Thoracic Wall and Muscles of Respiration Flashcards Preview

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Flashcards in Thoracic Wall and Muscles of Respiration Deck (89):
1

pectoralis major

primarily acts on the shoulder joint
innervated by both the medial and lateral pectoral nerves
because it attaches to the ribs /can elevate ribs- it assists in forced inspiration.

2

pectoralis minor

muscle deep to the pec. major and acts indirectly on the shoulder joint by helping stabilize it
innervated by the medial pectoral nerve

3

proximal and distal attachments of pectoralis major

proximal
1. clavicular head - medial 1/2 of clavicle
2. sternocostal head-anterior surface of sternum costal cartilages 1-6
Distal
1. lateral lip of the intertubercular (biciptal groove) of the humerus

4

serratus anterior

major muscle of UE
accessory in respiration
proximal attachment
- external surfaces of ribs 1-8
distal attachment
-anterior surface of the medial border of the scapula

5

external intercostal muscles

anteriorly, fibers directed from superolateral to inferiormedial
tubercle of rib to costochondral junction

6

external intercostal membrane

anterior to internal intercostal muscles and replaces the external intercostal muscles anteriorly

7

subclavius

proximal attachment
-1st rib
distal attachment
-clavicle middle 1/3

8

internal intercostal muscles

anteriorly, fibers are directed superomedial to inferolateral
angle of ribs to sternum

9

innermost intercostal muscles

tend to run in sam direction as the internal inercostal muscles
only present laterally

10

subcostal muscles

muscles usually cross intercostal spaces but are variable

11

transversus thoracic muscles

internal surface of the anterior thoracic wall
inferior attachment
-on sternum
extend superiorly to attch onto costal cartilages 3-6

12

internal thoracic artery and vein

course vertically on the internal surface of the thoracic cage, lateral to the sternum

13

internal thoracic artery

branch of subclavian
supplies chest wall as well as the breasts

14

internal thoracic vein

empties into the brachiocephalic vein

15

intercostal vein, artey, and nerves

each intercostal space has all three
travel between the internal and innermost intercostal muscles
travel within the costal groove

16

intercostal nerves

T1-T11 (T12 is cubcostal )

17

intercostal arteries

posterior - arise from aorta
anterior- arise from the internal thoracic artery

18

intercostal veins

posterior- empty into azygous venous system
anterior - empty into the internal thoracic veins

19

diaphragm

major muscle of respiration
innervated by the phrenic nerve (C3,4,5 keeps you alive)
separates the thoracic and abdominal cavities

20

dorsal body cavities

cranial and vertebral

21

ventral body cavities

thoracic, abdominal, and pelvic

22

what separates the abdominal cavity from thoracic?

diaphragm

23

T/F the abdominal and pelvic cavities are not physicall separated

TRUE - they are not

24

division of thoracic cavity

THREE
1. (2) pulmonary cavities - lungs
2. mediastinum - further subdivided into 1. superior and 2. inferior (anterior, middle-heart, and posterior)

25

what does the thoracic cage (bony structure of thorax) include and functions?

12 thoracic vertebrae and discs
12 pairs of ribs and costal cartilage
sternum
functions:
protects the heart, serves as an ATTACHMENT site for muscles (including muscles of respiration), and costal cartilages and joints contributing to the flexibility of the cage

26

vertebrae structure (number and curvature posteriorly)

7 cervical, concave - lordosis
12 thoracic, convex- kyphosis
5 lumbar, concave-
5 sacral, convex-
4 coccygeal (fused)

27

normal curvature of the spine

anteroposterior

28

intervertebral disc structure

annulus fibrosus - outer fibrocartilaginous rings
nucleus pulposa - inner gelatinous material

29

type of joint between the bony vertebra and intervertebral disc

symphysis
bones united by fibrous cartilage

30

which curves are primary curves?

thoracic and sacral

31

secondary curves in spine

cervical and lumbar curves - concave posterior

32

scoliosis

lateral curvature to the spine
this term always indicates an abnormal curvature

33

the body, pedicle, transverse process, lamina, spinous process, articulating processes (superior and inferior),
articular facets are components of what?

specific vertebral components

34

details on articular facets

flat surface where bones articulate (vertebra, and ribs)
these are synovial joints
facets have hyaline cartilage
superior and inferior articular processes form zygapophysial joints, but called facet joints

35

trend of size of intervertebral foramen

get smaller as go more caudal
lumbar openings not as large

36

major points of difference between lumbar vs. thoracic vertebra

*Body -upper thoracic smaller than lumbar body
*Spinous process- in thoracic it is large and points inferior. Lumbar process is short and stuby - indicating more ability to move in lumbar region
*Articular/costal facets-THORACIC VERTEBRAE HAVE A TRANSVERSE COSTAL FACET off of the transverse process and SUPERIOR AND INFERIOR COSTAL FACETS - on the body

37

components of a typical rib

Head - 2 FACETS
Neck
Tubercle - transverse process of the corresponding vertebrae
Angle
Costal groove

38

head of thoracic rib

two facets that articulate with the vertebral body at the same level and the body that is superior to it

39

Neck of thoracic rib

neck is between the head and the tubercle

40

Tubercle of thoracic rib

tubercle has articulating facets for the transverse process of the vertebral body at same level

41

angle of rib

rib turns anterolateral
flattens out as come around (more bulky in the posterior where contacting with the vertebral body)

42

costal groove of rib

location of intercostal nerve, artery, and vein

43

costo-transverse joint

transverse process of vertebra of same number as rib and the tubercle of rib

44

costovertebral joints

head of rib - body of rib superior to rib and body of rib at same level at the costal facets on body
*intervertebral disc positioned between the two bodies

45

example.. 7th rib will articulate with?

7th rib head- articulating with Body of T6 and T7
7th rib tubercle articulating with transverse process w/ facet of same level vertebral body (T7)

46

atypical ribs

1st and 2nd rib and 10-12

47

typical ribs

3-9

48

what type of costal cartilage do ribs have?

hyaline cartilage

49

true ribs

1-7

50

false ribs

8-10

51

floating ribs

11-12

52

costochondral joints

ribs with the costal cartilage = synchondrosis

53

sternocostal joints

sternum with costal cartilage -1st rib=synchondrosis - rib with costal cartilage
2nd-7 ribs = plane synovial joint

54

interchondral joints

between costal cartilages - synovial (most)

55

synchondrosis unites what

bones united by hyaline cartilage

56

symphsis unites what

bones united by fibrous cartilage

57

components of the sternum

Manubrium (most superior)
Body
Xiphoid process

58

Manubrium

jugular notch = suprasternal notch
sternal angle

59

sternal angle and what joint

this is the manubriosternal joint which is a symphysis - bones connected by fibrous cartilage
at the inferior portion of the manubrium
this is at notch two
JUNCTION B/W THIS AND BODY

60

what to note on body of sternum

costal notches - articulation for the costal cartilages

61

xiphoid process and what joint

Xiphisternal joint which is a synchondrosis (bones connected by hyaline cartilage) at 7th notch
inferior portion of sternum
this joint will often fuse in older adults

62

Proximal and distal attachments of pectoralis major

proximal attachments
1. medial half of clavicular head of clavical
2. sternocostal head- anterior surface of sternum. costal cartilages 1-6
Distal
1. lateral lip of the intertubercular (bicipital) groove of the humerus

63

proximal and distal attachments of serratus anterior

distal : anterior surface of the medial border of the scapula
proximal: external surfaces of ribs 1-8 (lateral)

64

pectoralis minor
innervation and action

innervated by the medial pectoral nerve
accessory muscle of respiration (forced inspiration)

65

subclavius muscle innervation and action

n. to subclavius
accessory muscle of respiration (forced inspiration
ELEVATES first rib

66

attachments of pectoralis minor

proximal : external surfaces of ribs 3-5
*1-8 = serratus anterior
distal: coracoid process of scapula

67

attachments of subclavius

proximal : 1st rib (makes sense because it lifts the 1st rib in function)
distal: clavicle (middle 1/3)

68

intercostal muscle divisoin

External intercostal muscles
Internal intercostal muscles
innermost intercostal muscles

69

External intercostal muscles

anteriorly- Fibers run like putting hands in pocket - superorlateral to inferior medial
go from tubercle of rib (transverse process of same level body vertebrae) to costochondral junction and replaced anteriorly by the external intercostal membrane

70

internal intercostal muscles

Anteriorly, fibers are directed from superiomedial to inferiolateral (opposite of external)
Go from angle of ribs to sternum
replaced posteriorly by internal intercostal membrane

71

innermost intercostal muscles

only present laterally and tend to run in same direction from superiormedial to inferior lateral like the internal intercostal muscles

72

muscles on the internal surface of the thoracic cage

subcostal muscles
transversus thoracic muscles

73

subcostal muscles

these muscles usually CROSS two intercostal spaces (variable though)

74

Transversus thoracis muscle
attachments and function

accessory muscles to respiration
4-5 muscle slips in internal aspect of thoracic cavity wall
attach from costal cartilages about 3-6 and pass towards inferior medial aspect of the lower body of the sternum and xiphoid process

75

components of intercostal space

each intercostal space has a vein, artery, and nerve (VAN)

76

where are the internal intercostal V,A, and N's?

only between the internal intercostal muscles and the innermost intercostal muscles
travel within the costal groove of the rib
V- most superior N- most inferior

77

intercostal nerves

t1-t11 (t12 is subcostal)

78

intercostal arteries
Post/Ant portions

Posterior - arise from the aorta
Anterior - arise from the internal thoracic artery
(internal thoracic artery is a branch of the subclavian artery)

79

intercostal veins
Post/Ant portions

Posterior- empty into the azygous venous system - see medistinum lecture
Anterior - empty into the internal thoracic veins

80

Astemosis

anterior and posterior arteries will of intercostal will come together

81

Diaphragm
Function and innervation
what does it separate?

major muscle of respiration
innervated by the phrenic nerve (c3,4,5 keep you alive)
separates the thoracic and abdominal cavities

82

Attachments of diaphragm

Xiphoid process, lower ribs and costocartilages, upper lumbar vertebrae (L1-L3)

83

3 openings/ hiatus of diaphragm and level

1. Caval (inferior vena cava) @ T8
2. Esophogeal hiatus @T10
3. Aortic hiatus @T12 - POSTERIOR to diaphragm - doesnt go through
'I(IVC) ate(8) ten eggs (Esoph) at (aorta) twelve)

84

inspiration and expiration does what to the thoracic volume?

Inspiration? - expands thoracic volume (secondary to the other effects)
Expiration? - decreases thoracic volume

85

Inspiration...

Diaphragm CONTRACTS AND DESCENDS - increasing vertical height of thorax and compressing the abdominal viscera
CONTRACTION OF INTER-COSTAL MUSCLES - causes an increase in the anteroposterior (AP) dimension of the thorax via movement of the ribs and sternum
CONTRACTION OF INTERCOSTAL MUSCLES - increase in lateral dimensions of thorax via movement of the lateral aspect of the ribs

86

accessory muscles to inspiration

sternocleidomastoid
pec major and minor
serratus anterior

87

principle muscle of inspiration

external intercostal muscles
internal intercostals -interchondral part

88

primary muscle of respiration

diaphragm - increasing dimensions of thorax in multiple planes

89

muscles involved in forced expiration

internal intercostal
abdominal muscles
rectus abdominous
external oblique, internal oblique, transversus abdominus