Mediastinum
These are the inferior and superior limit of the mediastinum
Inferior limit: plane from sternal angle to inferior lip of body of T4 vertebra
Superior limit: thoracic inlet> body of T1, 1st ribs, manubrium
These are the two rib movements
Bucket handle- elevation increases bilateral dimension
Pump handle- elevation of anterior end increases the anteroposterior dimension
This is the blood supply and innervation to the breast
Anterior and posterior intercostal arteries 2-6 or 7
Internal thoracic arteries
Lateral thoracic arteries
Innervation: ventral rami of spinal nerve T2-T7
These are the two recesses where the anterior and inferior borders of the lungs project into
What is costomediastinal and costodiaphragmatic recesses
LCT
Contains all structures inside ab wall
Attaches parietal peritoneum to transversalis fascia layer
The smallest part of the mediastinum and some things that it contains
Anterior mediastinum
-contains fat, internal thoracic arteries + veins, lymph notes, sternopericardial ligaments
The muscular portion of the thoracic wall is innervated by these nerves
Ventral rami of spinal nerves T1-T11
This makes up the posterior surface of the heart
Left atrium and left ventricle
These are the impressions that can be found in the LEFT lung
Descending thoracic aorta, cardiac impression
Arterial supply to abdominal wall
Lower intercostal and lumber arteries
Superior epigastric arteries and inferior epigastric arteries
These structures are found in the posterior mediastinum
Esophagus
Vagus nerves
Thoracic duct
Thoracic aorta
This is where the internal intercostal membrane found?
In the posterior 1/3 of space
- it occupies where the internal intercostal muscles are deficient
These structures are supplied by the left coronary artery
What is left ventricle, interventricular septum, left atrium
What nerve do the thoracic parasympathetic preganglionic fibers travel with?
CN X- vagus
Innervation of abdominal wall
Ventral rami T1-11 (intercostal n) + T12 (subcostal)
Ventral rami of L1> splits to iliohypogastric and ilioinguinal n
Define the thoracic outlet
Opening from thoracic to abdominal cavity, defined by body of t12, ribs 11+12, costal margins, inferior part of body of sternum
Write out the structure of the body wall by layers from superficial to deep
1. Epidermis
2. Dermis
3. Superficial fascia
4.deep fascia
5.skeletal muscle, bone, connective tissue
6. Deep fascia (again)
7. Loose connective tissue
8.parietal serous membrane
9. Body cavity
10. Visceral serous membrane
Describe the difference b/w a left dominant heart and a right dominant heart
Left: when posterior interventricular artery is branch off left coronary artery (10% off circumflex)
Right when posterior interventricular artery is a branch of the right coronary artery ( 90% off marginal)
Name and decribe the two types of superficial fascia
Camper’s- loose fatty connective tissue
Scarpas- fibrous connective tissue
Differentiate b/w a direct and indirect inguinal hernia
Indirect- reopens processus vaginalis and pass through entire canal
- lateral to inferior epigastric artery
Direct- push directly from behind superficial ring, doesn’t pass through deep
-medial to inferior epigastric artery
These are contained in the middle mediastinum
Heart
Roots of great vessels
Phrenic nerves
Loose connective tissue
This is the area where the SA node lies
Lies in the wall of the right atrium near the opening of the SVC
List the actions of the external oblique, internal oblique, transversus abdominus, rectus abdominus
EO: compress ab, flex & rotate trunk to OPPOSITE side
IO: compress ab, flex & rotate trunk to SAME side
TA: compress ab
RA: Flex trunk and compress ab
Name the three coverings of the spermatic cord and what they extend from
1. External spermatic fascia- extension of EO aponeurosis
2. Cremaster- extension from IO muscle
3.Internal spermatic fascia- extension of transversalis fascia