-
What is the term for lying with your face downwards?
Prone
-
What is the term for lying on your back with your face upwards?
Supine
-
Term(s) for toward the tail end of the body or lower
Inferior or Caudal
-
What structures constitute the thoracic outlet?
1. T12
2. Rib 12
3. Costal Margin
-
Name (3) characteristics of the 1st Rib
1. Short and Broad
2. Boundary for the Thoracic Inlet
3. Groove for subclavian Artery and Vein
-
What are the (3) functions of the thoracic cage?
1. Portect internal organs
2. Attachment of muscles
3. Assist in Breathing
-
Do they ribs articulate with the sternum directly? If not, what do they articulate with?
1. No
2. The costal cartilage
-
What is the origin of the Serratus anterior muscle?
From ribs 1 - 8
-
What are the muscles of the (5) Thoracic Wall?
1. Serratus Anterior
2. External Intercostal
3. Internal Intercostal
4. Innermost Intercostal
5. Subcostal
-
What (4) things should we know for each muscle?
1. Its origin
2. Its insertion
3. Its clinical implications
4. Its function
-
The Serratus Anterior muscle forms...?
It forms the medial wall of the axilla
-
What is the insertion for the serratus anterior muscle?
- Inserts in the costal surface of scapula include:
- 1. Superior Angle
2. Inferior Angle
3. Medial Border
-
What nerve innervates the serratus anerior muscle?
The long thoracic nerve
-
Where is the long thoracic nerve found?
Inside the axilla
-
Wha are the (4) functions of the Serratus Anerior Muscle?
1. Rotates the scapula
2. Abductor of the arm
3. Elevation above the horizontal plane
4. Respiration
-
What are the (3) clinical applications of cutting the long thoracic nerve?
1. Winging of the Scapula
2. Loss of Elevation
3. Problems with Respiration
-
What are the (3) intercostal muscles?
1. External Intercostal
2. Internal Intercostal
3. Innermost Intercostal
-
What is the attachment for the External Intercostal Muscle?
Lower borders of Ribs 1 - 11 to the upper borders of Ribs 2 - 12
-
Describe the fibers of the External Intercostal Muscle.
The fibers run down and forward
-
What replaces the External Intercostal Muscle at the Costochondral Joint?
External Intercostal Membrane
-
What are the (2) functions of the External Intercostal Muscle?
1. Elevate the rib cage
2. Muscle of Inspiration
-
What nerve innervates the External Intercostal Muscle?
The corresponding intercostal nerve
-
Describe the fibers of the Internal Intercostal Muscle.
The fibers run down and backward
-
What is the attachment of the Internal Intercostal Muscle?
Attached to the lower margins of ribs, costal cartilages and grooves.
(Same external intercostal muscle)
-
What is the function of the Internal Intercostal Muscle?
Muscle of Expiration
-
What never innervates the internal intercostal muscle?
The corresponding intercostal nerve
-
How many parts does the innermost intercostal muscle have...name them
- (3)
- 1. Innermost Intercostal per se
2. Subcostalis Muscle
3. Sternocostalis Muscle
-
What is the innermost intercostal per se?
Few fibers between the ribs except and the subcostalis muscle and the sternocostalis muscle. It is mostly membrane.
-
Where is the subcostalis muscle found?
Found at the angle of the rib only
-
What is the attachment of the subcostalis muscle?
Between the ribs posteriorly and my cross 1 or 2 ribs and attaches to the third rib
-
What is the function of the subcostalis muscle?
Expiration
-
What is another name for the sternocostalis muscle?
Transversus Thoracis
-
Where is the sternocostalis muscle found?
Near the sternum only
-
What is the attachment of the sternocostalis muscle?
back of the xiphoid process and sternum
-
What is the insertion of the sternocostalis muscle?
In the costal cartilages
-
What innervates the sternocostalis muscle?
The intercostal nerves
-
What is the function of the sternocostalis muscle?
Expiration
-
What is the first thing you should do when you encounter a picture on an exam?
Determine the orientation
-
Describe the fibers of the Innermost Intercostal Muscle
The fibers run down and backwards
-
Where is the Posterior Intercostal Neurovascular Bundle located?
between the internal intercostal muscles and the innermost intercostal muscles...helps distinguish between the (2) muscles
-
How many intercostal spaces are there?
(11)
-
What is the name for the space below the 12th rib?
The subcostal space
-
Where is the Nipple of the Breast located?
Intercostal space 4
-
What (4) arteries make up the arterial supply to the thoracic cage?
1. Internal Thoracic Artery
2. Highest Intercostal Artery
3. Posterior Intercostal Artery
4. Subcostal Artery
-
From what does the Internal Thoracic Artery originate from?
The subclavian artery
-
From what does the highest Intercostal Artery originate from?
The costocervical trunk...which is a branch of the subclavian artery
-
From what does the Posterior Intercostal Artery originate from?
From the thoracic aorta directly
-
From what does the Subcostal Artery originate from?
From the Thoracic Aorta directly
-
What supplies the anterior aspect of the thoracic wall with blood?
The internal thoracic arter...a branch from the subclavian artery
-
What (3) structures supply the posterior aspect of the intercostal spaces with blood?
1. 1st space is supplied by the highest intercostal
2. 2nd thru 11th spaces supplied by the posterior intercostal arteries
3. 12th (subcostal space) supplied by the subcostal artery
-
Where does the Internal Thoracic Vein drain?
Into the brachiocephelic vein
-
Veins have...?
Arteries have...?
Blood Vessels have...?
1. tributaries
2. Branches
3. Anastomoses
-
On the Right Side of the Thoacic Wall, where does the 1st (highest intercostal vein) drain?
Into the Brachiocephalic Vein
-
On the Right Side of the Thoracic Wall, where does the 2nd thru 3rd (higher intercostal vein) drain?
Into the Right Azygos Vein
-
On the Right Side of the Thoracic Wall, where does the 4th thru 11th intercostal veins drain?
Directly into the Azygos Vein
-
What do the 2nd and 3rd intercostal veins join to form?
The Higher Intercostal Vein
-
On the Right Side, in the Azygos System, where does the Subcostal Vein drain?
Directly into the Azygos Vein
-
Where does the Azygos Vein drain?
Into the Superior Vena Cava
-
Venous drainage of the posterior thoracic wall is not...?
Symmetrical
-
What is a Pleural Cavity Tap?
A needle inserted into the pleural cavity to extract fluid to examine for infection and corresponding medication
-
On the Left Side of the Thoracic Wall, where does the 1st (Highest Intercostal) Vein drain?
Into the Brachiocephalic Vein
-
On the Left Side of the Thoracic Wall, what does the 2nd thru 4th intercostal veins join to form?
The Accessory Hemiazygos Vein
-
On the Left Side of the Thoracic Wall, what does the 5th thru 11th intercostal veins and the subcostal veins join to form?
The Hemiazygos Vein
-
Where does all the venous blood from the Left Side of the Thoracic Wall drain?
Into the Azygos Vein...eventually into the Right Atrium
-
What are the (2) routes the venous drainage of the Accessory Hemiazygos Vein and the Hemiazygos Vein can take?
1. They can cross over to the right side independently
2. join as a single unit and drain into the Azygos Vein
-
What are the (2) places the Accessory Hemiazygos Vein may drain into?
1. Azygos Vein
2. Brachiocephalic Vein
-
What are the (12) layers of penetration in the Mid-Axillary Line?
1. Skin
2. Superficial Fascia
3. Deep Fascia
4. Serratus Anterior
5. External Intercostal Muscle
6. Internal Intercostal Muscle
7. Innermost Intercostal Muscle
8. Endothoracic Fascia
9. Parietal Pleura
10. Pleural Cavity
11. Visceral Pleura
12. Lungs
-
What does Parietal mean?
Membrane that lines muscle, bones and ligaments
-
What is the function of the Endothoracic Fascia?
To prevent the parietal pleura from rubbing against the innermost intercostal muscles
-
What is Sibson's Fascia?
Thickening of the fascia over the apex of the lung
-
What (8) structures does the Thoracic Cavity contain?
1. (2) pleural cavities...seperate and enclosed spaces containing pleural fluid
2. Mediastinum
3. Heart
4. Lungs
5. Trachea
6. Esophagus
7. Vagus and Phrenic nerves, etc.
-
What (2) veins join to form the Right Brachiocephalic Vein?
1. Right Internal Jugular Vein
2. Right Subclavian Vein
-
What (2) veins join to form the Left brachiocephalic Vein?
1. Left Internal Jugular Vein
2. Left Subclavian Vein
-
What (2) veins join to form the Superior Vena Cava?
1. Right Brachiocephalic Vein
2. Left Brachiocephalic Vein
-
The Superior Vena Cava drains into...?
The Right Atrium of the Heart
-
Where does the Inferior Thyroid Vein drain?
Into the Brachiocephalic Vein
-
While performing a Mid Pleural Cavity Tap, if you have pierced the Visceral Pleura, you have also pierced what?
The Lungs
-
What do the Pleural Reflection cover?
The Lungs
-
What is the purpose of the Pleural Fluid?
To minimize friction between the Parietal Pleura and Visceral Pleura
-
What part of the lung is not covered by Pleural Membranes?
The Root of the Lung
-
What lines the muscle wall surrounding the lung?
Parietal Pleura
-
What covers the Lung?
The Visceral Pleura
-
What is the Cupola?
Area of parietal pleura reflected on Apex of the Lung
-
How many vertebra are there? Name and number them...
(33) Total
(7) Cervical
(12) Thoracic
(5) Lumbar
(5) Sacral
(4) Coccygeal
-
Which rib is generally the longest?
Rib 7
-
How many ribs are in the typical human body?
(24) ribs...(12) pairs
-
Which rib is generally the shortest? Some also say...?
1. Rib 12
2. Rib 1
-
What ribs are considered "Typical" and what are their common features?
1. Ribs 3 thru 9
2. Each have a head, neck and shaft
-
Which ribs are considered "Atypical"?
Ribs 1, 2, 10 thru 12
-
What (3) structures does the costal groove shelter?
1. Intercostal Nerve
2. Intercostal Artery
3. Intercostal Vein
-
Which ribs are considered "False Non-Floating" ribs and what is their unique characteristic?
1. Ribs 8 thru 10
2. They articulate with adjacent costal cartilage
-
Which ribs are considered "true" ribs and what is their unique characteristic?
1. Ribs 1 thru 7
2. They articulate directly through their costal cartilage with the sternum
-
what articulates directly in the sternal angle?
Costal cartilage of Rib 2
-
What are the other (2) names for the Sternal Angle?
1. Angle of Louis
2. Manubrio-Sternal Joint
-
What level is the Xiphoid Process Located? (In relation to the vertebral column)
T10 or T11
-
What level is the Manubrio-Sternal Joint located? (In relation to the vertebral column)
Lower Border of T4
-
What (3) structures make up the Thoracic Outlet?
1. T12
2. Rib 12
3. Costal Margin
-
What (4) structures are located in the thoracic inlet?
1. Trachea
2. Esophagus
3. Nerves (Vagus and Phrenic)
4. Apex of the Lung
-
What (3) structures make up the thoracic inlet?
1. 1st Rib
2. Manubrium Sterni
3. 1st Thoracic Vertebra
-
What (3) structures make up the Sternum?
1. Manubrium Sterni
2. Body
3. Xiphoid Process
-
The mammary gland is composed of what (2) structures?
1. Breast
2. Axillary Tail
-
Name and describe the (2) types of fascia.
1. Superficial - more fat and found under the skin
2. Deep - more fibers and found around the muscle
-
What are the (2) patterns of Deep Fascia?
1. Irregular
2. Regular
-
Where is the breast located?
Between the sternum and mid-axillary line, between ribs 2 thru 6
-
What are the (2) major components of the breast?
1. Fat
2. Glands
-
What is a dimple?
Periosteum attached to the skin
-
What are flexure lines?
Skin that is freely movable over the superficial fascia...may be wrinkled or pulled up into folds
-
Fingerprints are and example of what structure?
Friction Ridges
-
Excessive scaring or excessive collagen secretion and lead to what?
Keloids
-
How many spinal nerves are there? Name them...
(31) Total
(8) Cervical
(12) Thoracic
(5) Lumbar
(5) Sacral
(1) Coccygeal
-
What are liver spots?
Accumulation of melanin...similar to freckles
-
What are (4) age changes evident in the skin?
1. Translucent (thinning)
2. Wrinkles (loss of fat)
3. Loss of hair
4. Liver Spots (Hands and Face)
-
What are (2) other names for tension lines?
1. Langers Lines
2. Lines of Cleavage
-
What are tension lines?
Skin that is not smooth, geometric pattern of creases, follows bundle of collagen fibers in dermis of skin
-
Why is it important to know the dermatomes?
To detect neurological lesions
-
How many contiguous spinal nerves are needed to be anesthesized during minor surgical intrusion of the skin?
(3)
-
Where does the chicekn pox virus lay dormant?
In the nerves
-
What does the chicken pox virus come back as later in life?
Shingles
-
What is a common medicaion for Shingles?
Valtrex
-
What type of fibers pass through the ventral ramus?
Both sensory and motor
-
What type of fibers pass through the dorsal root?
Sensory Fibers
-
What type of fibers pass through the dorsal ramus?
Both sensory and motor
-
What type of fibers pass through the ventral root?
Motor Fibers
-
What dermatome is the Nipple?
T4
-
What dermatome is the Navel?
T10
-
A lactating breast has increased...material
glandular
-
A non-lactating breast is mostly...?
Fat
-
The breast can be divided into ...? Name them...
Quadrants
1. Superomedial
2. Superolateral
3. Inferomedial
4. Inferolateral
-
In what (2) ways does the skin regulate body temp?
1. Evaporation of Sweat
2. Cooling of the blood
-
What the the (4) receptive functions of the skin?
1. Tactile
2. Pain
3. Pressure
4. Thermal
-
What are the (4) protective functions of the skin?
1. Secretion
2. Hair
3. Pigment (Melanin from Melanocytes)
4. Thickening (Extra layer of fat under skin of people whom live in cold climates)
-
What are the (4) functions of the skin?
1. Protection
2. Regulation of Body Temp
3. Reception
4. Excretion/Absorption
-
Where are the Ceruminous Glands located and what do they produce?
1. Ear
2. Ear Wax
-
how many appendages of the skin are there? Name them...
(6)
1. Hair
2. Nails
3. Sweat Glands
4. Sebaceous Glands
5. Ceruminous Glands
6. Mammary Glands
-
How many types of skin are there? Name them...
1. Thick (Palm and Sole of the Feet)
2. Thin (Eye lids, abdomen, etc...)
-
How many fibers are present in the skin? Name them...
(3)
1. Elastic
2. Collagen
3. Reticular
-
The skin is divided into how many layers? Name them...
(2)
1. Epidermis
2. Dermis
-
What percent of carcinoma of the breast is located in the superolateral quadrant?
60%
-
True/False
The breast is a modified sweat gland
True
-
Where is the Nipple located?
Intercostal space 4 on top of the pectoralis major and pectoralis minor (between ribs 4 and 5)
-
What dermatome is slight ly above the pubic bone?
T12
-
Where does 75% of the lyphatic drainage of the breast go?
Axillary Lymph Nodes
-
How many routes of lymph drainage are there from the breast? Name them...
(5)
1. Axillary Lymph Nodes
2. Transpectoral
3. Parasternal
4. To the opposite breast
5. Ligamentum Teres
-
Where does the Ligamentum Teres drain?
Liver
-
Lymph drainage from the breast allows the spread of carcinoma to what (3) structures?
1. Lungs
2. Mediastinum
3. Liver
-
What are BRAC I and BRAC II?
Genetic markers for breast cancer and ovarian cancer
-
What (7) structures are removed in a radical mastectomy?
1. Breast
2. Axillary Lymph Nodes
3. Parts of the pectoralis major and pectoralis minor muscles
4. Medial and lateral nerves
5. Medial and lateral arteries
6. Minor arteries
7. Opposite breast
-
What are stretch marks?
Exterior evidence of the breaking of collagen fibers
-
How many instances of male breat cancer are there each year?
~ 400
-
Where is milk stored in the lactating breast?
In the Lactiferous Sinus
-
Term for the front surface of the body?
Anterior or ventral
-
Term for the back surface of the body
Posterior or dorsal
-
Term for away from the midline (median) of the body
Lateral
-
Term for toward the midline (median) of the body
Medial
-
Term for near or toward a point of reference, usually the trunk or midline of the body, or the beginning source of a part
Proximal
-
Term for away from a point of reference, usually the trunk of the body or the source of a part
Distal
-
Term for towrads the surface of the body
Superficial or external
-
Term for toward the midline of the body or structure
Deep or central or internal
-
Any engthwise vertical plane running from front to back, dividing the body or part of the body into right and left sides
Sagittal
-
Term for toward the head of the body or upper
Superior or cephalic or cranial
-
Term for the vertical plane dividing the body into (4) apparently symmetrical parts
Paramedian
-
Term for the vertical plane dividing the body into (2) apparently symmetrical halves
Median
-
Term for a crosswise plane dividing the body or any part of the body into upper and lower parts
Transverse or horizontal
-
Term for any lengthwise vertical plane running from side to side, dividing the body or any part of the body into anterior and posterior parts
Frontal or coronal
-
What (2) structures make up the Central Nervous System?
1. Brain
2. Spinal Cord
-
What (6) strucutes make up the Peripheral Nervous System?
1. Afferent System
2. Efferent System
3. Somatic Nervous System
4. Autonamic Nervous System
5. Sympathetic Nervous System
6. Parasympathetic Nervous System
-
What is the Afferent System?
Sesnory messages from receptors in the periphery to the CNS
-
What is the Efferent System?
Motor messages from the CNS to effectors in the periphery
-
Describe the Somatic Nervous System (SNS)
Messages we control going from the CNS to skeletal muscle
-
Describe the Autonamic Nervous System (ANS)
Messages we can NOT control going from the CNS to Smooth muscle, Cardiac muscle, glands and skin
-
How many cranial nerves are there? Name them...
(12)
I. Olfactory
II. Optic
III. Oculomotor
IV. Trochlear
V. Trigeminal
VI. Abducent
VII. Facial
VIII. Vestibulocochlear
IX. Glossopharyngeal
X. Vagus
XI. Accessory
XII. Hypoglossal
-
What is a ganglian?
A collection of cell bodies in the CNS or elsewhere in the body (Ex. Sympathetic Trunk)
-
What is a dendrite?
The branched projection of a neuron that conducts the messages recieved from other nerve cells and sends these messages to the cell body
-
What is a synapse?
A junction that allows a neuron to pass electrical or chemical signals to another cell. The junction is a "space"
-
How many spinal nerves are there? Name them...
(31)
(8) Cervical
(12) Thoracic
(5) Lumbar
(5) Sacral
(1) Coccygeal
-
How many nerves make up the peripheral nervous system? Name them...
(43)
(12) Cranial Nerves
(31) Spinal Nerves
-
What cranial nerve also supplies structures outside the head and neck? Where are these structures located?
1. Vagus Nerve (X)
2. Thorax and Abdomen
-
What nerves make up the Parasympathetic Nervous System? Neame them...
Cranial Nerve III, VII, IX, and X
Sacral Nerve 2, 3 and 4
-
Name the (4) structures that supply blood to the breast
1. Pectoral Branch of the Thoracoacromial Artery
2. Lateral Thoracic Artery
3. Posterior Intercostal Arteries
4. Anterior perforating branches of the internal thoracic (mammary) artery
-
Which of the spinal nerves are sensory, motor or both?
All are both except for C1, which is only motor (Means it has no dorsal root)
-
Which of the cranial nerves are sensory, motor or both?
I. Sensory
II. Sensory
III. Motor
IV. Motor
V. Both
VI. Motor
VII. Both
VIII. Sensory
IX. Both
X. Both
XI. Motor
XII. Motor
-
What nerves make up the sympathetic nervous system?
T1 thru T12
L1 thru L2...sometimes L3
-
Collagen heals by what when cut?
Fibrosis
-
What dermatome is the Hallux
L4
-
What dermatome is the Middle Finger?
C7
-
What dermatome is the Little Finger?
C8
-
What is the root value of a nerve and give (2) examples?
The root value of a nerve is the spinal nerves that contribute to the nerves formation
- Ex. #1 - Sciatic Nerve: L4, L5, S1, S2, S3
- Ex. #2 - Phrenic Nerve: C3, C4, C5
-
What is a distinct characteristic of the fibers of the parasympathetic nervous system?
long pre-ganglianic fibers with short post-ganglianic fibers
-
What is another name for the nerves of the parasympathetic nervous system?
Pelvic Splanchnics
-
What does the term Splanchinic mean?
A nerve is called a splanchinic if it enters the sympathetic trunk then leaves without synapsing
-
What spinal nerves make up the Greater Splanchnic and where do they synapse?
T5 thru T9
Celiac Ganglian
-
What nevres make up the Lesser Splanchnic and where do they synapse?
T10 thru T11
Superior Mesenteric Ganglion
-
What nerves make up the Lowest Splanchnic and where do they synapse?
T12
Aortico Renal Ganglion
-
What nerves make up the Lumbar Splanchnic and where do they synapse?
L1 thru L2
Inferior Mesenteric Ganglion
-
What is Fascia?
A ixture of fat and connective tissue (a packaging material)
-
How are the pleura named? Give (2) examples...
According to where they are found
Ex. #1 - Costal parietal pleura
Ex. #2 - Diaphragmatic Visceral Pleura
-
What is the name for the pleura over the apex of the lung in the thoracic inlet?
Cupola...it is shaped like a cup
-
Where is the Costo-Diaphragmatic Recess found?
At the junction of the costal and diaphragmatic parietal pleura near the mid-axillary line
-
Where is a Pleural Cavity Tap done?
In the costo-diaphragmatic recess...intercostal space 9
-
Name the (3) Pleural Recesses
1. Costo-Diaphragmatic Recess
2. Costo-Mediastinal Recess
3. Costo-Vertebral Recess
-
What is the function of the Pleural Recess?
Allows expansion of lung during inspiration
-
What (2) structures supply the Parietal Pleura with blood?
1. Intercostal Artery
2. Internal Thoracic Artery
-
What structure supplies the Visceral Pleura with blood?
Bronchial Artery
-
What (3) nerves innervate the parietal pleura?
1. Intercostal Nerves T1 thru T11
2. Subcostal Nerve
3. Phrenic Nerve
-
Is the parietal pleura sensitive to pain?
Yes, very sensitive to pain
-
What nerves innervate the visceral pleura?
None
-
Is the visceral pleura sensitive to pain?
No
-
What is the nerve to the diaphragm?
The phrenic nerve
-
What (2) arteries come together to form the Brachiocephalic trunk?
1. Right Subclavian Artery
2. Right Common Carotid Artery
-
What (3) major arteris come join the Aortic Arch?
1. Left Subclavian Artery
2. Left Common Carotid Artery
3. Brachiocephalic Trunk
-
What is the medial region between the (2) pleural cavities that contains all the structures in the chest except the lungs and pleural sacs?
Mediastinum
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