Flashcards in Thoracic Wall and Pectoral Region Deck (29):
What are the parts of the sternum?
Manubrium, body, xiphoid process
Where is the sternal angle of louis?
At the intersection of manubrium and body of sternum, which is also where the costal cartilage of the second rib meets the sternum
Three abdominal organs protected by the rib cage and which ribs?
Liver (right ribs 9-11), Kidneys (ribs 11 and 12), Spleen (left ribs 9-11)
Two types of joints attaching ribs to vertebrae and where each attach
Costovertebral joints (attach heads of ribs to bodies of corresponding vertebra and vertebra above) and Costotransverse joints (attach tubercle of rib to transverse process of vertebra)
Describe the three types of ribs and the number of each
7 pairs of true ribs, 3 pairs of vertebrochondral (false) ribs, 2 pairs of floating ribs
What three ribs have an atypical number of vertebral attachments
Ribs 1, 11, and 12. They only attach to their corresponding vertebrae
Soreness of either the interface of rib and costal cartilage or costal cartilage and sternum, often caused by excessive coughing
Where does the scalenus anterior m (anterior scalenus muscle) attach?
Arises from transverse processes of 3-6 cervical vertebra and attaches to scalene tubercle of first rib (something special about 1st rib)
The four (usually fused in adults) sections which comprise the body of the sternum
Why is the sternum an optimal target for bone marrow biopsy?
It is rich in bone marrow, and it is superficial and easy to access
Upon inspiration which way do the sternum and ribs move respectively?
Sternum moves anterosuperiorly (forward and up), ribs move laterosuperiorly (out and up). Both motions expand the chest cavity
Give the posterior, lateral, and medial borders of the breast as well as which ribs it is anterior to
Posterior - The retro-mammary space (anterior to deep fascia of pec muscle), Lateral - Midaxillary line, Medially - The parasternal margin. The breast is located from the 2nd to the 6th rib
Give the flow of milk within the breast
Mammary gland lobule to lactiferous duct to lactiferous sinus to areola and nipple
How many lactiferous ducts empty into each lactiferous sinus?
Ligaments of Cooper
Suspensory ligaments in the breast (especially superior breast) which support the weight of the breast
What does the areola do?
Secrete oils during breast feeding
Give the innervation of the breast, and specifically the nipple
Breast - Intercostal nerves 2-6, Nipple - Intercostal nerve 4
Name the 4 arterial branches of the breast and trace each back to a major artery (against the flow of blood)
Lateral mammary branches (lateral thoracic --> Axillary), Medial mammary branches (Internal thoracic --> Subclavian), Mammary branches of deep regions of the breast (Intercostal arteries), Pectoral branches of thoracoacromial artery (Thoracoacromial --> Axillary)
What major veins do veins of the breast drain into?
Axillary, internal thoracic, and intercostal veins
Give the two primary places to which lymph of the breast drains and the approximate percentage going to each location
75 percent to superior and lateral to Axillary nodes and most of remainder going to parasternal nodes
Give the arteries that branch off the axillary artery in each of its three parts
First part - superior thoracic a, Second part - Thoracoacromial a, Lateral thoracic a, Third Part - Subscapular a, Ant. humeral circumflex a, Post. humeral circumflex
What artery does the internal thoracic arise from, where does it bifurcate, and into what two arteries?
Subclavian artery, at 6th intercostal space bifurcates into musculophrenic artery and superior epigastric artery
What arteries are given off by the internal thoracic and with what do they anastomose?
The anterior intercostal arteries, they anastomose with the posterior intercostal arteries (which are branches of the descending aorta)
Give venous drainage for the anterior and posterior thoracic wall respectively
Internal thoracic veins, Azygos system
Between which two layers of intercostal muscle do intercostal nerves and vessels run?
Between internal and innermost
Where do collateral branches of intercostal vessels and nerves run relative to other intercostal vessels?
Inferior. The collateral branches cross the intercostal space and run superior to the rib below, whereas the regular branches run inferior to the rib above
Give the branches given off by the subclavian artery, which part of the subclavian each branches off from, and the mnemonic for remembering these
First Part - Vertebral Artery a, Internal Thoracic a, Thyrocervical Trunk. Second Part - Costocervical trunk. Third (or Second) part - Dorsal Scapular a. Mnemonic is VITamin C and D (VITCD)
What artery runs down the trapezius side by side with the accessory nerve (CN XI)?
The superficial branch of the transverse cervical artery