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10/16

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
Q In which mediastinum is the Thymus found? Where does it lay in relation to the manubrium?   A In sup. just pos. to manubrium  
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Q The brachiocephalic vv. are formed by the internal jugular and subclavian. Which is longer?   A The L brachiocephalic v.  
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Q The brachiocephalic vv. are formed by the internal jugular and subclavian. Which passes in front of the scalene mm, and over the first rib?   A The R brachiocephalic v.  
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Q Q The brachiocephalic vv. are formed by the internal jugular and subclavian. Which brachiocephalic v. corsses ANT to branches of the aorta?   A The L  
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The SVC starts deep to #1 costal cartilage, and end where?   A It ends deep to #3 costal cartilage when it enters the RA  
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Q Which way does the aorta arch?   A the aorta arches posterosuperiorly and LEFT  
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Q The arch of the aorta starts on the R side at #2 costosternal joint. Where does it start it's descent?   A at the LEFT body of T4. Notice it switches sides as it arches.  
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Q There are two brachiocephalic VV., how many brachiocephalic AA. are there?   A just one-the "brachioc. Trunk".  
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Q The L common carotid, and L subclavian both branch directly off of the aorta. Where do the R sublcavian/common carotid branch off?   A The brachiocephalic trunk.  
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Q *** Is the L subclavian a. in front/behind the scalene mm.? What about the L subclavian v.?   A *** Artery is BEHIND the scalenes, and vein is in FRONT of them  
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Q Which of the R/L vagus nn. pass pos. to the root of the lung?   A BOTH  
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Q Does the R or L recurrent laryngeal (branch off vagus) ascend between the trachea and esophagus?   A the R  
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Q Does the R/L recurrent laryngeal n pass under the arch of the aorta?   A The L  
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Q The R vagus n. forms the pos. vagal trunk. What does the L vagus n. form?   A The ant. vagal trunk  
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Q What n. is found just lat. to the ligamentum arteriosum?   A The L vagus n.  
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Q The heart twists counter-clockwise as seen from the top. Which way do the nn. twist?   A Opposite, or clockwise  
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Q Do the phrenic nn. enter the thorax lat/med to the vagus n? Do they pass ant/pos to root of lung?   A Phrenic n. passes into thorax lat. to vagus, and passes ANT to root of lung.  
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Q How much of the phrenic n. supply is motor to the diaphragm?   A 2/3, so 1/3 is sensory  
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Q Is the trachea ant/pos to the esophagus? At what level does the trachea end?   A Ant, deviates slightly R, and end at the sternal angle, where it first divides  
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Q *** At what level does the esophagus peirce the diaphragm?   A *** T10, through the "esophageal hiatus" of R crus.  
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Q This is a flat, fibromuscular tube, that can't seem to run a straight course   A the esophagus, which is constantly getting pushed side to side by the aorta  
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Q The thoracic aorta is fron T4-12. Where is the aortic knob found?   A T4  
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Q The thoracic lymphatic duct drains everything into the L. subclavian v., except....   A head, neck, and R arm  
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Q What the thoracic lymphatic duct doesn't drain, the _______ takes care of?   A R. Lymphatic duct, into the R subclavian v.  
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Q The thoracic duct is the largest lymphatic channel, and is ant to T2-6. What is found to the R and L?   A The "cisterna chyli" on the R, and the subclavian v. on the L. Check the pictures on this one.  
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Q how many vv. are involved in the azygos system of vv.?   A 3. Azygos, hemiA, and accessory hemiA  
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Q The azygos v. runs from the pos. IVC to the SVC, but it can't be short. Where precisely does it extend?   A From the pos IVC in the abdomen, loops over the root of R lung, and into the SVC above the heart  
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Q At approx what level does the hemiA v. crossover to drain into the azygos v.?   A T9 The accessory hemiA v. also crosses over around this area, but this whole crossover thing tends to vary a LOT.  
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Q What drains intercostal vv. on the R side?   A Azygos v.  
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Q What drains the intercostal vv. on the L?   A T4-8 is accessory hemiA v. Below that is the hemiA, and T1-3 is actually the "sup intercostal v."  
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Q Large branches off of the symp ganglia form splanchnic nn. which go to abdominal viscera. What vert. levels for the Greater splanchnic?   A T5-9. lesser = T10-11, and least = T12  
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Q Is the trachea attached to the esophagus?   A Yup.  
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Q What is another name for secondary bronchi?   A Lobar bronchi. Think: 3 lobes on R, 2 on L  
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Q secondary bronchi branch into tertiary, then into bronchopulmonary segments in each lung, then into bronchioles. What is another name for tertiary bronchi?   A segmental bronchi  
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Q You just swallowed me and i took a wrong turn into your bronchioles. Which do i hit first, terminal or respiratory bronchioles?   A terminal. This is the END of cartilage.  
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Q I just jumped down your throat and into your lungs, looking for alveoli. Where is the first place i find them?   A Respiratory bonchioles  
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Q *** The diaphragm is convex toward the thorax. Where does it attach circumferentially?   A ***lower 6 ribs, xiphoid, and vert up to L4.  
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Q*** Where does the diaphragm attach in it's middle?   A ***to the "central tendon", and forming a "trifoliate aponeurosis", w/ 3 leaves. Check your picture-it's not that scary.  
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Q *** The diaphragm has 3 parts to it's muscular portion. 2 slips go to the xiphoid (called sternal part) w/ spaces for nn. Where is the costal part?   A *** The costal part extends from the the inf 6 costal cartilages anteriorly w/ their ribs, forming the R/L domes. Check your plate, or pictures, or whatever. Put some clouds and stars around the diaphragm.  
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Q*** The costal part of the diaphragm extends from the ant. inf. costal cartilages w/ their ribs. Where does the lumbar part of the diaphragm extend?   A *** From 2 arches bilaterally, and 1 centrally, and the upper 3 or 4 vertebrae. No seriously, it's not that bad....check netters or grays.  
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Q In the lumbar part of the muscular portions of the diaphragm, 2 arches are formed bilaterally. We call the medial ones the medial arcuate ligament, and the lateral the lateral arcuate ligament. What mm. do these wrap over/around?   A The medial arcuate ligament passes around the psoas, and the lateral the quadratus lumborum.  
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Q What does "crura" mean?   A leg  
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Q ***There are various "apertures" or holes in the diaphragm for structures to pass through. Does the vena caval foramen get bigger/smaller on inspiration?   A ***The vena caval foramen is surrounded by tendons, so it gets BIGGER with inspiration. This is at the T8 level  
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Q ***There are various "apertures" or holes in the diaphragm for structures to pass through. Which hiatus is at the T10 level, and pinches on inspiration?   A ***The esophageal hiatus. It pinches b/c it is surrounded by mm. IT does this to help keep food down.  
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Q ***There are various "apertures" or holes in the diaphragm for structures to pass through. At what level is the aortic hiatus, and what happens to it w/ insp/expiration?   A *** T12 level, and there is NO respiratory effect  
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Q Aside from the vena caval foramen, the esophageal hiatus, and the aortic hiatus.....what hiatus am i forgetting?   A The sternocostal hiatus....if you want to NOT bother with one of these, this is the one.  
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