17 Thoracic Wall Flashcards
(27 cards)
Thoracic inlet boundaries?
clavicle, sternum, first ribs, vertebral column
Thoracic outlet boundaries?
inferior - diaphragm
posterior - 12th thoracic ertebra
lateral - 10th,11th,12th ribs
anterior - costal cartilages of rib7-10, junctionbetween the body and xiphoid process of sternum
Sternal angle (angle of Louis)
where manubrium joins the body of sternum
palpable both by yourself or on others
If rib notching, how is it related to defect of thoraic aorta?
it means there is an obstruction of the aorta. blood is pushed through intercostal arteries and as these arteries expand, overlying bones are erode.
Relationship of transversus thoracis and intercostal muscles?
transverse thoracis is in same plane as innermost intercostals but located posterior to the sternum. It helps anchors internal thoracic vessels in place.
Blood supply of thoracic wall
Posterior intercostal a. - from thoracic aorta, supply lower 9 intercostal spaces
Anterior intercostal a. - supply intercostal musccles and skin, anastomoses with internal thoracic a / musculophrenic a.
Superior intercostal a. - branch off axillary a., supply upper 2 intercostal spaces
Nerve supply of thoracic wall
Intercostal nerve
intervertebral foramen -> posterior primary ramus -> para spinal region (muscles skin)
intervertebral foramen -> anterior primary ramus -> chest wall between internal intercostal, innermost intercostal
Why patient get back pain after open heart surgery?
because they sternum is split surgically to access medistinum and these ribs articulate with vertebrae and you split them apart so you compromise their integrity.
Inferior extent of lung
Front 6
side 8
back 10
inferior extent of pleural cavity
front 8
side 10
back 12
Pleural cavity
between visceral and parietal layer of lung.
No air or blood
little amount of lubricants
costdodiaphragmatic recess?
lowest point of thorax, if it is not pointed, round (meniscus) then its abnormal.
What is in peritoneal cavity?
no organs, secret fluid
lobes in right lung?
superior,middle inferior
oblique fissure, horizontal
lobes in left lung?
superior, inferior
oblique fissure
lungs on radiograph?
?
Hilum of each lung?
Artery
Bronchi
Vein
what nerve supply is associated with hilum of each lung? why is it important?
?
Diaphragm components
Right vault - higher because of underlying liver
LEft vault - lower
peripheral - muscular
central - membraneous, tendinous.
Attachment site of diaphragm?
?
Blood supply of diaphragm?
musculophrenic - superior surface
percardiophrenic - supreior
inferior phrenic - inferior surface
What structure pass through or posterior to diaphragm?
esophagus
inferior venacava
aorta
Nerve supply of diaphragm?
phrenic n. - motor, sensory to central tendon (Create hiccup if irritated)
intercostal n. - sensory to periphery
Nerve supply for lung
Pulomnary plexus
