2. Cardiopulmonary: Osteology, Arthrology, Myology Flashcards
What is contained in the pulmonary cavities and the mediastinum?
The lungs and the heart
What are the three bones that make up the sternum?
Manubrium (handle), body of the sternum, and the xiphoid process
There are 7 costal notches on the sternum, what goes in these?
NOT THE RIBS, costal cartilages meet the costal notches
What ribs are considered to be true (vertebrocostal) ribs? What ribs are considered to be flase (vertebrochondral) ribs? What ribs are considered to be floating (vertebral) ribs? Why?
- Ribs 1-7 d/t costal cartilage meeting sternum 2. Ribs 8-10 d/t all cartilage merging with the 7th ribs cartilage 3. Ribs 11-12 b/c they are not connected by cartilage to the sternum at all
What ribs are atypical and typical ribs?
Atypical are ribs 1-2, 10-12 Typical ribs are 3-9
How does vertebra 6 meet rib 6?
Rib 6’s inferior articular facet meets V6’s superior costal facet. The tubercle of the rib meets the transver process of V6. The rib’s superior aritcular facet meets with V5’s inferior costal facet
What is unique about the 1st rib?
Shortest, broadest rib, grooves for subclavian vein and artery, vein being anterior to the scalene tubercle, artery being posterior. Only has one articular facet
What is unique about the 2nd rib?
Short and broad, has a tuberosity for serratus anterior
What is unique about ribs 10-12 and 11/12?
Ribs 10-12 only have one articular facet on the head and no tubercle Ribs 11/12 are short and have no articulation with sternum
What are some common differences between simple and complicated rib fractures?
Simple: Transverse/Oblique/Overriding/Chondral fractures Costovertebral dislocation or Costochondral separation Complicated: Injure pluera and lung/many rib fractures/tear blood vessels/ puncture/injury to heart
What are supernumerary ribs? What can it cause?
When a cervical vertibra has transverse/horizontal element on the transverse process Causes thoracic outlet syndrome
What are the differences between synovial, fibrous, and cartilagenous joints and what are the types?
Synovial joints have a articular capsule and many different types: Plane, hinge, saddle, condyloid, ball and socket, and pivot Fibrous joints are like sutures in skull, between two bones, syndesmosis, schindylesis, gomphosis (tooth/socket) Cartilaginous Joints: Synchondrosis (primary) and Symphisis (secondary)
Manubriosternal Joint (Joint type, Bones involved, ligaments)
Joint Type:Symphysis
Bones: Sternal Angle/Second costal notch
Ligaments: None
Xiphisternal Joint (***First primary cartilage joint***)
Joint Type: Synchondrosis
Bones: Inferior limit of the thorax
Ligaments: None
Sternocostal Joints (Rib 1 different from 2-7)
Joint Type: Rib 1: Synchondrosis Rib2-7: Planar Synovial
Bones: Ribs and Sternum
Ligaments: Anterior/Posterior Radiate Sternocostal L
Costovertebral Joints
Joint Type: Planar Synovial
Bones: Ribs and Vertebrae
Ligaments: Radiate L
Intraarticular L.
Articular Capsule
Costotransverse Joint
Joint Type: Planar Synovial
Bones: Ribs and Transver processes of vertebrae
Ligaments:
Lateral Costotransverse L (rib/T process same segment)
Superior Costotransverse L (neck rib to T process one segment up)
Costochondral Joints
Joint Type: Synchondrosis
Bones: Ribs and costal cartilages
Ligaments: None
Interchondral Joints (different for between 6-9 and 9-10)
Joint Type: 6-7-8-9 : Planar Synovial 9-10: Fibrous Joint
Bones: Costal cartilages
Ligaments: Interchondral L.
Thoracic Vertebral Joints
Joint Type: Intervertebral Joint: Symphysis Zygopophyseal Joint: Planar Synovial (COMPOUND JOINT)
Bones: Between vertebrae
Ligaments:
Anterior Longitudinal L
Posterior Longitudinal L
Ligamentum Flavum
Interspinous L
Intertransverse L
Supraspinous L
Intervertebral Discs: Annulus fibrosis and Nucleus Pulposus
There are two forms of movement for the costovertebral joint, what are they called and what do they do?
Bucket Handle Movement: Elevation of the lateral most part of the rib- increases transverse diameter
Pump Handle: Elevation of the sternal end of the rib, increases anterior to posterior diameter of thorax
What is difference between elevation of the thorax and depression of the thorax?
Elevation of the ribs leads to an increase in thorax diameter, leading to an increase in air inside. Opposite for depression.
What is the difference between dislocation and separation of the ribs and the sternum?
Dislocation occurs at the sternocostal joint, costocartilage is dislocated from the sternum.
Separation occurs at the costochondral joint, rib is separated from the costocartilage
External Intercostal M. (Origin/Insertion, Action and Innervation)
Origin/Insertion: From posterior inferior rib to superior anterior rib
Action: Elevate Ribs
Innervation: Intercostal N
Internal Intercostal M
Origin/Insertion: Inferior anterior border ribs to superior posterior border (muscle fibers run perpendicular to external intercostal Mm)
Action: Depress ribs
Innervation: Intercostal N.
Innermost Intercostal M.
Origin/Insertion: Inferior border to superior border ribs
Action: IDK, probably depress ribs
Innervation: Intercostal N.
*** Remember*** Innermost intercostal M will obstruct view of intercostal N… So when you can see intercostal N, you can say the muscle behind it is internal intercostal M
Transverse Thoracic M
Origin/Insertion: Posterior surface of xiphoid process and inferior sternum to internal costal cartilages 3, 4, 5 and 6
Action: Depress Ribs
Innervation: Intercostal N
Subcostal M.
Origin/Insertion: inferior border of rib to superior border of rib (1-2 segments)
Action: Probabaly depress ribs
Innervation: Intercostal N.
**Usually more than one rib spaces**
What do the external intercostal M. and internal intercostal Mm form into near the sternum and vertebra, respectively?
External becomes Anterior (External) Intercostal Membrane
Internal becomes Posterior (Internal) Intercostal Membrane
How do you differentiate between external and internal intercostal muscles?
External muscles go in the direction as if you are putting your hands in your pockets, and internal muscles are perpendicular to those fibers, opposite direction
What is thoracentisis and what is important to do?
It is the insertion of a needle through the intercostal musculature to obtain fluid/drain blood from PLEURAL CAVITY
Make sure to insert need INFERIOR to intercostal neurovascular bundle and SUPERIOR to collateral branches
Describe how a chest tube is placed.
Insertion of a tube to remove LARGE amounts of air, fluid or blood from the pleural cavity. The tube is typically placed between the 5th and 6th intercostal space
What is a thorascopy and what is it used for?
It is insertion of a thorascope into the pleural cavity through small incisions for visualizing and biopsying space inside the cavity (5th/6th rib)
