Flashcards in Sievert Chest Deck (56):
What is the plane that cut the body into left and right?
Top and bottom?
Front and back?
2) Axial (transverse)
What axis would we have to move around in order to facilitate movement of the upper limb in the coronal plane?
The sagittal plane?
The axial plane?
1) AP axis
What are the 3 types of joints?
1) synovial (most common)
In synovial joints, opposing surfaces of adjacent bones are lined with (blank).
Examples of Fibrous joints...
Sutures or the interosseus membrane
Examples of Cartilaginous joints
epiphyseal plates where they permit growth in length of long bones or intervertebral discs where fibrocartilage provides shock absorption and strength.
Most common thing you will encounter is (blank).
Layers of superficial skin are
Epidermis, dermis, superficial fascia, deep fascia, skeletal muscle
Connection btn dermis and investing fascia
Differing amounts of strength ie hand, eye lid vs. palm of hand
What entities are found in the Superficial Fascia?
Blood vessels, small nerve fibers, receptors found here
comprised mostly of fat
Contains glandular portion of sweat glands and base of hair follicles.
Ligaments in the superficial fascia binds the (Blank) to underlying (Blank).
1) skin (dermis and epidermis)
2) deep fascia (retinacula cutis).
Dense (investing) fascia is comprised of (blank) and connected to the dermis by (blank).
1) Dense irregular connective tissue
2) attached to the skin by the ligaments in the superficial fascia (retinacula cutis)
Deep fascia is sandwiched between what 2 layers?
1) Skeletal muscle
2) superficial fascia
Bind to bone (periosteum)
The deep fascia creates (blank) to prevent the spread of infection or disease.
Create compartments that envelope groups of muscles
Diaphragm completely separates the (blank) from the (Blank) and is significantly domed superiorly.
thoracic cavity from the abdominal cavity
Rib cage opens...
1) Thoracic outlet above 1st rib (Superior thoracic aperture)
2) Open inferiorly between 7-12 ribs (Interior thoracic aperture)
Where do they stop and start?
1) External (hands in pockets)
a. Starts posterior and stops anterior
2) Internal (opposite of external)
a. Starts at front but doesn't go all the way to the back
3) Innermost (up and down)
b. Straight up and down
None of these layers go all the way around the torso
Nerve coming out of second intercostal space
Intercostal brachial nerve; contributes to chest wall and medial side of the arm; pain of the upper limb in MI
Three parts of the sternum and the lines separating them are...
Manubrium --> manubrial-sternal junction = Angle of Louie (5th vertebra)
Xiphisternal joint (9th vertebra) ---> Zyphoid process
Space created btn lateral chest wall and diaphragm
costal diaphragmatic recess (Xray)
Where the diaphragm is during respiration...
On exhalation: Diaph can go up to 4th rib
Passive: 5-6 rib
Deep Inhalation will go further (8-10?)
Nipple line is approximately the (blank) rib.
How many pairs of ribs are there?
True? False? Floating?
There are 12 pairs of ribs:
1-7 true ribs
8-10 false ribs
11 and 12 floating ribs
What is the definition of a typical rib?
Typical ribs have a head with 2 articular facets, a neck, a tubercle, an angle (fracture) and a body. Ribs 3-9.
It is the broadest with a more horizontal position, has only one facet on the head, and does not have a synovial joint where its cartilage articulates with the manubrial portion of the sternum. Also, generally not considered to be palpable.
inflammation of where rib attaches to sternum
Transverse costal facet for tubercle
Ribs 2-9 attach to the transverse costal facet of the vertebra with the same number as the rib.
The body of the rib houses...
Body with groove for neuromuscular bundle
Houses intercostal vein/ artery/ nerve ( hangs a little below)
(Blank) lines generally just medial to the nipple
The midaxillary lines run
Through the armpit
A line that runs down the scapula...
Scapular or paravertebral lines
(Blank) growth of cartilage that pushes the sternum backwards. Is surgically repairable.
(Blank) at the junction of the costal cartilage with the sternum. This pain is generally reproducible by pressure on the location.
Breast is always situated between the (Blank) ribs and from the (Blank) border of sternum to (Blank).
1) 2nd and 6th
3) midaxillary line
The breast is separated from the pectoral major's investing fascia by the (blank).
The Retinaculum cutis of the breast is called....
Suspensory ligaments (Cooper’s)
More well defined in breast to support more tissue
What happens to the female breast at puberty?
Before puberty the glandular tissue is undeveloped. At puberty, fat deposition occurs, and lactiferous ducts give rise to 15-20 lobes of glandular tissue which drain through the ducts to the nipple. These lobes further divide into lobules.
What is the small sac called that is located just inside the nipple that stores a droplet of milk in a lactating breast?
Lactiferous sinus which arise from lactiferous ducts
Describe what happens to the breast when a tumor has invaded.
Visualize the tumor; push on ligaments
Dimpling of skin indicates late stage of breast cancer --> mammogram development
Poer de orange
What are the 3 blood supplies for the breast? Which one is used in bypass?
1) lateral thoracic artery
2) posterior intercostal
perforating branches of internal thoracic artery (not sandwiched between intercostal muscles)
Used in Bipass bc other vessels will supply blood
What is the nerve of the breast?
Long thoracic nerve
What are the lymph nodes that supply the breast? Where do they drain to and which ones are sentient?
1)Apical axillary (subclavian) nodes
2)Central axillary nodes
3)Lateral axillary (humeral) nodes (upper arm)
4)Posterior axillary (subscapular) nodes
6) Anterior axillary (pectoral) nodes*
7) Parasternal nodes
8) subphrenic nodes (to liver)
Interpectoral and Anterior axil. Are the sentinel nodes (drain here first then to the central and apical nodes on its way to the junction of the lymphatic duct with the junction of the subclavian and Int. Jugular veins. )
Cancer shows up here first 65-70% of cancer in Upper lateral quad.
Intercostal arteries come off the (Blank) posteriorly under the ribs.
What are the directions lymph can go?
3) Across midline
5) Right to axillary nodes (to lymphatic duct) or left to the thoracic duct
Gynecomastia is swelling of the breast tissue in boys or men, caused by an imbalance of the hormones estrogen and testosterone. Gynecomastia can affect one or both breasts, sometimes unevenly. Newborns, boys going through puberty and older men may develop gynecomastia as a result of normal changes in hormone levels, though other causes also exist.
What ar the nerves and vessels in the Neurovascular bundle that supply the abdomen superficially?
Lateral cutaneous branch of intercostal nerve
and lateral cutaneous branch of posterior intercostal
artery. Come out in very segmental pattern.
Coordinate with vertebrae. Come from the Long thoracic nerve and lateral thoracic artery.
What are the nerves of the pectoral muscle and what's funny about them?
Lateral pectoral nerve and Medial pectoral nerve. Their names come from where they originate from in the Brachial plexus; however, they the lateral looks medial and the medial looks lateral in the pectoral fascia.
The nipple is from which Dermamyotome?
What is the function of the intercostal muscles?
1) Maintain space
2) Close off gaps between ribs
What is the muscle in the back that supports upper limb movement?
Serratus anterior muscle
What is the nerve running down the Serratus anterior muscle?
Long thoracic nerve
What is the blood supply for the Serratus anterior muscle?
The Lateral thoracic artery from the Subclavian artery
Intercostal veins drain to the (blank) system or the internal thoracic
Runs parallel to Vena Cava and vertically along the vertebra.
Where does the neuromuscular bundle sit in the ribs?
The neurovascular bundle lies between the two deepest layers of muscle and sits in a groove on the under side of each rib. Very Important*
Name some accessory respiratory muscles.
pectoralis major and minor, the scalenes, the serratus posterior and serratus anterior and the levator cost arum. Also, abdominal muscles.