
VAN (superior to inferior)
sup. – posterior intercostal vein
mid. – posterior intercostal artery
inf. – intercostal nerve

What is the more posterior groove on the first rib?
This is the groove for the subclavian artery and lower trunk of the brachial plexus

Where does the scalene muscle insert?
This inserts on the scalene tubercle of the first rib

what is the more anterior groove on the first rib?
This is the groove for the subclavian vein

where does the serratus anterior originate?
this originates on the slips of the rib

what are the two origins on the second rib?
these are two slips that provide origin for the serratus anterior

what are the atypical ribs?
these are ribs 1,2,10-12

What is the muscular etiology of thoracic outlet syndrome?
spasms of the scalenus anterior may cause this disease

what is the anatomical defect that can cause thoracic outlet sydrome?
this is caused by a cervical rib

how does a cervical rib cause thoracic outlet syndrome?
This can compress the subclavian artery and brachial plexus to give rise to ischemia and nerve pressure symptoms of the upper limb

What is the cephalic vein?
this is drains into the axillary vein and runs in the delto-pectoral groove

What are the branches of the intercostal nerves that pierce the pectoralis muscles and run along the midline?
these are the anterior cutaneous branches of the intercostal nerves

What are the branches of the intercostal nerves that pierce the serratus anterior?
these are the lateral cutaneous branches of the intercostal nerves

Which nerves supply the skin of the anterior chest wall?
The anterior cutaneous branches of the upper six intercostal nerves (T1 – T6) supply this

Which nerves supply the skin of the anterior abdominal wall?
The anterior cutaneous branches of the lower five intercostal nerves (T7 – T11) and the subcostal nerve (T12) supply this

What does the subcostal nerve supply?
this supplies the skin of the anterior abdominal wall and does not originate from the intercostal nerves

What direction do the external intercostal muscle fibers run?
these muscle fibers run in a downward and forward direction

what lies directly on top of the costal cartilage?
the external intercostal membrane lies here

What direction do the internal intercostal muscle fibers run?
these muscle fibers run in a downward and backward direction

what lies posteriomedial to the angle of the rib?
the internal intercostal membrane lies here

What are the three parts of the innermost intercostalis?
1. Tranversus Thoracis (sternocostalis)
2. Innermost intercostal membrane/muscle
3. subcostalis
make up this structure

what is the Tranversus Thoracis?
This is the muscle directly behind the sternum

what is the Innermost intercostal membrane/muscle
this is the middle part of the muscle that lies interior to the internal intercostal muscle

What is the subcostalis?
this is the most posterior part of the intermost intercostal

Where do the collateral branches of the intercostal neurovascular bundle run?
These run in the inferior portion of the space between the internal intercostal muscle and the innermost intercostal muscle

How many pairs of intercostal muscles are there?
there are 11 pairs of these

Where do the internal thoracic arteries arise?
these arise as branches of the first part of the subclavian artery

What are the branches of the internal thoracic artery?
1. anterior intercostal arteries in ICS 1-6
2. Pericardiacophrenic artery
3. perforating branches to mammary gland
4. superior epigastric artery
5. musculophrenic artery
are branches of this

what are the terminal branches of the internal thoracic artery?
1. superior epigastric artery
2. musculophrenic artery
are terminal branches of this

Where do the terminal branches of the internal thoracic artery arise?
these arterial branches arise in the 6th intercostal space

What is the origin of the sternocostalis muscle?
this originates from the posterior surface of the lower half of the body of the sternum

where is the insertion of the sternocostalis muscle?
This inserts into the slips of the 2nd to 6th costal cartilages

What is the superior attachment of the subcostalis muscle?
this attachment is on the inner surface of the rib, near the angle

What is the inferior attachment of the subcostalis muscle?
this attachment is on the upper border of the rib, 1-2 ribs below its superior attachment

Where do the anterior intercostal arteries arise?
In ICS 1 – 6, these arise from the internal thoracic artery, and in ICS 7-9, these arise from the musculophrenic artery

Where do the anterior intercostal arteries in ICS 1-6 arise?
These arteries, which travel in the costal groove, arise from the internal thoracic artery

Where do the anterior intercostal arteries in ICS 7-9 arise?
These arteries, which travel in the costal groove, arise from the musculophrenic artery

What are branches of the descending thoracic aorta?
The posterior intercostal arteries in ICS 3 – 11 and the subcostal artery are branches of this

Where do the posterior intercostal arteries in ICS 3 – 11 arise from?
these arteries, which run in multiple ICSs, arise from the descending thoracic artery

Where does the subcostal artery arise from?
This artery arises from the descending thoracic artery

Where do the posterior intercostal arteries in the upper ICS (1-2) arise?
These are branches of the costocervical trunk of the subclavian artery

What connects the sympathetic trunk to the spinal nerve?
The rami communicantes connects these two nerves

Where do motor muscular branches to only intercostal muscles arise?
these nerve branches arise from corresponding intercostal nerves 1-6 and do not pierce the intercostal muscles

What innervates only the skin of the front and lateral chest wall?
The anterior cutaneous and lateral cutaneous sensory branches in ICS 1-6 innervate this

Where do motor muscular branches to intercostal muscles and abdomen arise?
these nerve branches arise from corresponding intercostal nerves 7-11 and subcostal nerve (T12)

What innervates the skin of the front and lateral chest wall and skin of the abdomen?
The anterior cutaneous and lateral cutaneous sensory branches of intercostal nerves in ICS 7-11 and subcostal nerve

What structure is infected by Herpes Zoster?
This is a viral infection of the dorsal root ganglion

What are the symptoms of Herpes Zoster?
This causes painful blisters on the skin along the course of a nerve

What is the visceral plura?
This covers the lung and fuses with the lung tissue

What innervates the visceral plura?
This is supplied by autonomic nerves and is sensitive to pain, and is directly adjacent to the lung

What is the parietal plura?
This is a lung covering that lies outside the visceral plura

what separates the intercostal muscles and parietal plura?
The endothoracic fascia separates these two structures

What are the four parts of the parietal plura?
1. Costal pleura
2. Diaphragmatic pleura
3. Mediastinal pleura
4. Cervical pleura/Cupola
are parts of this structure

What is the blood supply to the visceral plura?
The pulmonary and bronchial vessels supply this covering of the lung

Where does the lymph of the visceral plura drain?
this drains into the bronchopulmonary lymph nodes

What is the arterial and nerve supply to the parietal plura?
the nerves and vessels of the thoracic wall supply this lung covering

What innervates the costal pleura?
The intercostal nerves innervate this lung covering that faces the the ribs

What innervates the Cupola?
The intercostal nerves innervate this lung covering that lies over the summit of the lung

what innervates the peripheral part of the diaphragmatic pleura?
The intercostal nerves innervate this lung covering that lies below the lung

Where is pain of the costal pleura felt?
pain of this structure is referred to the thoracic wall (there are 3)

Where is pain of the cervical pleura felt?
pain of this structure is referred to the thoracic wall (there are 3)

where is pain of the peripheral part of the diaphragmatic pleura?
pain of this structure is referred to the thoracic wall (there are 3)

What innervates the mediastinal pleura?
The phrenic nerve innervates this lung covering that lies on the medial side of the lung

what innervates the central part of the diaphragmatic pleura?
The phrenic nerve innervates this lung covering that lies on the lower side of the lung

Where is pain of the mediastinal pleura felt?
pain of this structure is referred to the shoulder (there are 2)

where is pain of the central part of the diaphragmatic pleura?
pain of this structure is referred to the shoulder (there are 2)

What is the suprapleural membrane?
this is the covering over the cupola

What is the relative position of the suprapleural membrane?
this is found on the apex of the lung, which lies 1 inch above the medial third of the clavicle

What is the risk of injury to the root of the neck, above the clavicle?
this injury may give rise to pneumothorax by inuring the pleural covering over the apex of the lung

What is the costo-mediastinal reflection of the pleura?
this is the region between the anterior and medial pleura of the lung at which it changes direction

What is the costo-diaphragmatic reflection of the pleura?
this is the region between the anterior and inferior pleura of the lung at which it changes direction

What are the pleural recesses?
These are the
1 – costomediastinal recess
2 – costodiphragmatic recess

What do the pleural recesses allow?
These allow deep breathing of the lungs

Which costo-mediastinal recess is larger?
The left of these recesses larger because of the cardiac notch

Where is the lower border of the lung?
This is found at the level of the 6th rib, at the midclavicular line, 8th rib at midaxillary line, and posteriorly at neck of 10th ribs

Where is the costodiphragmatic reflection of the plura?
this is found at the level of the 8th rib at the midclaviular line, the 10th rib at midaxillary line, and the 12th rib at neck of ribs

What is pleuritis (pleurisy)?
this is inflammation of the pleura

What is a pleural rub?
This is the sound heard when someone has pleuritis

what is a pleural effusion?
this is increased collection of fluid between the two plural layers

What is hydrothorax?
this is a type of pleural effusion in which serous fluid accumulates in the pleural cavity

What is hemothorax?
this is a type of pleural effusion in which blood accumulates in the pleural cavity

what is a pneumothorax?
this is collection of air in the pleural cavity

What is a pleural tap?
This is sampling or drainage of fluid from the pleural cavity during pleural effusion

Where is a pleural tap performed?
this is performed in the 8th or 9th intercostal space in the midaxillary line (or higher if there is a lot of chest fluid and the area of maximum dullness is higher)

What structures does the needle pierce during a pleural tap?
This pierces the
1 – skin
2 – superficial fascia
3 – external intercostal muscle
4 – internal intercostal muscle
5 – innermost intercostal muscle
6 – endothoracic fascia
7 – parietal pleura

Where does the phrenic nerve arise?
this arises from the ventral rami of C3,4,5

What is the motor innervation of the phrenic nerve?
this nerve provides movement to the diaphram

What is the sensory innervation of the phrenic nerve?
this nerve provides sensation to the mediastinal and central portion of the diaphragmatic pleura of the lungs, pericardium, and peritoneum

What vessels run along the phrenic nerve?
the pericardiacophrenic vessels run along this nerve

What is the root of the lung?
this includes
1 – pulmonary veins
2 – pulmonary artery
3 – primary/principal bronchus
4 – bronchial arteries (usually branches of thoracic aorta)
5 – anterior and posterior pulmonary plexus
6 – lymph nodes

What is the fissure between the upper and lower lobe of the right lung called?
This is called the oblique fissure of the right lung

What is the fissure between the upper and middle lobe of the left lung called?
This is called the oblique fissure of the left lung

What is the fissure between the upper and middle lobe of the right lung called?
This is called the horizontal fissure of the right lung

What is the lingula?
this is a projection of the left lung analogous to the middle lobe of the right lung

What is the found in the hilum of the right lung?
1 – pulmonary artery
2 – superior and inferior pulmonary veins
3 – bronchial arteries
4 – eparterial bronchus (right superior lobar bronchus)
5 – right principle bronchus
are found here

what is the most anterior major structure of the hilum of the right lung?
The superior pulmonary vein has this position in the right hilum

what is the most posterior major structure of the hilum of the right lung?
The eparterial and right chief bronchus have this position in the right hilum

what is the most medial major structure of the hilum of the right lung?
The pulmonary artery has this position in the right hilum

What is the found in the hilum of the left lung?
1 – pulmonary artery
2 – superior and inferior pulmonary veins
3 – bronchial arteries
4 – left principle bronchus
are found here

what is the most inferior major structure of the hilum of the right lung?
The inferior pulmonary vein has this position in the right hilum

what is the most anterior major structure of the hilum of the left lung?
The superior pulmonary vein has this position in the left hilum

what is the most inferior major structure of the hilum of the left lung?
The inferior pulmonary vein has this position in the left hilum

what is the most posterio-medial major structure of the hilum of the left lung?
The left chief bronchus have this position in the hilum

what is the most superior major structure of the hilum of the right lung?
The pulmonary artery has this position in the left hilum

what is the pulmonary ligament?
this is a point of reflection from visceral to parietal pleura

What groove is found posterior to the left hilum?
the groove for the descending thoracic aorta is found here

What groove is found just superior to the left hilum?
the groove for the aorta arch is found here

What is the most posterior indentation above the groove for the arch on the left lung
The impression for trachea and esophagus is found here

what is the middle impression above the groove for aorta arch?
the groove for left subclavian artery is found here

What is the most anterior impression on the superior portion of the upper left lobe?
The groove for the first rib is found here

What is the large indentation found anterior to the left hilum?
This is the cardiac impression of the left lung

What is the cardiac notch?
This is an area of access during pericardiocentesis that lies between the 5th and 6th intercostal space

Where does the vagus nerve travel relative to the hilum of the lung?
This nerve travels behind the root of the lung

Where does the phrenic nerve travel relative to the lung?
This nerve travels in front of the root of the lung

What indentation is found just anterior to the groove for the descending thoracic aorta, and below the hilum?
The impression for the lower end of the esophagus is found here

What is the ligamentum arteriosum?
This anchors the arch of the aorta to the pulmonary trunk

What nerve branch hooks by the ligamentum arteriosum?
The left recurrent laryngeal nerve hooks by this structure

What heart structures sit in the left cardiac impression?
The left ventricle and left auricle sit in this space of the lung

What is the most inferior surface of the left lung?
The diaphragmatic surface has this position on the left lung

What indentation is found just inferior to the right hilum?
the groove for the inferior vena cava is found here

what indentation is found just anterior to the groove for the inferior vena cava?
The cardiac impression of the right lung is found here

What indentation is found posterior to the hilum of the right lung?
The groove for esophagus is found here

What indentation is found superior to the right hilum?
The groove for the arch of azygos vein is found here

What indentation is found just anterior to the right hilum?
The impression for the superior vena cava has this position

What indentation is found superior to the groove for the superior vena cava?
The impression for the right brachiocephalic vein has this position

What indentation is found just posterior to the impression for the right brachiocephalic vein?
The groove for the trachea and esophagus has this position on the right lung

What heart structures are found in the right cardiac impression?
The right atrium and right ventricle are found in this indentation of the right lung.

What is the point where the trachea splits called?
This is called the carina

What are bronchiopulmonary segments?
These are independent respiratory units of the lung, supplied by a tertiary bronchus

What are the segments of the right upper lobe?
3 total – This lobe is divided into apical, posterior, and anterior segments

What are the segments of the right middle lobe?
2 total – This lobe is divided into medial and lateral segments

What are the segments of the right lower lobe?
5 total – This lobe is divided into superior, apical basal, anterior basal, lateral basal, and posterior basal segments

What are the segments of the left upper lobe?
5 total – this lobe is divided into apical, posterior, anterior, superior lingular, and inferior lingular lobes

What are the segments of the lower left lobe?
5 total – this lobe is divided into apical basal, anterior basal, medial basal, lateral basal, and posterior basal lobes.

What are the first branches of the trachea?
The left principal bronchus and the right principal bronchus are branches of this

what is the difference in morphology of the right and left principal bronchi?
The left is long, narrow, and at an angle, while the right is broad, shorter, and in direct continuation with its source

Which section of the bronchus inserts into the bronchopulmonary segements?
the tertiary bronchus inserts into these

Which section of the bronchus inserts into the lobes of the lung?
the secondary (lobar) bronchus inserts into this part of the lung

What are the secondary branches of the bronchus?
Left – chief
Right – chief and eparterial

How can damage to a single bronchopulmonary segment or lobe be treated?
The damaged section of the lung can be removed without compromising the rest of the lung

medial rectus muscle right eye lateral rectus muscle right eye WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR ONLY $13.90/PAGE Write my sample superior rectus muscle right eye inferior rectus muscle right eye superior …

Abscess Risk factors Smoking (70-80%) Immunodeficiency Bronchiectasis Malignancy (lung cancer in 12%) COPD Steroids Aspiration Decreased level of consciousness Seizures Alcohol abuse Swallowing disorders Mechanical ventilationImaging Thick, irregular wall Thickness > 15 mm suggests neoplasm Spherical Small contact with chest …

cervical What type of vertebrae is shown in blue? lumbar (5 largest) What type of vertebrae is shown in blue? WE WILL WRITE A CUSTOM ESSAY SAMPLE ON ANY TOPIC SPECIFICALLY FOR YOU FOR ONLY $13.90/PAGE Write my sample sacrum …

A 30-year-old female presents with a five day history of a sore throat. She denies cough or nasal congestion. She also denies vomiting or diarrhea. On physical exam, her temperature is 101˚F, the pharynx is red with tonsillar exudates, and …

David from ajethno:

Hi there, would you like to get such a paper? How about receiving a customized one? Check it out https://goo.gl/chNgQy