1. Pericardium
1.1. Definition
1.1.1. fibrous sac enclosing the heart and roots of the great vessels
1.1.2. middle mediastinum
1.1.3. 2nd - 6th Costal cartilage
1.1.4. Atbang 5th - 8th Vertebrae
1.2. Function
1.2.1. Restric Excessive mvoement sa heart
1.2.2. lubricated container tingz
1.3. Types
1.3.1. Fibrous Pericardium
1.3.1.1. Strong Fibrous Part
1.3.1.2. Firmly attached below central tendon
1.3.1.3. fuses with aorta, pulmo trunk, and vena cavas and pulmo veins
1.3.1.4. sternopericardial ligaments
1.3.2. Serous Pericardium
1.3.2.1. Parietal Layer
1.3.2.1.1. lines fibrous pericardium and roots of great vessels
1.3.2.2. Visceral Layer
1.3.2.2.1. Epicardium
1.4. Pericardial Sinuses
1.4.1. Oblique Sinus
1.4.2. Transverse Sinus
1.5. Pericardial Cavity
1.5.1. space between visceral layers that contain pericardial fluid
1.5.1.1. 50 mL
1.6. Nerve Supply
1.6.1. Phrenic Nerves
1.6.1.1. Fibrous Pericardium
1.6.1.2. Parietal Layer
1.6.2. Vagus Nerves (sympathetic trunk)
1.6.2.1. Visceral Layer
2. Heart
2.1. Surfaces of the Heart
2.1.1. Anterior Surfaces
2.1.2. Base
2.1.2.1. Left atrium
2.1.3. Right Pulmonary Surface
2.1.4. Diaphragmatic Surface (Inferior)
2.1.4.1. right and left ventricle separate by the posteriorinterventricalr group
2.1.4.2. this is there the heart rests
2.1.5. Left Pulmonary Surface
2.1.6. Inferior (acute) margin
2.1.7. Obtuse Margin
2.1.8. Apex
2.1.8.1. downward point
2.1.8.1.1. left intercostal space, 9 cm form midleine
2.1.8.2. left ventricle
2.2. Borders of the Heart
2.2.1. Left border
2.2.1.1. left auricle
2.2.2. Right border
2.2.2.1. right atrium
2.2.3. Lower border
2.2.3.1. Right Atrium
2.2.3.2. Right Ventricle
2.2.3.3. These two are separated by the atrioventricular groove
2.3. Grooves
2.3.1. Atrioventricular Groove
2.3.2. Anterior Interventricular Groove
2.4. Chambers of the Heart
2.4.1. Right Atrium
2.4.1.1. Right Auricle
2.4.1.1.1. small out pouching
2.4.1.2. Sulcus Terminalis
2.4.1.2.1. junction between right atrium and right auricle
2.4.1.2.2. a vertical group
2.4.1.3. Crista Terminalis
2.4.1.3.1. ridge inside the
2.4.1.4. Musculi Pectinati
2.4.1.4.1. rough area in front of the ridge
2.4.1.4.2. trabeculated by bundles of muscle fibers
2.4.1.4.3. runs from the crista terminalis to auricle
2.4.1.5. Openings
2.4.1.5.1. Superior Vena Cava
2.4.1.5.2. Inferior Vena Cava
2.4.1.5.3. Coronary Sinus
2.4.1.5.4. Right Atrioventricular Orifice
2.4.2. Right Ventricle
2.4.2.1. infundibulum
2.4.2.1.1. funnel shaped
2.4.2.2. trabeculae carneae
2.4.2.2.1. projecting ridges
2.4.2.2.2. sponge like
2.4.2.2.3. 3 Types
2.4.2.3. IV Septum
2.4.2.3.1. ??
2.4.3. Left Atrium
2.4.3.1. Smaller but thicker walls than the right atrium
2.4.3.2. Walls are smooth except a few pectinate muscles
2.4.3.3. Most posterior
2.4.3.4. Receives oxygenated blood through four pulmonary vveins
2.4.4. Left Ventricle
2.4.4.1. Left Ventricle Proper
2.4.4.2. Aortic Vestibule
2.4.4.2.1. Leads to Aorta
2.4.4.3. Works harder
2.4.4.4. thicker
2.4.4.5. more conical in shape than the right
2.5. Walls of the Heart
2.5.1. Fibrous Pericardium
2.5.2. Parietal Layer
2.5.3. Pericardial Cavity
2.5.4. Epicardium (Viscera)
2.5.4.1. Endocardium
2.5.5. Myocardium
2.5.5.1. Covered by Serous Pericardium
2.6. Heart Valves
2.6.1. Pulmonary
2.6.1.1. Audible over left 2nd ICS, lateral to sternum
2.6.1.2. opened by ventricular systole
2.6.1.3. shuts slightly after aortic valve
2.6.2. Tricuspid (Right AV)
2.6.2.1. between righ atrium and right ventricle
2.6.2.2. audible over right lower part of sternum
2.6.2.3. closed during ventricular systole
2.6.2.4. closure contributes to first LUB sound
2.6.3. Aortic
2.6.3.1. behind left of sternum
2.6.3.2. opposite to 3rd ICS
2.6.3.3. closed in start of ventriculare diastole
2.6.3.4. closure at beginning of the ventricular diastole causes second DUB heart sound
2.6.3.5. audible over Right ICS lateral sternum
2.6.4. Bicuspid (Left AV) Valve
2.6.4.1. Mitral Valve
2.6.4.2. between left atrium and ventricle
2.6.4.3. two cusps
2.6.4.4. closed slightly before the tricuspid valve by the ventricular systole
2.6.4.5. its closure at onset of systole causes first LUB sound
2.6.4.6. most audible over apical region of the heart in 5th ICS midclavicular
2.6.5. Bicuspid (Left AV) Valve
2.6.5.1. Mitral Valve
2.7. Heart Sounds
2.7.1. First "LUB" Sound
2.7.1.1. caused by closure of tricuspid and mitral valves at onset of sytole
2.7.2. Second "DUB" Sound
2.7.2.1. caused by closure of the aortic and pulmonary valves at onset of diastole
2.8. Conducting System of the Heart
2.8.1. Sinoatrial (SA) Node
2.8.1.1. Keith Flack?//
2.8.1.2. Pacemaker
2.8.1.3. generate impoulses
2.8.1.4. intitates contraction
2.8.2. AV Node
2.8.2.1. smaller than ^^
2.8.2.2. conducts to AV
2.8.2.3. 0.11 sec
2.8.3. AV Bundle (of HIS)
2.8.3.1. means of conducting from atria to ventricles
2.8.4. Right and LEft Bundle of HIS
2.8.4.1. sub endocardial??/
2.8.5. Subendocardial Purkinje Fibers
2.8.5.1. yes
2.9. Coronary Arteries
2.9.1. Right Coronary Artery
2.9.1.1. SA Nodal Artery
2.9.1.2. Marginal Artery
2.9.1.3. Posterior IV (Descending) Artery
2.9.1.4. AV Nodal Artery
2.9.2. Left Coronary Artery
2.9.2.1. Anterior IV (Left Anterior Descending) Artery
2.9.2.1.1. Anterior Interventricular Sulcus
2.9.2.2. Left Circumflex Artery
2.9.2.3. Mo agi sa Left Coronary Sulcus
2.9.2.3.1. the thing that divides the left atrium and ventricle
2.9.2.4. shorter than right
2.9.3. Cardiac Veins and Coronary Sinus
2.9.3.1. Coronary Sinus
2.9.3.1.1. largest vein draining the heaart
2.9.3.1.2. coronarly sulcus
2.9.3.1.3. opens into IVC and AV
2.9.3.1.4. one cusp valve
2.9.3.1.5. receives the great, middle, and small cardiac veins; the oblique vein of the left atrium and posterior vein of left ventricle
2.9.3.2. Great Cardiac Vein
2.9.3.2.1. starts at apex and ascends along IV branc of left coronary artery
2.9.3.2.2. continuous through the coronary sulcus to the coronoary sinus
2.9.3.3. Middle Cardiac Vein
2.9.3.3.1. drains into right end of coronary sinus
2.9.3.4. Small Cardiac Vein
2.9.3.5. Oblique Vein of the Left Atrium
2.9.3.5.1. descends to empty in to the coronoary sinus, left end
2.9.3.6. Anteriror Cardiac Vein
2.9.3.6.1. drains the anterior right centrice
2.9.3.6.2. crosses coronary groove
2.9.3.6.3. ends in the right atrium
2.9.3.7. Smallest Cardiac Veins (Venae Cordis Minimae)
2.9.3.7.1. begins in the wall of the heart and directly empties into chambers
2.9.4. Blood flow thingy
2.9.4.1. Maximal Blood flow in Diastole
2.9.4.2. Minimal Blood Flow in Systole
2.10. Lymphatic Vessels
2.10.1. receives lymph from myocardium and epicardium
2.10.2. follows right coronary arteery to empty into the
2.10.2.1. anterior mediastinal nodes
2.10.2.1.1. follows the left coronary arter to empty into a tracheo bronchial node
2.11. Cardiac Plexus
2.11.1. Superficial cardiac plexus
2.11.1.1. beneath arch of aorta
2.11.1.2. in front of pulmonary artery
2.11.2. Deep Cardiac Plexus
2.11.2.1. posterior arch of aorta
2.11.2.2. in front of bifurcation of trachea
2.11.3. Functions
2.11.3.1. sympathic
2.11.3.1.1. dilation of coronary arteries
2.11.3.1.2. increase heartrate
2.11.3.2. Parasympathetic fibers
2.11.3.2.1. decrease heart rate
2.11.4. ligamentum arteriosu,
2.11.4.1. connects left pulmo artery to aorta
2.12. Great Vessels
3. Lungs
3.1. Formation of the Lungs
3.2. Pleurae
3.2.1. Layers
3.2.1.1. Parietal Layer
3.2.1.2. Visceral Layer
3.2.2. Pleura
3.2.2.1. Cervical Pleura
3.2.2.2. Costal Pleura
3.2.2.3. Diaphragmatic Pleura
3.2.3. Recess
3.2.3.1. Costodiaphragmatic Recess
3.2.3.2. Costomediastinal Recess
3.2.4. Nerve Supply
3.3. Trachea
3.3.1. Relations of the Trachea
3.3.2. Blood Supply
3.3.3. Lymph Drainage
3.3.4. Nerve Supply
3.4. The Bronchi
3.4.1. Principal Bronchi
3.4.1.1. Left Main Bronchus
3.4.1.2. Right Main Bronchus
3.5. Lungs
3.5.1. Surfaces
3.5.2. Lobes and Fissures
3.5.3. Bronchopulmonary Segments
3.5.4. Blood Supply
3.5.5. Lymph Drainage
3.6. Nerve Supply of the Lungs
3.6.1. Mechanics of Respiration
3.6.2. Types of Respiration
4. Thoracic Cage
4.1. Basic Anatomy of the Thorax
4.1.1. Boundaries
4.1.1.1. Covered by skin and muscles
4.1.1.2. Posterior
4.1.1.2.1. Vertebral Column
4.1.1.3. Anterior
4.1.1.3.1. Sternum and Costal Cartilages
4.1.1.4. Laterally
4.1.1.4.1. Ribs and Intercostal Spaces
4.1.1.5. Superiorly
4.1.1.5.1. Suprapleural Membrane
4.1.1.6. Inferiorly
4.1.1.6.1. Diaphragm
4.1.2. Thoracic Inlet/Outlet
4.1.2.1. Thoracic Inlet
4.1.2.1.1. First thoracic vertebra
4.1.2.1.2. First rib
4.1.2.1.3. Sternum
4.1.2.2. Thoracic Outlet
4.1.2.2.1. 12th Rib
4.1.2.2.2. Subcostal Margin
4.1.2.2.3. Xiphoid Process
4.1.2.3. Thoracic Outlet Syndrome
4.1.2.3.1. a group of disorders that occur when blood vessels or nerves in the space between your collarbone and your first rib (thoracic outlet) are compressed.
4.1.3. Thoracic Wall
4.1.4. Mediastinum
4.1.4.1. space betwen lungs that serves as the chest cavity
4.1.4.2. contains the following:
4.1.4.2.1. Heart and its Vessels
4.1.4.2.2. Esophagus
4.1.4.2.3. Phrenic Nerves
4.1.4.2.4. Cardiac Nerves
4.1.4.2.5. Thoracic Duct
4.1.4.2.6. Thymus
4.1.4.2.7. Lymph Nodes of the Central Chest
4.1.4.3. Superior
4.1.4.3.1. 1st Rib: T4
4.1.4.3.2. Contents
4.1.4.3.3. Mnemonic
4.1.4.4. Inferior
4.1.4.4.1. Anterior
4.1.4.4.2. Middle
4.1.4.4.3. Posterior
4.1.5. Pleura
4.1.5.1. Visceral Pleura
4.1.5.1.1. Passes from each lung to inner surface of chest wall
4.1.5.2. Parietal Pleura
4.1.5.2.1. Inside the wall na sha
4.1.5.3. Pleural Cavity
4.1.5.3.1. Formed between the layers of lungs and thoracic walls (2)
4.1.6. Joints, Bones, & Cartilages
4.1.6.1. Sternum
4.1.6.1.1. Manubrium
4.1.6.1.2. Body
4.1.6.1.3. Xiphoid Process
4.1.6.2. Ribs
4.1.6.2.1. By Relationship to Sternum
4.1.6.2.2. By Features
4.1.6.2.3. By Articulation
4.1.6.3. Costal Cartilage
4.1.6.3.1. Mo connect sa ribs to the sternum
4.1.6.3.2. 1 - 7 connect to sternum
4.1.6.3.3. 8 - 10 connect to 7
4.1.6.3.4. mo calcify the older you get so less movement
4.1.6.4. Joints
4.1.6.4.1. Cartilagenous Joints
4.1.6.5. Movements of the Ribs and Cartilages
4.1.6.5.1. Pump Handle Movement
4.1.6.5.2. Bucket Handle Movement
4.1.7. Intercostal Spaces
4.1.7.1. 3 Muscles of Respiration
4.1.7.1.1. External Intercostals
4.1.7.1.2. Internal Intercostals
4.1.7.1.3. Innermost Intercostal muscles
4.1.7.2. Intercostal Vessels Alignment
4.1.7.2.1. Veins
4.1.7.2.2. Arteries
4.1.7.2.3. Nerves
4.1.7.3. Intercostal Arteries
4.1.7.3.1. Left Ventricle
4.1.7.4. Intercostal Veins
4.1.7.4.1. Right Atrium
4.1.7.5. Intercostal Nerves
4.1.7.5.1. somatic nerves that come from the anterior divisions of the thoracic spinal nerves from T1 - T11
4.1.7.5.2. Posterior rami something ???/
4.1.7.5.3. mo split into anterior and posterior
4.1.8. Endothoracic Fascia
4.1.8.1. thin layer of loose ocnnective
4.1.8.2. seaparte thoracic plerura from abdominal wall
4.1.8.3. Suprapleural Membrane
4.1.8.3.1. dense fascia closes the layers smht
4.1.9. Muscles
4.1.9.1. IONA Gang Table 2.1
4.1.10. Diaphragm
4.1.10.1. Openings of the Diaphragm
4.1.10.1.1. Esophageal Hiatus
4.1.10.1.2. Caval Opening
4.1.10.1.3. Aortic Hiatus
5. Nerves of the Thorax
5.1. Vagus
5.1.1. Left Recurrent Laryngeal
6. Esophagus
6.1. Anatomy
6.1.1. 10 inches
6.1.1.1. 25 cm
6.1.2. above laryngeal part of pharynx opposite the sixth cervical vertebra
6.1.3. passes through diaphragm at T10 to join stomach
6.2. Blood Supply and Lymph Drainage of the Esophagus
6.3. Relations pf Thoracic Part of Esophagus Downward
6.3.1. Anterior
6.3.1.1. trachea
6.3.1.2. left laryngeal nerve
6.3.1.3. bronchus
6.3.1.4. pericardium
6.3.2. Posterior
6.3.2.1. bodies of thoracic vertebra and duct
6.3.2.2. azygos veins
6.3.3. Right Side
6.3.3.1. Mediastinal Pleura
6.3.3.2. Terminal part of azygos vein
6.3.4. Left Side
6.3.4.1. Left subclavian artery
6.3.4.2. aortic arch
6.3.4.3. thoracic duct
6.3.4.4. mediastinal pleura