Descends from midpoint of axilla, right and left, where you put a chest tube in [surface anatomy]

Dome of respiratory diaphragm; at T4 level [surface anatomy]

At level of T10 [surface anatomy]

Sternum includes

Ribs: _____ pairs

True ribs:

Articulate with sternum

Ribs 1-7

False ribs:

Ribs 8-12:

Floating ribs:

Ribs 11-12

Anterior thoracic wall muscles that act on upper limb:

______ are anterior rami of first 11 thoracic spinal nerves

12th spinal nerve gives rise to the:

Neurovascular bundle (NAV) lies ______ to each ribs

Many rib fractures --> chest wall expands and goes out, one part will sink in (chest wall destabilized)

Ribs can puncture lung and cause lungs to collapse

The pain caused by rib fractures can be intense because of the expansion and contraction of the rib cage during respiration

Rib fractures sometimes require palliation by anesthetizing the _________ (nerve block)

Complicated thoracic cage injuries

Tear of blood vessels

Simple thoracic cage injuries:

What lies underneath each rib

______ is composed of compound tubuloacinar glands organized into 15-20 lobes, separated by fibrous connective tissue

The fibrous connective tissue in the mammary tissue is called

extension of mammary tissue superolatterally towards the axilla

When doing exams on female, make sure to check _____ to not miss any potential breast cancers that might be there.

About 50% of breast cancer develops in the upper, outer quadrant of the breast.

Lymph is drained from

75% of lymphatic drainage is to the

After lymph drains to the axillary lymph nodes, the remainder drains to:

Lungs lie in the pleural cavity

lines the lung

line's the cavity / thoracic wall

has 3 lobes

has 2 lobes and lingula

shorter, wider, and more vertical

diaphragm moves down and intercoastal muscles increase diameter of throacic wall, decreasing intrapleural pressure

elastic recoil of the lungs, relaxation of the diaphragm, and relaxation of throacic cage muscles expels air

innervates diaphragm (comes from C3, C4, C5)

parasympathetic bronchoconstrictor fibers contract smooth muscle, vasodilator pulmonary vessels, and initiate secretion of alveolar glands

Lymphatic drainage of the lungs is to

Lymphatic drainage is to pulmonary (intrapulmonary) nodes and bronchopulmonary (hilar) nodes, which are also called the

upper right sternal border [features of various heart sounds]

Upper left sternal border to below left clavicle; second heart sound

Left fourth intercostal space; or sternal border of 5th rib

aortic stenosis

tricuspid and aortic regurgitation

left fifth intercostal space in midclavicular line; apex; first heart sound

pulmonary valve murmurs, VSD murmur of patent ductus arteriosus (PDA)

fibrous crowds that connect papillary muscles to valve leaflets

superoposterior, inferior, and spetal projections of myocardium extending into ventricular cavity

ridges of myocardium inside auricle (pouchlike appendage of atrium)

vagus nerve

vagus nerve

dec HR, dec force of contraction, vasodilates coronary resistance vessels

inc HR, force of contraction and minimally vasocontriction coronary resistance vessels

40-50% frequency, affects anterior and apical left ventricle and anterior two thirds of interventricular septum (IVS)

30-40% frequency, affects posterior wall of left ventricle, posterior one third of IVS (if right-dominant coronary circulation)

15-20% frequency, affects lateral wall of left ventricle (can also affect posterior wall if left dominant coronary circulation)

Leads to left ventricular overload and hypertropy; caused by rheumatic heart disease (RHD), calcific stenosis, congenital biscuspid valve (1-2%)

Caused by congentially malformed leaflets, RHD, IE, ankylosing spondylitis, Marfarn's syndrome, aortic root dilation

Leads to left atrial dilation; usually caused by RHD

Caused by abnormalities of valve leaflets, rupture of papillary muscle or chordae tendineae, papillary muscle fibrosis, IE, left ventricular enlargement

thymus, SVC, brachiocephalic veins, aortic arch and 3 branches, trachea, phrenic and vagus nerves, thoracic duct and lymphatics

divided into anterior, middle, and posterior

posterior to the body of the sternum and anterior to the pericardium; contains fat

contains pericardium and the heart

posterior to heart and anterior to bodies of T5-T12. Contains esophagus and its nerve plexus, thoracic aorta, azygous system of veins, sympathetic trunks and thoracic spine nerves, lymphatics, and thoracic duct

"pacemaker" of the heart, located at superior end of crista terminalis near the opening of SVC

receives from SA node and conveys to bundle of His, located btwn opening of coronary sinus and origin of septal cusp of tricuspid valve

ramification of bundle brances in ventricles of heart's conduction system

contraction and blood pumps out of the heart to arteries

heart muscles are relaxed and filled with blood

stimulation from the SA node initiates the contraction of the atria, forcing the remaining atrial blood volume into the ventricles

stimulation from the AV node and the AV bundles initiates contraction of the ventricles

relaxation of the ventricles, causes backward flow in the pulmonary trunk and aorta and closure of the pulmonary and aortic valves

The "middle space" in the middle of the thoracic cavity

heart muscle tissue

connective tissue encompass heart and vessels