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SHB > 10.24.16 Overview of the Thorax > Flashcards

10.24.16 Overview of the Thorax Flashcards

1
Q

What are the three major functions of the thoracic wall?

A
  1. Protection of contents in the thoracic cavity and upper abdominal cavity
  2. Respiration
  3. Attachment for skin, fascia, and overlying muscles of the neck, thorax, upper limbs, abdomen, and back
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2
Q

What are the boundaries of the thoracic cage?

A

Anterior: Sternum, costal cartilage
Lateral: Ribs
Posterior: Thoracic vertebrae and IV discs

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3
Q

The thoracic cage is formed by ___ pairs of ribs, the manubrium, costal cartilages, and 12 ___.

A

12; thoracic vertebrae

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4
Q

What forms the thoracic wall?

A

The thoracic cage, skin, associated fascia, and muscles

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5
Q

The thoracic vertebrae have unique long, inferiorly angled ___.

A

Spinous processes

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6
Q

Where are the costal facets located?

A

On the transverse processes

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7
Q

Where are demifacets located?

A

Laterally on the bodies of T2-T9

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8
Q

Which rib does the superior demifacet articulate with? The inferior demifacet?

A

Superior demifacet articulates with the head of the rib of the same number; inferior demifacet articulates with the head of the rib inferior to it (+1)

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9
Q

The superior articular facet of the rib head articulates with the vertebra ___. The inferior articular facet of the rib head articulates with the vertebra ___.

A

Above; of the same number as the rib

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10
Q

What does the crest of the head of the rib attach to?

A

The intra-articular ligament at most of the costovertebral joints

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11
Q

What does the crest of the neck of the rib attach to?

A

Superior costotransverse ligament

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12
Q

What does the tubercle of the rib attach to?

A

Costotransverse ligaments

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13
Q

What does the tubercle articulate with? Which vertebra (#)?

A

Transverse costal facet; same numbered vertebra

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14
Q

What are the true ribs?

A

1st-7th ribs

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15
Q

What are the false ribs?

A

8th-10th ribs

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16
Q

What are the floating ribs?

A

11th-12th ribs

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17
Q

What is a true rib?

A

Inserts onto the sternum

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18
Q

What is a false rib?

A

Does not insert onto the sternum on their own (come to a common place)

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19
Q

What is a floating rib?

A

Does not articulate at all with the sternum anteriorly

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20
Q

What is atypical about the 1st rib?

A

Has a scalene tubercle (anterior scalene attachment); single facet for articulation with T1 only

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21
Q

What is atypical about the 2nd rib?

A

Tubercle for origin of serratus anterior

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22
Q

What is atypical about the 10th rib?

A

Only one facet for articulation with only one vertebra

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23
Q

What is atypical about the 11th and 12th ribs?

A

No necks or tubercles; free floating; articulate with only one vertebra

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24
Q

What are the three parts of the sternum?

A
  1. Manubrium
  2. Body
  3. Xiphoid process
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25
Q

Manubrium is found at the level of the bodies of which vertebrae?

A

T3 and T4

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26
Q

The body of the manubrium is formed by 4 ___.

A

Sternebra

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27
Q

The body of the manubrium is located at the level of which vertebrae?

A

T5-T9

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28
Q

The xiphoid process is located at the level of which vertebrae?

A

T10

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29
Q

The jugular (suprasternal) notch is palpated at the ___ vertebral level.

A

T2

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30
Q

The sternal angle (of Louis) is palpated at the ___ vertebral level.

A

T4

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31
Q

Communication occurs between the thoracic cavity, the neck, and the abdomen through ___ and ___.

A

Superior and inferior thoracic apertures, respectively

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32
Q

What are the boundaries of the superior thoracic aperture?

A

T1, the first ribs/cartilages, and the superior border of the manubrium

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33
Q

What structures pass through the superior thoracic aperture?

A

Trachea, esophagus, nerves and blood vessels supplying/draining the head, neck, and upper extremities

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34
Q

What are the boundaries of the inferior thoracic aperture?

A

T12, the 11th and 12th pairs of ribs, costal cartilages of ribs 7-10, and the xiphisternal joint

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35
Q

Which of the thoracic apertures is more spacious?

A

Inferior thoracic aperture

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36
Q

What separates the thorax from the abdomen?

A

Diaphragm

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37
Q

Because of the closing off of the thoracic outlet by the diaphragm, structures pass to and from the thorax to the abdomen via what three openings?

A
  1. Esophageal hiatus
  2. Aortic hiatus
  3. Inferior vena caval hiatus
38
Q

What are the muscles of the thoracic cage?

A
  1. External intercostal
  2. Internal intercostal
  3. Innermost intercostal
  4. Transversus thoracis
39
Q

What is the origin of external intercostal?

A

Lower border of ribs

40
Q

What is the insertion of external intercostal?

A

Upper border of rib below rib of origin

41
Q

What innervates external intercostal?

A

Intercostal nerves

42
Q

What is the function of external intercostal?

A

Supports intercostal spaces in inspiration and expiration, elevates ribs in inspiration

43
Q

What is the origin of internal intercostal?

A

Lower border of ribs

44
Q

What is the insertion of internal intercostal?

A

Costal cartilage and edge of costal groove of rib above rib of origin

45
Q

What innervates internal intercostal?

A

Intercostal nerves

46
Q

What is the function of internal intercostal?

A

Prevents pushing out or drawing in of intercostal spaces in inspiration and expiration, lowers ribs in forced expiration

47
Q

What is the origin of innermost intercostal?

A

Lower border of ribs

48
Q

What is the insertion of innermost intercostal?

A

Upper border of rib below rib of origin

49
Q

What innervates innermost intercostal?

A

Intercostal nerves

50
Q

What is the function of innermost intercostal?

A

Elevates ribs

51
Q

What is the origin of transversus thoracis?

A

Internal surface of costal cartilages 2-6

52
Q

What is the insertion of transversus thoracis?

A

Posterior surface of lower sternum

53
Q

What innervates transversus thoracis?

A

Intercostal nerves

54
Q

What is the function of transversus thoracis?

A

Depresses ribs and costal cartilages

55
Q

Which intercostal muscles depress the ribs?

A

Transversus thoracis and internal intercostal

56
Q

Which intercostal muscles elevate the ribs?

A

Innermost intercostal and external intercostal

57
Q

What is the orientation of the muscle fibers of external intercostal?

A

From superior/posterior to inferior/anterior (hands in pockets)

58
Q

What is the orientation of the muscle fibers of internal intercostal?

A

From inferior/posterior to superior/anterior (praying)

59
Q

What is the orientation of the muscle fibers of the innermost intercostal?

A

From superior/anterior to inferior/posterior

60
Q

What is the key muscle of respiration?

A

Diaphragm

61
Q

What is the origin of diaphragm?

A

Xiphoid process, lower 6 costal cartilages, L1-L3

62
Q

What is the insertion of diaphragm?

A

Converge into central tendon

63
Q

What innervates diaphragm?

A

Phrenic nerve

64
Q

What is the function of diaphragm?

A

Draws central tendon down and forward during inspiration

65
Q

Where do the inferior vena cava, esophagus, and aorta pass through the diaphragm?

A

Inferior vena cava: T8
Esophagus: T10
Aorta: T12

I ate ten eggs at noon (I:8, 10:E, A:12)

66
Q

During inspiration, what happens to the vertical diameter of the thoracic cage?

A

Increases as the diaphragm descends

67
Q

During expiration, what happens to the vertical diameter of the thoracic cage?

A

Decreases to original size as diaphragm descends

68
Q

When the intercostal muscles contract, what happens to the transverse diameter of the thoracic cage?

A

Increases slightly (bucket handle motion)

69
Q

The movement of ribs 2-6 at the costovertebral joints about an axis going through the neck of the ribs causes the sternal ends of the ribs to rise, changing the ___ diameter.

A

Anteroposterior (pump handle motion)

70
Q

What three things lay within the costal groove of each rib?

A

Intercostal vein, artery, and nerve (in that order)

71
Q

The posterior wall of the thorax is supplied by posterior intercostals which are branches of the ___ and ___.

A

Aorta; costocervical trunk

72
Q

The anterior wall of the thorax is supplied by anterior intercostals which are branches of the ___ and ___ arteries.

A

Internal thoracic; musculophrenic

73
Q

The intercostal veins drain into what two veins?

A

Azygos and hemiazygos veins

74
Q

Intercostal muscles are innervated by ___ of thoracic nerves (intercostal nerves).

A

Ventral rami

75
Q

What dermatome is found at the level of the clavicles and jugular notch?

A

C4

76
Q

What dermatome is found at the level of the sternal angle?

A

T2

77
Q

What dermatome is found at the level of the nipples?

A

T4

78
Q

What are the three basic subdivisions of the thoracic cavity?

A
  1. Pleural cavities (2)
  2. Lungs (2)
  3. Mediastinum
79
Q

The pleural cavities surround but do not contain the ___.

A

Lungs

80
Q

The lungs are suspended by roots from the ___ and ___, and are surrounded by pleural cavities.

A

Trachea; pulmonary vessels

81
Q

What is the thick middle partition in the thorax?

A

Mediastinum

82
Q

What lines the mediastinum?

A

Mediastinal pleura

83
Q

What are the boundaries of the thoracic mediastinum?

A 
Lateral: two pleural sacs (lungs)
Superior: superior thoracic aperture
Inferior: diaphragm
Anterior: sternum and costal cartilage
Posterior: thoracic vertebral bodies
84
Q

What are the two parts of the thoracic mediastinum?

A
  1. Superior mediastinum

2. Inferior mediastinum

85
Q

The superior mediastinum is found superior to the manubriosternal junction (sternal angle) and ___ but inferior to the ___.

A

T4-T5 IV discs; thoracic inlet

86
Q

The inferior mediastinum is inferior to the ___ but superior to the ___.

A

Sternal angle; diaphragm

87
Q

What are the three further divisions of the inferior mediastinum?

A

Anterior, middle, and posterior

88
Q

What is contained within the superior mediastinum?

A

Thymus, brachiocephalic veins/superior vena cava (left and right), phrenic and vagus nerves, aortic arch and branches (brachiocephalic trunk, left common carotid artery, left subclavian artery), trachea, esophagus, recurrent laryngeal nerve, thoracic duct

89
Q

What is contained within the anterior mediastinum?

A

Lower portion of thymus, sternopericardial ligaments, loose connective tissue, fat, lymphatic vessels and their nodes, branches of internal thoracic vessels

90
Q

What is contained within the middle mediastinum?

A

Pericardial cavity/heart, great vessels (ascending aorta, pulmonary arterial trunk, right/left superior and inferior pulmonary veins, inferior portion of superior vena cava, attaching portion of the azygos vein to the SVC), phrenic nerve, roots of lungs

91
Q

What is contained within the posterior mediastinum?

A

Esophagus, descending aorta/branches, azygos veins, thoracic duct, sympathetic chain, splanchnic nerves

92
Q

What are the boundaries of the anterior mediastinum?

A

Anterior: sternum
Posterior: pericardium

SHB (36 decks)

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