Thoracic Wall Flashcards

1
Q

Function of ribcage

A

protect vital organs; needs movement to breathe

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2
Q

Level of suprasternal notch

A

vertebral level T2-T3

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3
Q

Sternal angle (of Louis)

A

Vertebral level T4-T5
Manubriosternal joint
costal cartilage of 2nd rib

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4
Q

Xiphoid process

A

Vertebral level of T9-T10

ossifies at about 40 years of age

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5
Q

Sternum

A

flat bone, levels T5-T9

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6
Q

Root of spine of scapula

A

vertebral level T4, palpate at spine of T3

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7
Q

Inferior angle of scapula

A

vertebral level T8, overlies Rib 7 and points to rib 8

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8
Q

Midclavicular line

A

1/2 way through clavicle

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9
Q

Anterior axillary line

A

vertical line dropped at lateral border of pectoralis major

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10
Q

Mid-axillary line

A

vertical line through middle of axillary fossa, down middle of armpit to illiac crest

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11
Q

Posterior axillary line

A

vertical line dropped at lateral border of latissimus dorsi

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12
Q

Scapular line

A

vertical line through inferior angle of scapula

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13
Q

Midsternal line

A

vertical line cuts body in half down sternum

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14
Q

Thoracic Inlet (Superior thoracic aperture) consists of

A

Body of T1, 1st pair of ribs and cartilages, and superior end of manubrium (suprasternal notch)

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15
Q

Thoracic Outlet syndrome

A

things get pinched between first rib and clavicle (arteries, nerves, veins)

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16
Q

Thoracic Outlet (inferior thoracic aperture) consists of

A

Xiphisternal joint, 12th ribs and costochondral junction, closed by thoracic diaphragm

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17
Q

Sternal region of thoracic cavity (median anterior wall) consists of

A

Sternum (manubrium, body, xiphoid process), Clavicular and chondral attachments to sternum

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18
Q

Costovertebral joint

A

connects head of rib and vertebral body at and above its level

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19
Q

Costotransverse

A

Tubercle of rib and transverse process of vertebra - at same level

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20
Q

True Ribs

A

connected to vertebrae and sternum; 1st to 7th pair

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21
Q

False ribs

A

Don’t directly attach to sternum; 8th to 12th pair

Floating ribs - 11th & 12th

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22
Q

Rib head

A

attaches to vertebral body

2 facets - demifacets articulate with vertebral body at level and one above

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23
Q

Rib Tubercle

A

part of rib that articulates with transverse processes at transverse costal facet

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24
Q

Rib Shaft

A

angle - point of greatest curvature

forms lateral thoracic wall

25
Q

Rib costal groove

A

houses intercostal neurovascular bundle

VAN - vein on top, artery, nerve on bottom

26
Q

Costochondral joint

A

rib to cartilage - no movement

27
Q

Sternocostal joint

A

1st rib is primary cartilaginous joint, rest are synovial plane-type joints

28
Q

Sternoclavicular joint

A

between sternum and clavicle; synovial, saddle-type joint

29
Q

Manubriosternal joint

A

immovable - between sternal body and manubrium

secondary cartilagenous joint

30
Q

Xiphisternal joint

A

primary cartilagenous joint - immovable

between xiphoid process and body of sternum

31
Q

Male breast is located

A

in 4th intercostal space

32
Q

Female breast is located in

A

superficial fascia, is a modified sweat gland
1/3 sits on serratus anterior and 2/3 sits on pectoralis major
vertically from 2nd to 6th ribs, transversely from lateral border of sternum to mid-axillary line

33
Q

Lactiferous ducts

A

open onto the nipple

34
Q

Pectoralis Major

A

O: lateral border of sternum upper 6 costal cartilages, clavicle
I: lateral lip of interubercular sulcus of humerus
N: medial and lateral pectoral nerves (on deep surface)
A: flex, adduct, and rotate arm medially
B: pectoral branch of thoraco-acromial artery

35
Q

Pectoralis Minor

A
Deep to P. major
O: outer surface of ribs 3-5
I: Coracoid process of scapula
N: Medial pectoral nerve
B: Pectoral branch of thoraco-acromial trunk
A: lowers lateral angle of scapula
36
Q

Serratus Anterior

A

O: lateral surface of upper 8-9 ribs
I: costal surface of medial border of scapula
N: Long thoracic nerve
B: Lateral thoracic artery (on superficial surface of muscle)
A: protracts scapula, holds it against thoracic wall

37
Q

Retromammary Space

A

between lactiferous glands and deep fascia, allows movement of breast

38
Q

Suspensory (Cooper’s) ligament

A

attaches gland to dermis of skin, well developed superiorly

If breast tumor grows here, will pull suspensory ligament in and dimples skin

39
Q

Vasculature to breast

A

Internal thoracic a., lateral thoracic a., and pectoral branches of thoracoacromial trunk

40
Q

Levator Costarum

A

Transverse processes C7-T11 to costal tubercle and costal angle
12 pairs of fan shaped muscles

41
Q

Intercostal muscles

A

between ribs, innervated by local intercostal nerves (ventral primary ramus of spinal nerve)
11 intercostal spaces

42
Q

External intercostal muscle

A

Elevates ribs
Fibers run anteroinferiorly from upper to lower rib
starts at costal tubercle, runs to costochondral junction
Extends to sternum as external (anterior) intercostal membrane

43
Q

Internal intercostal muscle

A

starts anteriorly
Costal (bony ribs) portion depresses
Chondral (costal cartilage) portion elevates
Fibers run posteroinferiorly from upper to lower rib
Muscle starts at lateral border of sternum, runs to costal angle
Extends to vertebrae as internal (posterior) intercostal membrane

44
Q

Innermost intercostal muscle

A

elevates ribs
located in third muscular layer of intercostal space
found internally on poserolateral thoracic walls

45
Q

Subcostal muscle

A

located internally on posterior thoracic wall
crosses more than one intercostal space
elevates ribs
located in third muscular layer of intercostal space posteriorly

46
Q

Transversus thoracics

A

Depresses ribs
Lower sternum to internal surface of 2nd to 6th costal cartilage
Located in third muscular layer of intercostal space anteriorly

47
Q

Parietal pleura

A

lines internal thoracic cavity external to the pulminary pleura, covers diaphragm
attaches to thoracic muscles via endothoracic fascia

48
Q

Neurovascular bundle

A

housed in the costal groove between the second and third muscular layers

49
Q

Intercostal nerves

A
in costal groove
Thoracic nerves (T1-T11)
Thoracoabdominal nerves (T7-T11)
50
Q

Intercostal arteries

A

anastomoses within intercostal space

51
Q

Anterior internal thoracic artery

A

terminates at 6th IC space

Branches into Musculophrenic and Superior epigastric arteries

52
Q

Musculophrenic artery

A

branch of internal thoracic artery

supplies 7th - 9th IC space

53
Q

Superior epigastric artery

A

branch of internal thoracic artery

54
Q

No anterior intercostals in

A

10th and 11th intercostal spaces

55
Q

Posterior intercostal artery

A

supplies 3rd to 11th IC spaces

56
Q

Superior intercostal artery

A

branch of costocervical trunk, assists in supplying 1st and 2nd spaces - posterior

57
Q

Thoracic aorta

A

supplies all 11 IC spaces

posterior

58
Q

Subcostal nerve, artery, and vein

A

located under 12th rib

T12 nerve