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Flashcards in Chapter 1 - Introduction Deck (14)
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1

Boundaries of thoracic cage

Anteriorly: Sternum
Posteriorly: Thoracic vertebrae
Each side: 12 ribs

2

Describe the thoracic cage in children

-In children, the chest wall is highly elastic.
-Fractures are therefore rare.
-Fractures occur mostly due to violence.
-Weakest point is at the angle.
-Upper two ribs are protected by clavicle and floating ribs are least commonly injured.

3

Hiccups

-Due to spasmodic contractions of diaphragm accompanied by closed glottis.
-Stimulated by gastric irritation.
-May also be due to phrenic nerve irritation, uraemia or hysteria.

4

Boundaries of inlet of thorax

Anteriorly: Manubrium sterni
Posteriorly: Body of T1
Each side: 1st rib

The plane of the inlet is directed forwards and downwards at an angle of 45.

5

Sibson's fascia

1.suprapleural membrane
2.Partially separates thorax from neck
3.Triangular
4.Apex: transverse process of C7
5.Base: inner border of 1st rib.
6.Flattened tendon of scalenus minimus
7.Inferior surface: Fused to cervical pleura
8.Superior surface: related to subclavian vessels
9.Provides rigidity to thoracic inlet so that root of neck is not puffed during respiration.

6

Structures passing through thoracic inlet

1. Oesophagus
2. Trachea
3. Brachiocephalic A
4. Left common carotid and left subclavian A
5. RL brachiocephalic V
6. Internal thoracic A
7. Superior intercoastal A
8. Posterior intercoastal V
9. Inferior thyroid V
10. Phrenic N
11. Vagus N
12. Sympathetic trunk
!3. Sternothyroid, Sternohyoid, Longus colli

7

Boundaries of outlet of thorax

Anteriorly: Infrasternal angle between coastal margins
Posteriorly: T12
Sides: Cartilages of 7th-12th ribs

8

3 large openings in diaphragm

1. Vena caval
2. Oesophageal
3. Aortic

9

Vena caval opening

-T8
-Quadrilateral
1. Inferior vena cava
2. Right phrenic nerve
3. Lymphatic of liver

10

Oesophageal opening

-T10
-Elliptical
1. Oesophagus
2. Vagal trunks
3. Left gastric vessels

11

Aortic opening

-T12
-Rounded
1. Aorta
2. Thoracic duct
3. Azygos vein

12

Small openings of diaphragm

1. Superior gastric A through space of Larrey
2. Musculophrenic A
3. Greater and lesser splanchnic N
4. Left phrenic N pierces left cupola

13

space of Larrey

Between slip of xiphoid process and 7th coastal cartilage slip of diaphragm

14

Thoracic inlet syndrome

-Subclavian artery and 1st thoracic N pass over first rib
-They may be pulled or pressed by cervical rib or by scalenus anterior
-Vascular/Neural symptoms or both