Thorax

通報

問題一覧

Breasts have similar structures in male and female during puberty

False

System of ducts embedded in connectice tissue within the areola

Breast tissue

Breast matures under the influence of ovarian hormones

True

Breast

Base is from 2nd to 6th ribs, sternum to midaxillary line

Dilation near the nipple area

Ampulla

Produces the tubercles on the areola

Areolar glands

Supported by suspensory ligaments

Entire breast

Filled with connective tissue

Retromammary space

Layers of breast

Intercostal space, Pectoralis muscle, Lobules, Nipple, Areola, Ducts, Fat tissue, Skin

Breast at pregnancy: Rapid increase in length and branching of duct system

Early

Breast at pregnancy: Development of secretory alveoli at the enda of small ducts and connective tissue

Early

Breast at pregnancy: Increase vascularity of the breast

Early

Breast at pregnancy: Enlarging nipples and darker

Early

Breast at pregnancy: Growth slows down

Late

Breast at pregnancy: Still increasing size

Late

Breast at pregnancy: Ducts filled with colostrum

Late

Interlobular connective tissue thickens

Post weaning

Areola faded but never to original color

Post weaning

Breast decrease in size and become pendulous

Postmenopausal

Secretory aveoli disappears but ducts remain

Postmenopausal

Due to absence of ovarian estrogen and progesterone

Postmenopausal

Decrease in size

Post weaning

Remaining milk is absorbed

Post weaning

Breast and nipple return to near original sizes

Post weaning

Breast lymphage drainage: anterior axillary pr pectroal groyp posterior to the lower borders of pectoralis major

Lateral quadrant

Breast lymphage drainage: internal thoracic group

Medial quadrant

Ribs

3 cavities of thorax

Mediastinum, Left thoracic cavities, Right thoracic cavities

Sternal angle of Louis

T4-T5 IV disc

Articulates with body of sternum

Ribs 2-7

Articulates with manubrium sterni

Rib 1

Typical ribs

Rounded at the superior border, Sharp at the inferior border

Parts of typical ribs

Head, Neck, Shaft, Angle

Arise from C7

Cervical rib

Flattened from above downward

First rib

Closely associated with lower brachial plexus and the subclavian artery and vein

First rib

Occurs in 0.5% population

Cervical rib

Free anterior end or connected to 1st rib by fibrous band

Cervical rib

Joints of the chest wall

Manubrium sternal joint, Xiphisternal joint

Connects the head to the intervertebral disc

Interarticular ligament

1st rib and 3 lowest ribs have one synovial joint

True

Articulates with the transverse process of the corresponding vertebral body

Joints of the tubercle of the ribs

No movement possible

Joints of the ribs and costal cartilage

No movement possible

1st costal cartilage

Articulates with lateral border of the sternum by synovial joint

2nd to 7th costal cartilage

Articulates with one another by the small synovial joint

6th, to 10th costal cartilage

Embedded in the musculature

11 and 12th ribs

Structures tbat pass through thoracic outlet

Esophagus, Trachea, Nerves and vessels to the head and upper limbs

Entire thoracic outlet is covered by what membrane?

Suprapleural membrane

External intercostal

Downward, forward

Internal Intercostal

Downward, backward

Azygos

Right

Hemiazygous

Left

Drains into azygos and hemiazygos

Posterior intercostal veins

Drains into internal thoracic vein and musculophrenic vein

Anterior intercostal veins

Intercostal nerves: Distribute to corresponding intercostal space

1st 6

Intercostal nerves: Enters the costal cartilage to distribute to the abdominal wall

7th to 9th

Intercostal nerves: Ends pass to the abdominal all

10th and 11th

Intercostal nerves: Becomes the subcostal nerve and enters the abdominal wall directly

12th

Intercostal nerves: Supplies the skin and the pleurac intercostal muscles, levatores costar and serratus posterior

1st 6

Intercostal nerves: Supplies the abdominal skun, peritoneum, external oblique, transversys abdominus and the rectus abdominis

10th and 11th

Most important muscle for breathing

Diaphragm

Diaphragm: high as the upper border of the 5th rib

Right dome

Diaphragm: high as the lower border of the 5th rib

Left dome

Right crus

L1 to L3 vertebral body and discs

Left crus

From L1 to L2 vertebral body and discs

Structures that pass through the aortic opening

Aorta, Azygos vein, Thoracic duct

Structures that pass through the esophageal opening

Esophagus, Left and right vagus, Esophageal branches of the left gastric vessels, Lymphatics from the lower esophagus

Structures that pass through caval opening

Inferior vena cava, Terminal branches of the right phrenic nerves

Accompany the terminal branches of the correspondung intercostal nerves

Perforating arteries

Enters the rectus sheath of the anterior abdominal wall and supplies the rectus muscle

Superior epigastric artery

Runs around the costal margin of the diaphragm and supplies the lower intercostal spaces and diaphragm

Musculophrenic artery

For the upper six intercostal spaces

Anterior intercostal arteries

Scapula

T2 superior angle, T7 inferior angle

Spine of scapula posteriorly to the 6th rib and costal cartilage anteriorly

Oblique fissure

Line along 4th costal cartilage

Horizontal fissure

Superior mediastinum contents

Thymus, large veins, large arteries, trachea, esophagus and thoracic duct, sympathetic trunk

Inferior mediastinum contents

Thymus, heart, phrenic nerves, esophagus and thoracic duct, descending aorta, sympathetic trunk

Covers the thoracic wall, undersudr of suprapleura membrane, thoracic side of diaphragm, lateral side of the mediastinum

Parietal pleura

Covers the lungs

Visceral pleura

Sensitive to pain, temperature, touch and pressure

Parietal pleura

Supplies by the intercostal nerves

Costal pleura

Supplied by the phrenic nerve

Mediastinal pleura

Supplied over the domes by the phrenic nerve and around the perophery by the lower six intercostal nerves

Diaphragmatic pleura

Sensitive to stretch

Visceral pleura

Insensitive to pain and touch

Visceral pleura

Receives autonomic nerve supply from pulmonary plexus

Visceral pleura

Clinically detectable increased at 300 ml

Pleural fluid

Inflammation of pleura

Pleurisy or Pleuritis

Air in the pleural cavity causing collapse of the lungs

Pneumothorax

Increase fluid in the lungs

Hydrothorax

Pleural fluid is clinically detectable increased at how many ml?

300

Trachea becomes the left and right bronchus

True

How long is the trachea?

4.5 inches

Trachea

Trachea > Left and Right bronchus > Bronchioles > Terminal Bronchioles > Respiratory Bronchioles > Alveolar ducts > Alveolar sacs

Bronchus: Wider, shorter, more vertical

Right

Bronchus: about 1 inch

Right

Bronchus: Branches out to superior lobar bronchus, middle and inferior lobar bronchus

Right

Bronchus: Narrower, longer, more horizontal

Left

100

Bronchus: About 2 inches

Left

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