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Flashcards in Thoracic Wall Deck (57):
1

Function

Protection
Space for lungs (respiration)

2

Suprasternal Notch

T2 to T3

3

Sternal Angle

T4 to T5
Manubriosternal Joint
Costal cartilage of 2nd rib

4

Xiphoid process

T9 to T10
Ossifies at age 40

5

Root of spine of scapula

Vertebral level of T4
Spine of T3 (palpate)

6

Inferior angle of scapula

Vertebral level of T8
Spine T7 (palpate)
Overlies rib 7, points to rib 8

7

Midsternal

line down middle of sternum

8

Midclavicular

1/2 btw clavicle and line down

9

Scapular

Vertical line through inferior angle of scapula

10

Anterior Axillary Line

Vertical line dropped at lateral border of pec major

11

Midaxillary line

Vertical line through middle of axillary fossa (down armpit)

12

Posterior axillary line

Vertical line dropped at lateral border of latissimus dorsi

13

Thoracic Inlet

Body of T1
1st pair of ribs and cartilages

14

Thoracic Outlet Syndrome

Cervical rib impinging on subclavian --> brachial plexus
Numb and swollen arm
Nothing to do with anatomical thoracic outlet

15

Thoracic Outlet

Xiphisternal joint
12th ribs and costochondral junction
Closed by the diaphragm

16

Sternal Region

Sternum (Manubrium, Body, Xiphoid)
Clavicular and chondral attachments to sternum

17

Manubrium

T2 to T5

18

Body of Sternum

T5 - T9

19

Xiphoid Process

T9-T10

20

Sternoclavicular Joint

Synovial, saddle type joint that acts as a ball and socket

21

Manubriosternal

Secondary cartilaginous joint (gives you rib 2)

22

Xiphisternal Joint

Primary cartilaginous joint

23

Costovertebral Joint

Head of rib and vertebral body at and above its level

24

Costotransverse Joint

Tubercle of rib and transverse process of vertebrae at the same level

25

True Ribs

1st - 7th pair
Anteriorly and inferiorly

26

False Ribs

8th - 12th
8, 9, 10 join with 7 and get to sternum that way
11 and 12 are floating

27

Rib

Head - vertebral end, two articular facets (demifacets)
Tubercle (on if edge with facet next to it)
Shaft - Angle (point of greatest curvature)
Costal Groove (houses VAN)

28

Costochondral Joint

No movement
Cartilaginous and ossifies later in life

29

Sternocostal Joint

1st rib is primary cartilaginous joint (immovable)
Rest are synovial plane type joints (slightly movable)

30

Breast

Located in superficial fascia
Modified sweat gland
Areola - ring around
Nipple
20 glands - lactiferous ducts that open onto nipple

31

Anatomcal location of breast - Male

4th intercostal space

32

Anatomical location of breast - Female

Vertically from 2nd - 6th rib
Transversely from lateral border of sternum to midaxillary line
2/3 on deep fascia of pec major
1/3 on deep fascia of serratus anterior

33

Retromammary Space

btw glands and deep fascia
Allows for movemement of breast
Tumor - cancer - less movement

34

Suspensory LIgament

attaches gland to dermis of skin
well developed superiorly
holds breast in position
lose elasticity as age
Cancer - tumor - impingement - dimpling

35

Vasculature of the Breast

Internal Thoracic Artery
Lateral Thoracic Artery
Thoracoacromial Branches

36

Lymphatic Drainage

75% through axillary nodes
25% through clavicular and parasternal nodes

37

Serratus Posterior Superior

Elevates

38

Serratus Posterior Inferior

Depresses

39

Levator Costarum

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

40

Thoracic Muscles - Supeficial to Deep

Intercostal Muscles (External, Internal, Innermost)
Subcostal Muscles
Transversus Thoracis

41

Intercostal Muscles

Innervated by local intercostal nerves (ventral primary rami of spinal nerves)
External
Internal
Innermost

42

External Intercostal Muscles

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

43

Internal Intercostal Muscles

Fibers run posteroinferiorly from upper to lower rib
Muscle starts at lateral border of sternum and runs to costal angle
Extends to vertebrae as internal intercostal membrane
Costal region - depresses
Chondral region - elevates

44

Innermost Intercostal Muscles

Located in 3rd muscular layer of intercostal space
Found internally on posterolateral thoracic walls
Elevation and Depression

45

Subcostal Muscles

Located in 3rd muscular layer of intercostal space posteriorly
Found internally on posterior thoracic wall
Muscle crosses more than one intercostal space
Elevates

46

Transversus Throacis

Located in 3rd muscular layer of intercostal space anteriorly
Lower sternum to the internal surface of 2nd to 6th costal cartilage
Head toward inferior part of body of sternum on inside
Depresses ribs

47

Thoracic Diaphragm

Sternal, Costochondral and lumbar attachments
80% of quiet breathing

48

Intercostal Space

11 Spaces

49

Intercostal Space - Muscles

3
Above muscles attached internally to parietal pleura via endothoracic fascia

50

Intercostal Space - Parietal Pleura

1st of 3 serous membranes
Helps prevent friction build up
On the wall

51

Intercostal Space - Neurovascular Bundle

Housed in the costal groove btw the second and third muscular layers (internal and innermost)
VAN

52

Intercostal Space - Intercostal Nerves

Thoracic NErves T1 - T11 (typical spinal nerve)
Thoracoabdominal nerves (T7 - T11) - these become cutaneous branches - dermatomes

53

Intercostal Space - Arteries - Anterior

Internal Thoracic Artery (1st of subclavian) - Terminates 6th IC space
Then bifurcates
1. Musculophrenic - supplies 7th - 9th space
2. Superior Epigastric
3. No anterior intercostals in 10th and 11 (only post)

54

Intercostal Space - Arteries - Posterior

Superior Intercostal (from costocervical trunk) - assist in supplying 1st and 2nd spaces
Thoracic Aorta - supplies all 11 IC spaces - gives off subcostal artery under 12th rib

55

Intercostal Space - Veins

Azygos system of veins - Venous drainage from R and L posterior intercostal veins, arch up over bronchus and go to SVC
Internal Thoracic Vein

56

Intercostal Space - Subcostal VAN

Subcostal Vein - Close to bone
Subcostal Artery - Middle
Subcostal Nerve - most inferior
Located under 12th rib
T12 nerve

57

Costodiaphragmatic Recess

Where diaphragmatic pleura reflects onto the ribs as costal pleura (still one membrane)
AKA costophrenic angle