2 Topography of the Cell Wall: Thoracic Wall Flashcards
Q: What is the system of terminology used to describe body positions and relations based on? What is this?
A: anatomical position
-body is lying on back palms up
Q: Define:
- anterior
- posterior
- superior
- inferior
A: =ventral= front of body inc abdomen
=dorsal= behind of body
=canial, rostral= top end of body towards head
=caudal= lower half of body towards feet
Q: Define:
- midline
- medial
- lateral
A: =mid sagital plane (cut from head to toe, down between eyes)
=from head to toe, between eyes
=going away from centre
Q: Define:
- proximal
- distal
A: =pointing closer to chest
=pointing away through fingers
Q: Define:
- sagital
- frontal
- horizontal
A: =cut from head to toe, down between eyes
=coronal (cut between ventral and dorsal)
=transverse/axial= cut where a belt would be (between cranial and caudal)
Q: How many pairs of ribs do we have? 3 types?
A: 12
- 1 to 7 reach sternum and are true ribs
- 8 to 10 reach costal cartilage above and are false ribs
- 11 and 12 lack anterior attachment and are floating ribs
Q: What are articulations? (2)
A: joints of ribs
- with vertebral column via head and tubercle
- with costal cartilages
Q: What is a tubercle?
A: raised portion of bone that have attachments to muscle and ligaments
Q: What’s the relationship between the thoracic vertebrae and the ribs?
A: 12 pairs of ribs and 12 thoracic vertebrae associated (1 with each pair)
Q: Anterior chest view. What is easily palpable? (3)
A: costal margin, sternal angle, jugular notch
Q: How many parts does the sternum have? Names? Describe structures.
A: 3- manubrium, body, xiphoid
manubrium: has articular sites for clavicles, jugular notch, attachment sites for first pair of ribs
sternal edge= rib II joins
body: has articular facets for ribs II to VI and includes transverse ridges
between body and xiphoid is where there are artocular facets for rib VII
Q: What is the thoracic inlet? Formed of? (3) Contains? (6)
A: superior thoracic aperture
- 1st thoracic vertebrae (T1)
- 1st pair of ribs
- manubrium (of sternum)
- great vessels heading for neck and upper limb
- oesophagus
- trachea
- nerves (cranial)
- lymphatics
- part of lung
Q: Where is most lung tissue and most capacity for lung expansion?
A: lower parts of thorax
Q: Describe the diaphragm structure. Movement? (2)
A: has a flat central tendon with muscle radiating to costal margin and vertebrae (is attached to costal margin)
1st- dome flattens to increase vertical diameter of chest
2nd- pulls costal margin up to increase transverse and antero-posterior diameters
Q: What is the secondary role of intercostals?
A: stiffen chest wall to improve efficiency of breathing movements
Q: How do ribs move to increase chest volume?
A: up and out
Q: What makes up intercostal muscles? Descibe.
A: 3 layers of muscle (from most superficial to deep)
- external intercostals
- internal intercostals
- innermost intercostals
Q: Describe external intercostals. Direction? Replaced by? when?
A: downward and medially from lower border of rib above to rib below
-> replaced by anterior intercostal membrane at costo-chondral (rib-cartilage) junction
Q: Describe internal intercostals. Direction? Replaced by?
A: attachments begin anteriorly at the sternum- from lower border of rib above to rib below- fibres directed at right angles to external intercostals (down and lateral)-> replaced by membrane posteriorly
Q: Describe innermost intercostals. Direction?
A: same direction as internal: downward and laterally from lower border of rib above to rib below
Q: How are internal intercostals anterially described?
A: superomedially= situated above and at or TOWARD the midline
Q: What’s vulnerable to damage between the internal and innermost intercostal muscles? (2)
A: blood vessels and nerves
Q: Where are intercostal nerves? How many are there? Composed of? Supply?
A: between innermost and internal intercostal muscle layers
-11 thoracic pairs (T1 to 11) (and 1 subcostal (T12))
- mix of motor and sensory
- supply intercostal spaces and muscle and skin overlying muscle
Q: Where do lateral cutaneous branches of the intercostal nerves go? anterior?
A: anterior and posterior
medial and lateral
Q: What is an intercostal neurovascular bundle? where?
A: vein, artery and nerve that run just below rib deep to internal intercostal
Q: What can build up between the pleural membranes that is damaging?
A: pus and air
Q: What are the implications for putting a needle or chest drain through the chest well? (2)
A: -air can go in and out through it
-lungs don’t expand (rely on surface tension between pleural cavity and pleural membranes)
Q: Where is a safe area to insert a chest drain?
A: -safe area/triangle
-anterior border of the latissimus dorsi, the lateral border of the pectoralis major muscle, line superior to the horizontal level of the nipple and the apex just below the axilla
-5th intercostal space anterior to mid axillary line
Q: What is running along the bottom of each rib? (2)
A: costal groove runs along inferior edge-> find the veins, arteries and nerves (particular order)
Q: What happens in terms of arteries at the end of the intercostal space?
A: each intercostal artery joins (anastamoses) with a major artery at each end of the intercostal space
Q: What are internal thoracic arteries?
A: vessels that come from subclavian arteries and go to limbs / brachiocephalic veins and supplies abdominal wall
Q: What is the contents of the thoracic cavity?
A: -filled laterally by the lungs- each lying in its pleural cavity
-space between the pleural cavities = mediastinum
Q: What does the mediastinum contain? (8)
A: -heart lying in pericardial sac
- great vessels
- oesophagus
- trachea
- thymus
- thoracic duct and other major lymph trunks
- lymph nodes
- phrenic and vagus nerves
Q: What does a PA radiograph mean?
A: shows the direction of X rays: that they went from posterior to anterior (back to front)-> important as images could be slightly different
