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Thorax 1 Flashcards

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1
Q

What is the structure of the thoracic wall?

A

skin–>fascia–>muscles–>bones and cartilage, blood vessels and nerves

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2
Q

What are the functions of the thoracic wall?

A

-Protects thoracic and some abdominal viscera
-Provides the mechanical function of breathing
-Provides attachment for the upper limb, neck back
muscles

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3
Q

What does the thoracic wall consist of?

A

-Sternum
-12 pairs of ribs and costal cartilages(CCs)
-12 thoracic vertebrae

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4
Q

How many intercostal spaces does the thoracic wall have?

A

Intercostal spaces ( 11)

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5
Q

What are the boundaries of the superior thoracic opening?

A

T1 Vertebra,
first rib,
manubrium

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6
Q

What are the boundaries of the inferior thoracic opening?

A

T12 vertebra,
11th& 12thribs,
7th-10th CCs,
xiphisternal joint

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7
Q

What is the sternum?

A

Flat, vertically elongated bone

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8
Q

What forms the sternum?

A

Forms the middle anterior part of the thoracic cage

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9
Q

What is the sternal angle also known as?

A

The manubriosternal joint
(angle of Louis)

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10
Q

What is the anatomical location of the sternal angle?

A

Opposite to the 2nd costal cartilage:
At the level of the T4-T5 disc

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11
Q

What are the 3 types of ribs and there vertebrae level?

A

-True ribs (1st-7th): vertebro-sternal
-False ribs(8th-10th): vertebro-chondral
-Floating(11th and 12th): Free

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12
Q

What are the features of typical ribs?

A

ØAnterior costal end articulate with its CC
ØShaft/body
ØPosterior vertebral end (head, neck and tubercle)

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13
Q

What ribs are considered typical

A

3rd– 9th ribs are considered typical

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14
Q

What is the superior margin of typical ribs like?

A

Smooth

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15
Q

What is the inferior margin of typical ribs like?

A

Sharp

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16
Q

What do typical ribs articulate with?

A

articulate with 2
vertebrae

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17
Q

What do non-typical/atypical ribs articulate with?

A

Non-typical/ Atypical:
articulate with its own
vertebra.

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18
Q

What ribs are atypical?

A

Atypical ( 1, 2,10,11,12)

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19
Q

What is the first rib like?

A

Highest, shortest, strongest, flattest,most curved, most fixed rib

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20
Q

Where is the scalene tubercle on the first rib?

A

Scalene Tubercle; on the inner border for insertion of scalene anterior muscle

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21
Q

What are the grooves for in the first rib?

A

Grooves for the subclavian vein in front of it , and behind it for subclavian artery , and lower trunk of brachial plexus.

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22
Q

Where do ribs fracture in adults?

A

*In adults ribs fractures at the weakest point i.e. at the angle

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23
Q

Where does thoracic outlet syndrome impact?

A

On the superior thoracic opening
(anatomical inlet)

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24
Q

What occurs in thoracic outlet syndrome?

A

Compression of brachial plexus,
subclavian artery and/or subclavian vein

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25
What are the symptoms of thoracic outlet syndrome?
Pale colour & coldness on the skin of the upper limb
26
What are the causes of thoracic outlet syndrome?
Causes: trauma, anatomical defect like cervical rib
27
What happens to radial pulse in thoracic outlet syndrome?
Diminished radial pulse
28
What is a cervical rib?
A rib arising from the anterior tubercle of TP of C7
29
What can a cervical rib cause?
Can cause pressure on the lower brachial plexus or subclavian vessels
30
What do deltoid muscles do?
Abduct arm
31
What do the clavicular fibres assist in the deltoid with?
Clavicular fibers assist in arm flexion
32
What do posterior fibres assist in the deltoid with?
Posterior fibers assist in arm extension
33
What does the pectoralis major do?
Adducts arm
34
What does the pectoralis major medially rotate?
Medially rotates humerus
35
What does the pectoralis major extend?
Extends flexed arm
36
What is the origin of the clavicular part of the pectoralis major?
anterior surface of medial half of clavicle
37
What is the origin of the sternocostal part of the pectoralis major?
anterior surface of sternum, Costal cartilages of ribs 1-6
38
What is the origin of the abdominal part of the pectoralis major?
Anterior layer of rectus sheath
39
Where is the insertion of the pectoralis major?
Crest of the greater tubercle of the humerus
40
What is the function of the pectoralis minor?
Depression of scapula
41
Where is the origin of the pectoralis minor?
Anterior surface, costal cartilages of ribs 3-5
42
Where is the insertion of the pectoralis minor?
Coracoid process of scapula
43
What is the function of the serratus anterior?
Protraction and rotation of scapula
44
What is the origin of the superior part of the serratus anterior?
Ribs 1-2, intercostal fascia
45
What is the origin of the middle part of the serratus anterior?
Ribs 3-6
46
What is the origin of the inferior part of the serratus anterior?
Ribs 7-8/9/10 and the external oblique muscle
47
What is the insertion of the superior part of the serratus anterior?
Anterior and posterior surface of superior angle of scapula
48
What is the insertion of the middle part of the serratus anterior?
Anterior surface of entire medial border of scapula
49
What is the insertion of the inferior part of the serratus anterior?
Anterior and posterior surface of inferior angle of scapula
50
What is the origin of the external intercostal muscle?
Inferior border of ribs
51
What is the insertion of the external intercostal muscle?
Superior border of immediate rib below
52
What is the origin of the internal intercostal muscle?
Costal groove of ribs
53
What is the insertion of internal intercostal muscle?
Superior border of immediate rib below
54
What is the origin of innermost intercostal miscle?
Costal groove of ribs
55
What is the insertion of the innermost intercostal muscle?
Superior border of immediate rib below
56
What is the direction of the external intercostal muscle fibre?
-Downward and forwards -'Hands in pockets'
57
What is the direction of the internal and innermost intercostal muscle fibre?
-'Upwards and forwards' -'Hands on shoulders'
58
What is the direction of the internal intercostal muscle fibres?
-'Upwards and forwards' -'Hands on shoulders'
59
What is the subcostalis?
Internal surface of one rib to internal surface of another
60
What are the transverse thoracis?
From xiphoid process and lower body of sternum to lower border of CCs 3-6
61
What intercostal muscles are most active during inspiration?
External intercostal muscles
62
What do interchondral portions of the internal intercostal elevate during inspiration?
Elevate ribs and sternum
63
What intercostal musclesa re most active during expiration, what portion and what do they do to the ribs and sternum?
Internal intercostal muscles -Interosseous portion -Depress ribs and sternum
64
What does the diaphragm seperate?
Separates the thoracic cavity above and the abdominal cavity below
65
What shape was the diaphragm?
Dome shaped
66
What does the diaphragm consist of?
Consists of: -Peripheral muscular part -Centrally placed tendon
67
What nerve innervates the diaphragm?
Phrenic nerve
68
What is the shape of the diaphragm during inspiration?
Contracted and flattened
69
What is the shape of the diaphragm during expiration?
Relaxed and elevated
70
What do changes in the anteroposterior and lateral dimensions result from?
Changes in the anteroposterior and lateral dimensions result from elevation and depression of the ribs
71
How does the anteroposterior diameter of the thoracic cage represent the pump-handle effect?
When intercostal muscles contract: -Upper ribs rise upwards and outwards in a similar fashion to a pump handle -This increases anteroposterior diameter of thorax, drawing air into lungs
72
How does the transverse diameter of the thoracic cage represent bucket-handle effect?
-Ribs articulate in front with the sternum and behind with vertebral column -Curve downward and resemble bucket handles
73
How is the intercostal neurovascular bundle arranged?
VAN: Vein --> Artery --> Nerve
74
Where is the intercostal neurovascular bundle found between?
Found between the internal and innermost intercostal muscles
75
What is the intercostal neurovascular bundle protected by?
Protected by the costal groove of the superior rib
76
What does the intercostal nerve branch into?
Branches into: -Posterior ramus -Lateral cutaneous branch
77
What does the lateral cutaneous branch of the intercostal nerve branch into?
-Posterior branch -Anterior branch
78
What does the collateral branch of the intercostal nerves give off?
Gives off muscular branches
79
What does the anterior cutaneous branch of the intercostal nerve repersent?
Termination of intercostal nerve
80
Where do the anterior rami of the intercostal nerves, T1-T6 pass by?
-1-6 intercostal spaces
81
Where do the anterior rami of the intercostal nerves, T7-T9 pass by?
Pass deep to CCs to enter the anterior abdominal wall
82
Where do anterior rami of the intercostal nerves, T10-T11 pass by?
10-11 pass directly to the anterior abdominal wall
83
What is the intercostal nerve at T12 also known as?
Subcostal nerve
84
What are intercostal nerves joined to at T1?
Joined to brachial plexus
85
What branches do intercostal nerves not have at T1?
-No lateral cutaneous branch -No anterior cutaneous branch
86
What intercostal arteries does each intercostal space have apart from which 2 spaces?
-Large posterior intercostal artery -Small anterior intercostal arteries -Apart from the 10th and 11th space
87
What intercostal arteries are present in the posterior thoracic cage?
-Superior intercostal artery (1st, 2nd spaces) -Descending aorta (3-12 spaces)
88
What intercostal arteries are present in the anterior thoracic cage?
-Internal thoracic artery(1-6 spaces) -Musculophrenic artery(7-9 spaces)
89
What intercostal vein does each intercostal space have?
-Large posterior intercostal vein -Small anterior intercostal veins
90
What intercostal vein does the posterior thoracic cage have?
Azygos vein and hemiazygos vein
91
What intercostal vein does the anterior thoracic cage have
Internal thoracic vein and musculophrenic vein
92
What intercostal vein does the right brachiocephalic vein receive from and via what veins?
Receives anterior intercostal veins via internal thoracic and musculophrenic veins
93
What intercostal veins does the azygous vein receive from?
receives lower 8 right posterior intercostal veins, right superior intercostal vein and hemiazygous veins
94
What does the left superior intercostal vein drain and what does it drain into?
drains 2-3rd left posterior intercostal veins -Drains into the left brachiocephalic vein
95
What intercostal vein does the superior (accessory) hemiazygos vein receive from?
receives 4-8th left posterior intercostal veins
96
What intercostal vein does the inferior hemiazygos vein receive from?
Receives 9-11th left posterior intercostal veins
97
What do both superior and inferior hemiazygos vein drain into?
Drain into azygous vein
98
What does the Left ascending lumbar vein branch into?
Branches into left subcostal vein and inferior hemiazygos vein
99
What is the breast also a modified version of?
Modified sweat gland
100
Where does the breast lie?
It lies in the superficial fascia of the front of the chest
101
What is the shape of the breast like
Conical
102
Where does the breast extend from?
It extends from the lateral margin of the sternum to the midaxillary line
103
What ribs does the breast overlie?
Overlies the 2nd-6th rib
104
What muscle does the breast rest on?
-2/3 of it rests on pectoralis major -1/3 rests on serratus anterior
105
What are the 3 main sources of arterial blood to the breast?
1. Perforating branches of the internal thoracic (internal mammary) artery 2. Mammary branches of the lateral thoracic artery 3. Mammary branches of intercostal arteries
106
What is the venous supply of breasts?
-Circular venous plexus are found at the base of nipple -Finally veins of this plexus drain into axillary and internal thoracic veins

Anatomy (12 decks)

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