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Anatomy Exam 2 > Lecture 14 > Flashcards

Lecture 14 Flashcards

1
Q

Structure of the Thoracic Cage

  1. Components
  2. Superior Boundary
  3. Inferior Boundary
A
  1. Twelve thoracic vertebrae, twelve pairs of ribs and their costal cartilages, sternum, intercostal muscles
  2. First thoracic vertebra, first pair of ribs and costal cartilages, manubrium
  3. Twelfth thoracic vertebra, twelfth pair of ribs and costal cartilages, xiphisternal joint; larger of the two openings
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2
Q

Manubrium

A

Articulates with superior aspect of body of sternum at the sternal angle (of Louis); has superior jugular notch, concave surfaces for clavicle, and concave surfaces for first rib

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3
Q

What type of joint is the manubriosternal joint?

A

Symphysis joint; may be ossified in 10% of adults by the age of 30

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4
Q

Body of Sternum

A

Made up of four fused sternebrae; ossification occurs during third trimester; fused into a single bone in young adult

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5
Q

Xiphoid Process

A

Fibrocartilage extension of sternum into abdominal musculature (rectus sheath) and marks level of dermatome 6

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6
Q

Costa

A

Rib bone and its cartilage

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7
Q

Vertebrosternal Ribs

A

Ribs 1-7

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8
Q

Vertebrochondral Ribs

A

Ribs 8-10

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9
Q

Vertebral Ribs (Floating)

A

Ribs 11-12

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10
Q

Head of a Rib

A

Two articular facets for articulation with costal demifacets on adjacent thoracic vertebrae; bony crest between facets for attachment to intervertebral disc

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11
Q

Neck of a Rib

A

Narrow portion between head and tubercle

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12
Q

Tubercle

A

Articulates with transverse process of vertebra with same number

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13
Q

Shaft

A

Sternal extremity, angle, costal groove contains superior to inferior (intercostal vein, intercostal artery, intercostal nerve); takes a downward slope

Costal cartilage takes an upward slope

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14
Q

First Rib

A

Important because of its relation to nerves of brachial plexus and subclavian vessels; flattened in a horizontal (transverse) plane

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15
Q

Scalene Tubercle

A

For insertion of scalenus anterior muscle on first rib

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16
Q

Where is the shallow groove for the subclavian vein?

A

Anterior to tubercle

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17
Q

Where is the shallow groove for the subclavian artery?

A

Posterior to tubercle

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18
Q

Thoracic Vertebra

A

Heart shaped centrum (body); centrum notched on left side for descending aorta; intervertebral discs makes up 1/4 of the total length of the thoracic vertebral region; has superior and inferior costal demifacets (usually on T2-9), vertebra prominens on C7 (first spinous process to be palpated)

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19
Q

Which spinous process is the most prominent?

A

T1

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20
Q

Which vertebra are atypical and why?

A

T1: Has a superior costal facet (not a demifacet)
T10: One pair of costal facets located partly on body and partly on pedicle
T11-12: One pair of costal facets located on pedicles

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21
Q

Sternal Angle

A

Marks rib 2 and lies at the level of T4-5 IV disc

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22
Q

Apex Heart Beat

A

Fifth intercostal space along midclavicular line about 8.5 cm from the adult midline

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23
Q

Aortic Valve Heart Sound

A

Can be heard at the second intercostal space on the right side of the sternum

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24
Q

Pulmonary Valve Heart Sound

A

Can be heard at the second intercostal space along the left side of the sternum

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25
Q

Tricuspid Valve

A

Projected to the fifth intercostal space on the right side of the sternum

26
Q

Bicuspid Valve Heart Sound

A

Projected to the fifth intercostal space about 10 cm to the left of the sternal midline

27
Q

Bifurcation of the Trachea

A

Between sternal angle and T4/5 vertebral level

28
Q

Scapula Landmark

A

Scapular spine is at level of 3rd rib and T2 vertebra; inferior scapular angle is at the level of the 7th rib, the spine of T7 or the body of T9

29
Q

Costal Margin

A

Superior part is marked by the 7th cartilage and inferior part is marked by the 10th cartilage

30
Q

Infrasternal Angle

A

Important in CPR; depression between is the infrasternal fossa; xiphisternal joint within the fossa is at the level of the body of T9

31
Q

Scapular Line

A

Vertical line running through the inferior angle of the scapula

32
Q

Anterior Axillary Line

A

Projects downward from anterior axillary fold; formed by lower border of pectoralis major

33
Q

Posterior Axillary Line

A

Projects downward from posterior axillary fold; formed by tendon of latissimus dorsi muscle

34
Q

Which spinal cord levels innervate the clavicular and scapular regions of upper thorax?

A

C3-4

35
Q

Which spinal cord levels innervate the upper thorax?

A

T1-5

36
Q

Which spinal cord level innervates the xiphoid process region?

A

T6

37
Q

Which spinal cord levels innervate the lower parts of the thorax and lateral/anterior abdominal wall?

A

T7-12

38
Q

Where does the pectoral region get its arterial supply from?

A

Axillary artery and its branches

39
Q

External Intercostals

A

Extend from vertebrae posteriorly to junction of ribs and intercostal cartilages; deep fascia continues to the sternum and forms the external intercostal membrane; fiber direction is inferiorly and anteriorly

40
Q

Internal Intercostals

A

Begin at lateral edge of sternum and extend toward vertebral column; deep fascia extends to vertebrae as internal intercostal membrane; fibers direction is inferiorly and posteriorly

41
Q

Innermost Intercostals

A

Incomplete layers with fibers arranged in a more horizontal direction

42
Q

Transversus Thoracis

A

Four or five slips that originate from the inferior sternum and extend superolaterally to internal surface of upper ribs

43
Q

Posterior Intercostal Arteries

A

1-2 arise from the costocervical trunk; 3-12 are segmental branches from the descending aorta; posterior intercostal arteries give off lateral cutaneous branches

44
Q

Anterior Intercostal Arteries

A

Branches of the internal thoracic (mammary) arteries; also give off anterior cutaneous branches

45
Q

Intercostal Nerve

A

Each is derived from the ventral ramus of a spinal nerve; 12 pairs; most of the first intercostal nerve joins the brachial plexus and has no anterior cutaneous branch; lateral cutaneous branch of the second intercostal nerve supplies the floor of the axilla; lateral cutaneous branch of the subcostal nerve supplies the skin over gluteal region

46
Q

Location of the Breast

A

Extends from 2-3 rib superiorly to 6-7 costal cartilage inferiorly; extends from lateral border of sternum to beyond the anterior axillary fold; rests on pectoral fascia above pectoralis major

47
Q

Retromammary Space

A

Potential space between breast and pectoral fascia

48
Q

Sinus Mammarumis

A

Space between the two glands; innervated by intercostal nerves (4-6)

49
Q

Mammary Gland Attachment and Structure

A

Attaches to dermis of overlying skin via suspensory ligaments (Cooper’s Ligaments); 15-20 lobes separated by fibrous septae; 15-20 lactiferous ducts (1/lobe) converge on nipple, which is surrounded by pigmented areola

50
Q

Lactiferus Sinus

A

A dilation at the end of each as it enters the nipple

51
Q

Fibrous Tela Subcutanea

A

Connective tissue layer surrounding the entire gland

52
Q

Fatty Tela Subcutanea

A

Adipose tissue deep to fibrous layer

53
Q

Suspensory Ligament of Cooper

A

Bundles of collagen fibers in dermis and hypodermis

54
Q

Where do the anterior perforating arteries come from and go to?

A

From internal thoracic artery to medial part of mammary gland

55
Q

Where do the medial mammary rami come from and go to?

A

From 2nd-4th anterior perforating arteries to the deep medial part of the gland

56
Q

Where does the lateral mammary artery come from and go to?

A

From the lateral thoracic artery to the inferior part of the gland

57
Q

Where does the lateral mammary rami come from and go to?

A

From lateral cutaneous branches of intercostal arteries to the lateral part of the gland

58
Q

Where does the blood in the breast drain to?

A

Mainly axillary vein via lateral thoracic veins and medial mammary veins; some drainage to internal thoracic vein via anterior intercostal veins

59
Q

Why is lymphatic drainage of breast tissue important?

A

Plays a role in metastasis of cancer cells

60
Q

What is the path of lymphatic drainage?

A

Perilobular and interlobular lymphatic vessels into the subareolar plexus into the lateral lymphatic trunk (from lateral and superior gland) and the medial lymphatic trunk (from medial and inferior gland) into the pectoral group of axillary lymph nodes into the subclavian lymphatic channels

61
Q

What is the innervation of the breast tissue?

A

Lateral mammary nerve (T2-6); anterior branches of lateral cutaneous branches of intercostal nerves; medial mammary nerve (T2-6); lateral branches of anterior cutaneous branches of intercostal nerves; also supraclavicular nerves

Anatomy Exam 2 (8 decks)

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