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CP Exam I > Thoracic Wall and Cavities > Flashcards

Thoracic Wall and Cavities Flashcards

1
Q

How many pairs of costae are there?

A

12

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2
Q

What are the 3 types of ribs and which ribs are categorized in each type?

A

True ribs = 1-7

False ribs = 8-10

Floating ribs = 11-12

[rib types are classified based on their attachments to the sternum - aka their sternocostal joints]

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3
Q

Describe the sternocostal joints associated with true ribs

A

True ribs costal cartilages are attached directly to the sternum

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4
Q

Describe the sternocostal joints associated with false ribs

A

Costal cartilages of false ribs are attached indirectly to the sternum

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5
Q

Describe attachments of floating ribs

A

No direct attachment to the sternum

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6
Q

What type of joints are costovertebral joints?

A

Synovial plane joints

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7
Q

Describe costovertebral joints in terms of what 3 things the head of a typical rib articulates with

A

Head of a typical rib articulates with:

Superior costal facet of corresponding vertebra

Inferior costal facet of vertebra superior to it

Adjacent intervertebral disc uniting the two vertebrae

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8
Q

What type of joint is a costotransverse joint?

A

Synovial plane joint

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9
Q

What are the components of a costotransverse joint?

A

Tubercle of rib articulates with the transverse process of corresponding vertebrae

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10
Q

What type of movement occurs at a costotransverse joint?

A

Rotational movement of ribs 1-7 and gliding movement of ribs 8-10

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11
Q

Rotational movement of ribs 1-7 and gliding movement of ribs 8-10 occur via costotransverse joints. What overall movements of the rib cage are allowed by these joints during forced inspiration vs. forced expiration?

A

Elevation of ribs during forced inspiration

Depression of ribs during forced expiration

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12
Q

What are the 3 overall components of the sternum?

A

Manubrium
Body
Xiphoid process

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13
Q

What 4 things does the manubrium articulate with?

A

Clavicles (via SC joints)

1st pair of ribs

2nd pair of ribs at sternal angle

Body of sternum at sternal angle

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14
Q

The body of the sternum is composed of _____ fused _________

A

4; sternebrae

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15
Q

What 3 things does the body of the sternum articulate with?

A

Manubrium (via manubriosternal joint)

Costal cartilages 2-7

Xiphoid process

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16
Q

What movement occurs at the manubriosternal joint? What does this movement allow?

A

Hinge-like movement of body anteriorly and posteriorly - facilitates increased inspiration via thoracic cavity expansion

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17
Q

What joint connects the xiphoid process to the body of the sternum?

A

Xiphisternal joint

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18
Q

At what spinal level would you find the xiphisternal joint?

A

T8

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19
Q

What is the difference in sternum characteristics between males and females?

A

The angle between the manubrium and sternal body is larger in males - so they can have broader chest cavities and thus larger hearts and lungs

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20
Q

What are the 3 groups of intercostal muscles?

A

Exernal intercostals

Internal intercostals

Innermost intercostals

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21
Q

Of the intercostal muscles, which is the most superficial layers?

A

External intercostals

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22
Q

What is the orientation of the external intercostal muscle fibers, and what action does this lead to?

A

Fibers oriented inferomedially

Elevation of ribs

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23
Q

What are the attachments of the external intercostal muscles?

A

Extends from the tubercles of ribs to junction of costal cartilages with the bony ribs

External intercostal membrane passes from anterior margin to lateral sternal border

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24
Q

The internal intercostals are the middle layer of intercostal muscles. What are the attachments?

A

Extend from sternum to the mid-axillary line

Internal intercostal membrane passes from the lateral margin to the region of vertebral column to fuse with the superior costotransverse ligaments

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25
Q

What direction are the fibers of the internal intercostal muscles oriented? What action does this allow?

A

Fibers are oriented inferolaterally

Action: depression of ribs

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26
Q

The deepest layer of intercostal muscles are the innermost intercostals. What are their attachments?

A

Extend from angles of ribs to just anterior of mid-axillary line

Innermost intercostal membrane passes from anterior border to the lateral border of the transversus thoracis m.

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27
Q

What direction are the fibers of the innermost intercostals oriented? What action does this allow?

A

Fibers are oriented inferolaterally

Action: depression of ribs

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28
Q

What muscle associated with respiration is not associated with the intercostal muscles?

A

Transversus thoracis m.

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29
Q

What are the attachmens of the transversus thoracis m.?

A

Extends from posterior surface of lower half of body of sternum and xiphoid process to costochondral junction of ribs 3-6

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30
Q

What is the action of transversus thoracis m.?

A

Depression of ribs

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31
Q

What provides innervation to the intercostal muscles?

A

Intercostal nerves = ventral primary rami of T1-T11

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32
Q

What do the motor branches of the ventral primary rami of T1-T11 innervate?

A

Intercostal muscles and transversus thoracis m.

33
Q

What do the cutaneous branches of the ventral primary rami of T1-T11 innervate?

A

Sensory innervation to lateral and anterior surfaces of thorax

34
Q

Which intercostal nerves have branches that continue into the abdominal wall to provide motor and cutaneous innervation to the muscles and skin in that region?

A

Intercostal nerves T7-T11

35
Q

T/F: parietal and visceral pleura have both sensory and motor innervation

A

False; they have sensory innervation only! No motor fibers associated with the pleura

36
Q

What major arteries supply blood to the thorax?

A 
Posterior intercostal aa.
Superior thoracic aa.
Supreme intercostal aa.
Anterior intercostal aa.
Musculophrenic a.
37
Q

The posterior intercostal arteries are branches off of what?

A

Descending aorta

38
Q

Where are the posterior intercostal arteries located?

A

Between 2 deepest layers of intercostal muscles in intercostal spaces 3-11

39
Q

What do the posterior intercostal arteries supply?

A

Muscular branches supply intercostal, pectoral, and serratus anterior mm.

Also supplies breasts in females via intercostal spaces 3-5

40
Q

The supreme thoracic arteries are branches off what artery? What do they supply?

A

Branches of axillary a.

Supplies intercostal spaces 1-2

41
Q

What do the supreme intercostal arteries branch from? What do they supply?

A

Branches of costocervical trunk

Supply intercostal spaces 1-2

42
Q

The anterior intercostal arteries are branches of what artery?

A

Internal thoracic a.

43
Q

Where are anterior intercostal arteries found and what do they supply?

A

Found in intercostal spaces 1-6

Supply skin, intercostal mm., breasts, and thymus gland (anterior mediastinum)

44
Q

What artery exists as the terminal branch of the internal thoracic a.?

A

Musculophrenic a.

45
Q

What does the musculophrenic a. supply?

A

Supplies anterior intercostal arteries to intercostal spaces 7-9

46
Q

What apertures are associated with the thoracic cavity?

A

Superior thoracic aperture

Inferior thoracic aperture

47
Q

What are the boundaries of the superior thoracic aperture (posterior, lateral, and anterior)?

A

Posterior = body of 1st thoracic vertebrae

Lateral = 1st pair of costae

Anterior = manubrium

48
Q

What are the boundaries of the inferior thoracic aperture (posterior, lateral, and anterior)?

A

Posterior = body of 12th thoracic vertebra

Lateral = 11th and 12th costae

Anterior = xiphoid process and costal cartilages 7-10

49
Q

What separates the thorax from the abdomen, thus closing off the inferior thoracic aperture?

A

Respiratory diaphragm

50
Q

The dome of the diaphragm rises to what levels on each side of the body? What purpose does it serve in terms of thoracic and abdominal viscera?

A

Right = rises to level of 5th intercostal space

Left = rises to level of 6th intercostal space

Provides protection to thoracic and some abdominal viscera

51
Q

The right and left pleural cavities are separated by a 3D space called the _______

A

Mediastinum

52
Q

Which division of pleura lines the pleural cavity?

A

Parietal pleura

53
Q

What are the pleural surfaces associated with the parietal pleura?

A

Costal pleura
Mediastinal pleura
Diaphragmatic pleura
Cervical pleura

54
Q

Which of the following is attached to ribs and intercostal spaces?

A. Cervical pleura
B. Mediastinal pleura
C. Costal pleura
D. Diaphragmatic pleura

A

C. Costal pleura

55
Q

At which region of parietal pleura does it become continuous with the visceral pleura?

A

Mediastinal pleura (adheres to mediastinum)

56
Q

Which pleural surface adheres to the superior surface of the respiratory diaphragm?

A

Diaphragmatic pleura

57
Q

Which of the following lines the pleural cavity above the 1st ribs, in the root of the neck?

A. Cervical pleura
B. Mediastinal pleura
C. Costal pleura
D. Diaphragmatic pleura

A

A. Cervical pleura

58
Q

Which is more sensitive in terms of pain, temperature, touch, and pressure - parietal or visceral pleura?

A

Parietal pleura

59
Q

What are the 2 sources for sensory innervation to the parietal pleura?

A

Intercostal nerves T1-T11

Phrenic nerves

60
Q

Sensory innervation of the parietal pleura is provided by intercostal nerves T1-T11 and the phrenic nerves.

What do the intercostal nerves T1-T11 supply fibers for specifically?

A

Pain and irritation to costal pleura in addition to supplying the periphery of the respiratory diaphragm

61
Q

Sensory innervation of the parietal pleura is provided by intercostal nerves T1-T11 and the phrenic nerves.

What do the phrenic nerves supply fibers for specifically?

A

Pain and irritation to mediastinal pleura and diaphragmatic pleura

62
Q

What concept refers to pleura extending to specific parts of the thoracic cavity (aka boundaries of the pleura)?

A

Lines of reflection

63
Q

Which extends further, the parietal pleural layers or the visceral pleural layers?

A

Parietal pleural layers - so lines of reflection are not fully symmetrical

64
Q

Where does the vertebral line of reflection occur?

A

Where costal and mediastinal pleura become continous posteriorly

65
Q

Where does the sternal line of reflection occur?

A

Where costal and mediastinal pleura become continuous anteriorly

66
Q

Where does the costal line of reflection occur?

A

Where the costal and diaphragmatic pleurae become continuous inferiorly

67
Q

________ ________ occur where 2 layers of parietal pleura form an acute angle and are in direct contact with each other in the living person

A

Pleural recesses

68
Q

What are the 3 major pleural recesses?

A

Right costodiaphragmatic recess

Left costodiaphragmatic recess

Left costomediastinal recess

69
Q

During normal, quiet inspiration, the lungs do not fully occupy the thoracic cavity. This means that there is a space between visceral and parietal layers in the inferolateral corners of each side of the thoracic cavity. What is this space called?

A

Costodiaphragmatic recess (can be divided into right and left)

70
Q

The right and left costodiaphragmatic recesses are located laterally along the _______ reflection

A

Costal

71
Q

What pleural recess is located anteriorly along the sternal reflection and lies close to the cardiac notch?

A

Left costomediastinal recess

72
Q

T/F: the lungs normally occupy the pleural recesses

A

False - they do not normally occupy these recesses

73
Q

What may occur within the pleural recesses with certain respiratory infections?

A

Pus, fluid, or dead cells may collect in the recesses and be visible on a radiograph

74
Q

_______ ______ covers the surfaces of the lungs and acts as a connecting layer; surrounding the roots of lungs like a sleeve, covering structures passing into the lungs like bronchi, pulmonary vessels, nerves, and lymphatics

A

Visceral pleura

75
Q

_______ ______ = potential spaces between parietal and visceral pleura

A

Pleural cavities

76
Q

What is contained in the pleural cavities and what purpose does this serve?

A

Pleural cavities contain pleural fluid produced by the pleural membranes - this fluid lubricates the surfaces of the pleural membranes and prevents adhesions

77
Q

In which of the following would you find the lungs?

A. Pleural cavities
B. Pleural recesses
C. Pleural reflections
D. Pleural sacs

A

D. Pleural sacs

78
Q

What is defined as the space contained within the visceral pleura?

A

Pleural sacs - THIS IS WHERE THE LUNGS ARE FOUND

79
Q

A fracture at the head of the 6th rib would affect what costal facets of what vertebrae?

A

Superior costal facet of T6

Inferior costal facet of T5

CP Exam I (18 decks)

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