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Anatomy of the thoracic wall, accompanying viscera, and heart (Lectures…

- - - - Sternum
        
        Manubrium
        
        Body of the sternum
        
        Xiphoid Process
      - 12 Thoracic Vertebrae
      - 12 Ribs
        
        True (vertebrocostal) Ribs are 1-7
        
        False (vertebrochondral) Ribs are 8-10
        
        Floating Ribs are 11-12
      - External Intercostal Muscles
      - Internal Intercostal Muscles
      - Innermost Intercostal Muscles
      - Transversus Thoracis
      - Dorsal Ramus of Spinal Nerve
      - Intercostal Nerve
        
        Lateral Cutaneous Branch
        
        Anterior Cutaneous Branch
      - Posterior Intercostal Artery (from aorta)
        
        Dorsal Branch
        
        Lateral Cutaneous Branch
      - Anterior Intercostal Artery
      - Internal Thoracic Artery
    - - Capitular joint
      - Costotransverse joint
      - Xiphisternal joint
      - Sternoclavicular joint
      - Manubriosternal joint
      - Stenocostal, costochondral joints
      - Interchondral joints
    - - Protect Vital Organs
        
        Lungs
        
        Left: two lobes (upper, lower)
        
        Connected to trachea by left main bronchus
        
        Upper and lower branches
        
        Less steep angle than right main brochus
        
        Pulmonary artery is SUPERIOR to left bronchus on surface of lung
        
        Right: three lobes (upper, lower, middle)
        
        Connected to trachea by right main bronchus
        
        Upper, middle, and lower branches
        
        More steep angle than left main bronchus (more like a continuation of the trachea)
        
        :warning: This is why objects aspirated by a standing person are more likely to end up in the right lung
        
        Pulmonary artery is anterior to ANTERIOR to right bronchus on surface of lung
        
        Enclosed by the pleura
        
        parietal: surrounds pleural cavities
        
        Visceral: surrounds lungs
        
        Heart
        
        Circulation through the heart
        
        Deoxygenated blood enters the Right Atrium via the superior and inferior vena cava
        
        Tricuspid valve
        
        Right Ventricle
        
        3 more items...
        
        Anterior, Posterior, and Septal cusps
        
        Pectinate Muscles
        
        Fossa Ovalis
        
        Crista Terminalis
        
        Coronary Circulation (supplies the heart)
        
        :warning: Left dominant versus right dominant heart
        
        Right dominant heart (75% of poeple): right coronary artery gives rise to the posterior interventricular branch
        
        Left dominant heart: LEFT coronary artery gives rise to the posterior interventricular branch
        
        THUS all blood to the left ventricle is supplied by the left coronary artery ( no back up flow from a right coronary-derived posterior interventricular artery)
        
        1 more item...
        
        Fetal Circulation Differences
        
        Foramen Ovalis connects the right and left atrium
        
        Bypass the lungs, as oxygenated blood flows in from the placenta
        
        Ductus Arteriosis connects the pulmonary trunk to the aortic arch
        
        Thus any blood which flows into the pulmonary trunk would be flushed into the system via the aorta rather than into the non-operative fetal lungs
        
        Mediastinum
        
        Remember that the RIGHT posterior intercostal veins drain into the Azygous Vein while the LEFT posterior intercostal veins drain into the HEMIAZYGOUS (and accessory azygous) veins
        
        Remember that the Phrenic nerve runs anterior to the hilum of the lung and the Vagus nerve runs posterior to the hilum of the lung
      - Breathing
        
        Pump Handle Model
        
        Most apparent for upper ribs
        
        Increases ant/post diameter of rib cage
        
        Bucket Handle Model
        
        Most apparent for lower ribs
        
        Increases mediolateral diameter of rib cage
        
        Inspiration
        
        Diaphragm low, thoracic volume (+), abdominal pressure (+)
        
        Muscles: diaphragm (contract), sternocleidomastoid, scalene, external intercostal, chondral internal intercostal
        
        Expiration
        
        Diaphragm high, thoracic volume (-), abdominal pressure (-)
        
        Muscles: Internal/innermost intercostal, rectus abdominus, external and internal oblique, trasnversus abdominus