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315 - anatomy > lecture 6: thoracic wall > Flashcards

lecture 6: thoracic wall Flashcards

1
Q

what is the thoracic cage

A

osteocartilagenous structure that encloses the thorax and thoracic viscera

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2
Q

give some examples of thoracic viscrea

A

heart, lungs, esophagus etc

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3
Q

what is tthe rib cage bounded by

A

by the thoracic vertebrae, ribs and sternum

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4
Q

what is the rib cage walled off by

A

muscles and conneective tissue with a few key passageways

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5
Q

how many ribs are thre

A

12

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6
Q

what are the 2 openings of the rib cage

A

=superior thoracic aperature (thoracic inlet)
=inferior thoracic aperature (thoracic outlet)

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7
Q

which is larger the superior or inferior tthoracic aperature

A

the inferior

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8
Q

what are the true ribs

A

1-7

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9
Q

why are ribs 1-7 considered true ribs

A

direct insertion to the stternum via the costal cartilage

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10
Q

what are the false ribs

A

8-10

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11
Q

why are ribs 8-10 considered false ribs

A

they have an indirect insertion on sternum via costal margin (with the rib above them)

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12
Q

what are the floating ribs

A

11-12

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13
Q

why are ribs 11-12 called floating ribs

A

no insertion on the sternum att al l

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14
Q

what is it the costal margin

A

The costal margin is the medial margin formed by the cartilages of the seventh to tenth ribs

-anterior side of tthe thoracic outlet

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15
Q

what are the importtant features of a typical rib

A

head, tubercle, neck, costal angle, costal groove, body of the ribs, costal carttlage

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16
Q

do the tubercle and costal groove lie inferior or superior

A

inferior

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17
Q

where is the neck of the rib loacted

A

betweemn the head and the tubrecle

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18
Q

what are the 3 articulations of the rib

A

1) hed of the rib (posterior, veertt)
2) tubercle of the rub (posterior, vert)
3) costal cartilage (anterior, sternum)

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19
Q

is the articulation of the head of the rib located posterior or anterior

A

posterior

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20
Q

is the articulation of the tuebrcle of the rib located posterior or anterior

A

posterior

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21
Q

is the articulation of the costal cartilage of the rib located posterior or anterior

A

anterior

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22
Q

where dos the head of the rib articulate

A

with the body of the vert (on the demi facets)

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23
Q

where dos the ttubercle of the rib articulate

A

on the veertebra (specifcally on the costal facet on thte transverse process)

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24
Q

whatt are the facets on the vertebral body of the thoracic vert called

A

demi facets

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25
Q

whatt are the facets on the transverse process of the thoracic vert called

A

costal facet

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26
Q

how many joint facets are unique to the thoracic vert

A

3 joint facets

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27
Q

true or false: the ribs associate with the vert of the same nmber

A

ttrue

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28
Q

where is the costotransverse joint located

A

betwen the rib and the transverse process

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29
Q

explaiin the articulation of the costotransverse joint

A

rib at TP
=tubercle of the rib articulates with the costal facet on the TP of the same numbered vertebra

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30
Q

truue or false: tubercle of the rib articulates with the costal facet on the TP of the vertebra above

A

false, of the same numbereed vertebra

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31
Q

explain thee articulation at the costovertbereal joint

A

rib at VB
= head of the tubercle articulatese with 2 demi facets:
1) the VB of the same numbered vert and 2) the inferior demi facet of the VB above

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32
Q

what are the posterior joints of the thoracic cage

A

costotranverse jointt
costcovertebral joint

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33
Q

true or false: rib 7 only acticulates with T7 (

A

false, also the inferior demi facet of t6

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34
Q

which rib is condered short flat and horizontally oriented

A

rib 1

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35
Q

what is special about the grooves on rib 1

A

anterior and psoterior grooves for subclavian vein and artery

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36
Q

what is the articulation of the costovertberal joint of rib 1

A

articulates with VB of its own level only.

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37
Q

what is the articulation of the costovertberal joint of ribs 10,11,12

A

the costovert joint articulatest with VB of own level only (no inferior facetts on t10,t11,t12)

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38
Q

true or false: ribs 1,10,11,12 only articulate with VB of own level only

A

yes

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39
Q

what is the missing physical feature of ribs 11,12

A

no tubercles or neck

40
Q

which ribs are shorter than normal

A

floating (11,12)

41
Q

whatt are tthe physical features of the sternum

A

jugular notch
manubirum
sternal angle/manubriosternal jointt
body of the sternum
xiphisternal joint
xiphoid process

42
Q

what level is the sternal angle/manubriosternal jt

A

at tthe level of t4-t5

43
Q

what level is the xiphisetrnal jt

A

level of T9

44
Q

what are the anterior joints of the rib cage

A

1) costochondral
2) sternocostal
3) interchondral

45
Q

what typee of joint is the costochondral joint

A

solid, synchondrosis

46
Q

what typee of joint is the sternocostal joint

A

synovial, plane/gliding
(exception: 1st rib-synchondrosis)

47
Q

what is the only rib that has an exception in terms of the sternocostal jt

A

1st rib is syncondhrosis

48
Q

where is the interchodnral joints loxated

A

between costal cartilageese of false ribs (8-10)

49
Q

what ttype of joints are interchondral

A

uniquely synovial

50
Q

what are the 2 movements of the thoracic cage for respiration

A

pump handle movement
bucket handle movement

51
Q

explain the pump handle movement

A

volume of the thoracic cavity changes in an anteerior to posterior axis

52
Q

in the pump handle movement, where are there smaller movements and why

A

three are smallre movements superiorly (because of solid synchondrosis joints) and larger movement inferiorly

53
Q

where does the movement of tthe pump handle movement come from

A

costotransverse/vertebral of ribs 1-6

54
Q

explain the bucket handle movementt

A

laeteral (side to side) changes in thoracic cavity voke

55
Q

what joints are responsible for the bucket handle movement

A

costotransverse, costcovert and sterno costal joints for rib 6-12

56
Q

what muscle is responsible for forcee inspiration

A

extternal inteercostal muscles

57
Q

be able to know thee diffeerence in muscle oritenttaiton between exetrnal and internal interncsotals

A

l

58
Q

what is the fiber oritentation of the external intercostals

A

from orgin to isnertion (anterior and inferior)

59
Q

what is the function of external intercostal muscles

A

elevates ribs.
forceful inspiration

60
Q

what muscles are responsible for forces expiration

A

internal intercosttal
innermost intercostals
transversus thorasis

61
Q

what is thee fiber orientation for intternal intercostals

A

from oirgin to insertion, posterior to infeerio

62
Q

what is the function of the internal intercosatl muscles

A

depresses ribs
forceful expiration

63
Q

what is the fiber direction for innermost intercostal muscles

A

psoterior, inferior (like internal intercostals)

64
Q

what is the functino of the innermost intercostaks

A

depresses ribs
forceful expiration

65
Q

where is tthe transversus thoracis located

A

sternum body and xiphoid process to ribs 2-6

66
Q

what is the function of transversus throracic

A

depresses ribs, froceful expiration

67
Q

how many intercondral joints are there

A

betwteen 3 and 4

68
Q

does the neurovasculature for thee thoracic wall come from anterior or postterior rami

A

anterior

69
Q

what are the main nerves that innervate the tnoracic wall

A

Intercostal n (t1-t11) and subcostal n (t12)
=anterior rami of thoracic spinal n

70
Q

what is the function of intercostal and subcostal nerves

A

motor/sensory

71
Q

what are some of the nerves tah branch off the intercostals

A

lateral cutaneous neve and anterior cutaneous

72
Q

what is lateral and anterior cutaneuous nerve responsible for

A

somattic sensory

73
Q

wwhat is a dermatone

A

area/region of the skin innerevated by a single spinal nerve

74
Q

what is the dermatome area for t4

A

nipple

75
Q

what is the dermatome area for t6

A

skin over xiphoid process

76
Q

what is the dermatome area for t10

A

umbilicus

77
Q

what is the nerve responsible for nipple dermatome

A

t4

78
Q

what is the nerve responsible for skin over xiphoid dermatome

A

t6

79
Q

what is the nerve responsible for umbilicus dermatome

A

t10

80
Q

what si the clinical signigicance of thoracic dermatomes

A

youu can have pathology associated to 1 nerve root
ex: shnigles

81
Q

explain shingles

A

lies dorman in spinal nerve
=affected is spinal cord level tt5 since its right below the nipple which is t4

82
Q

what is the blood supply for the thoracic wakk

A

thoracic aorta
posttrior intercostals
anterior intersoclsa
internal thoracic

83
Q

what two veins form an anastomosis in the thoracic wall

A

the posterior and anterior intercostatls

84
Q

where do the posterior intercostatls branch off

A

thoracic aorta

85
Q

wheree do the anterior intervostals branch off from

A

the internal thoracic (which is off the subclavian)

86
Q

true or false: the anterior and psoterior drainage of the thoracic wall is the same

A

false, the anterior side is paired with the blood but the posterior side is diff

87
Q

what is an anastomosis

A

joining of arterial supply in opp. direction

88
Q

what is the neurovascular bundle under the costal groove

A

intercosttal nerve, artery and vein

89
Q

what is the order of the vessels under the costal grove (sup to inferior)

A

intercostal vein, arterey nerve
VAN

90
Q

between what muscles is the intercostal nerve

A

betweeen innermost and intercostals

91
Q

what is the clinical significanc eof the neurovasculature bundle

A

where to insert a chest tube

92
Q

why is the left domee of the diaphram lower

A

because of the heart

93
Q

what is the diapgram involved in

A

normal resting breathing

94
Q

what level is the diaphragm located during resp

A

att rib 5

95
Q

true or false: thoracic cavity volume chanes in an inferior to superior axis

A

no , opposite

96
Q

what is the innervation of the diaphragm

A

phrenic nerve (anterior rami of spinal nerves c3-c5

97
Q

truee or false: the sphenic splits to leeft and right

A

true

315 - anatomy (25 decks)

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