The skeleton and musculature of the thoracic wall functions to protect the viscera and to modify intrathoracic volume for respiration.
Be able to identify on a typical rib:
What structures form the wall of the thoracic cavity posteriorly, laterally, anteriorly, inferiorly, superiorly?
How does rotation of the ribs about the following axes influence volume of the thoracic cavity:
What mechanisms exist for influencing the volume of the thoracic cavity
What are the three layers of intercostal muscles and how might one distinguish among them?
In what relation to ribs and muscles do the intercostal nerves and vessels run?
What is the relationship of the intercostal nerves to the ventral and dorsal rami of the thoracic spinal nerves? What are the major branches of an intercostal nerve and what do these branches do?
From whence do the posterior intercostal arteries arise? Anterior?
Name the branches of the internal thoracic artery and designate their area of supply.
Coarctation of the aorta entails constriction of this vessel at a site that is usually just distal to the origin of the left subclavian artery. Via what routes can blood pass from the branches of the aortic arch to reach the branches of the descending aorta in order to make coarctation compatible with life?
What is the endothoracic fascia?
Understand the vascular supply, lymphatic drainage and glandular structure of the breast.
What is the mediastinum? Understand, in general, the divisions thereof.
Be able to discuss the development of the pleural and pericardial cavities and the invagination of each by their respective visceral organs.
What is the difference between visceral and parietal pleura? What is the epicardium? What is the fibrous pericardium?
What structures leave and enter the thoracic cavity through its superior aperture?
What structures leave and enter the thoracic cavity through the diaphragm?
What structures leave and enter a lung through the hilus?
In what primary bronchus do foreign objects usually get lodged? Why?
Be able to describe the vascular supply, lymphatic drainage, and innervation of the lungs and pleura.
Be familiar with the branching of the bronchi into primary, secondary (lobar), and segmental bronchi. How do the pulmonary arteries and veins distribute through the lungs?
Distinguish between parietal and visceral pleura with respect to
What are the transverse and oblique sinuses of the pericardium? Where might one find them?
Understand the differences between fetal and neonatal circulation and the reasons for these differences. Be able to describe the changes in blood flow through the heart that occur at birth.
With respect to the development of the heart and circulatory system, be able to identify the following:
From a developmental perspective, what are the following:
Be able to trace the flow of blood through the heart, understanding along the way
What is the skeleton of the heart, and what is its function?
Be able to trace the paths of the coronary arteries from their origin throughout the heart. Be familiar with variations in the vascular supply of the heart.
What is the coronary sinus? Where does it empty
Trace the venous drainage of the heart.
What and where are the following:
What are the sources of parasympathetic and sympathetic input to the cardiac plexus?
What is referred pain and what is the area of referred pain from a myocardial intarct? Explain the distribution of referred pain from this condition on the basis of your knowledge of sensory innervation to the heart.
Which groups of thoracic lymph nodes are drained by the bronchomediastinal trunk and which are drained by the thoracic duct?
Where do the bronchomediastinal trunks and thoracic duct enter the venous system.
Be able to discuss the lymphatic drainage of the mammary gland and the thoracic viscera.
You should be aware of the relationships of the thoracic structures to one another as well as to surface landmarks.
What is the relationship of the phrenic nerve to the root of the lung?
In the neck the vagus nerve lies just posterolateral to the common carotid artery. As the nerve enters the mediastinum, it passes posteriorly to reach the back surface of the bronchus at the root of the lung. In so doing, on the right side the vagus nerve lies on the right surface of the ___________ and on the left side on the left surface of the _________ then __________.
Trace the course of the vagus nerves from the hili of the lungs to the point where they leave the thorax.
What is the position of the sympathetic trunk in the thorax? What are its branches?
The phrenic neve enters the mediastinum by passing between the _______________ artery and _______________ vein at the root of the neck. It then moves anteriorly and on the right side is related to the right surfaces of the ___________________, ___________________, ___________________, and ___________________ before it reaches the diaphragm. Because the left brachiocephalic vein crosses to the right soon after it formation, the left phrenic nerve comes to lie anterolateral to the left common carotid artery and then crosses on the left side of the ____________, _________, _______, and ________ before it reaches the diaphragm.
On the left side, lying in the groove between the trachea and esophagus is the ________________.
How might a tumor of the left principal bronchus, or an abscess of the upper lobe of the right lung produce hoarseness?
Name the thoracic vertebrae (or IV discs) transected by a transverse plane that passes through:
By what landmark is the 2nd rib identified on the front of the chest? By what landmark is the 8th rib identified on the back of the chest?
Identify the location of the dome of the diaphragm in relation to the bones of the anterior chest wall.
Where is the beginning of the descending aorta projected onto the front of the thorax?
What vascular structure intervenes between the three branches of the aortic arch and the upper half of the manubrium?
Be able to identify the location of the borders of the heart.
Identify the location of the following (just some examples):
Trace the esophagus and trachea from their point of entry into the thoracic cavity to their exit or bifurcation, respectively.