2401- Anatomy Thoracic Cavity, Thoracic Wall And Diaphragm Flashcards
What are true ribs?
Ribs 1-7 that articulate directly with the sternum (vertebrosternal ribs)
Define false ribs.
Ribs 8-10 that do not articulate directly with the sternum (vertebrochondral ribs)
What are floating ribs?
Ribs 11-12 that do not have any anterior attachment (vertebral ribs)
What is the primary function of the thoracic cage?
- Protects upper abdominal viscera
- Protects heart and lungs
- Serves for muscle attachment involved in respiration
What is thoracic inlet syndrome?
A condition caused by compression of the subclavian artery and brachial plexus due to structural anomalies
What are the clinical features of thoracic inlet syndrome?
- Numbness and tingling in the forearm and hand
- Wasting of small hand muscles
- Ischemic symptoms in the upper limb
Where is the sternal angle located?
Around 5cm below the suprasternal notch at the level of the intervertebral disc between T4 and T5
What anatomical structures bifurcate at the level of the sternal angle?
- Trachea into right and left principal bronchi
- Pulmonary trunk into right and left pulmonary arteries
- ascending aorta ends, arch of aorta begins and ends and descending aorta begins.
What is funnel chest (pectus excavatum)?
A condition where the chest is compressed anteroposteriorly, pushing the sternum backward
Describe pigeon chest (pectus carinatum).
A condition where the chest is compressed laterally, projecting the sternum forward and downward
What is the preferred site for bone marrow aspiration?
Manubrium Sterni
What distinguishes typical thoracic vertebrae from atypical vertebrae?
Typical vertebrae (T2-T8) have standard features, while atypical ones (T1, T9-T12) have unique characteristics
What are the classifications of ribs based on features?
- Typical ribs: 3rd - 9th ribs (CAT)
- Atypical ribs: 1st, 2nd, 10th, 11th, 12th ribs
Give some characteristics of typical thoracic vertebrae.
Articular faucets on each side
Upper larger costal facet corresponds with rib.
Body heart shaped
Vertebral foreman circular
Spinous process long, slender
List the ligaments of the vertebral column.
LA LISI
Ligamenta flava
Anterior and posterior longitudinal ligaments
Ligamentum nuchae
Interspinous ligament
Supraspinous ligament
Intertransvere ligament
Give the characteristics of the typical ribs.
Head, neck, angle
Upper and lower faucet with intra- articular crest in between
Upper and lower boarder
Inner (costal groove) and outer surface
Posterior (weakest point of rib) and anterior angle
Give the characteristics of the atypical ribs.
Single head
Neck and tubercle (1st, 2nd and 10th rib)
11th and 12th - no neck and tubercle
12th - no angle and costal groove.
11th rib- small angle and shallow groove.
List the intercostal muscles and give its function.
External intercostal - elevates the ribs during inspiration
Internal intercostal - elevates/ pull down ribs during expiration
Intercostalis intimi - Elevates the ribs during expiration
Subcostalis- depressor of the ribs
Sternocostalis - pulls/ draws down the costal cartilage
Levatores Costarum - rotates and elevates the neck of the ribs and rotates and flexor of the vertebral column.
List the nerve supply of intercostal muscles, parietal pleura and periosteum of the ribs.
Collateral branch of intercostal nerve.
At which rib would a thoracotomy be performed?
The 6th rib
Give the origin of the anterior and posterior intercostal arteries.
Anterior -
1-6 derived from the internal thoracic artery.
7-9 derived from the musculophrenic artery
Posterior -
1-2 derived from the superior intercostal artery - costocervical trunk
3-11 derived from the descending thoracic aorta.
List your posterior arteries of the diaphragm
DM LCM
Dorsal
Muscular
Lateral cutaneous
Collateral
Mammary
The coarctation of aorta involves which arteries.
Posterior intercostal
Arteries are markedly enlarged and causes notching of the ribs.
Give the relations/ boundaries of the Thoracic outlet.
Anteriorly - xiphoid process
Posteriorly - thoracic vertebrae
Laterally - costal margin and 11&12 ribs
List the strutures that pass through the following:
Median arcuate ligament
Medial lumbocostal arch
Lateral lumbocostal arch
A) aorta
B) sympathetic trunk
C) subcostal nerves and vessels
Medial and lateral arcuate ligaments contains B and C respectively.
List the structures that are found in the following major openings in the diaphragm:
A) vena caval
B) oesophageal
C) aortic
A) superior vena cava & right phrenic nerve
B) esophagus, right and left vagus trunks & esophagus opening of left gastric artery
C) aorta, thoracic duct and azygos vein
The nerves for openings are T8, T10 and T12 respectively.
State the blood supply of the diaphragm.
Superior and inferior phrenic arteries
Pericardiophrenic arteries
Musculophrenic arteries
Superior epigastric arteries
Posterior intercostal and subcostal arteries
Give the nerve supply of the diaphragm.
Right and left phrenic nerve
Lower 5 intercostal and subcostal nerves
Diaphragmatic paralysis results in the damage of ___?
Phrenic nerve
Give the development of the diaphragm.
Septum transversum, ventrally
Pleuro-Peritoneal membrane, sides
Dorsal mesentery of esophagus, dorsally
Body wall, peripherally.
Give the development of the following:
A) central tendon
B) domes of diaphragm
C) section of diaphragm around esophagus
D) peripheral part of diaphragm
A) septum transversum
B) pleuroperitoneal membrane
C) dorsal mesentery of esophagus
D) body wall
State how the following of the thoracic cavity is increased:
A) anterior posterior diameter
B) transverse diameter
C) vertical diameter
A) pump handle movement by the vertebrosternal ribs (2-6)
B) bucket- handle movement by the vertebrochondral ribs (7-10)
C) contraction (descent) of diaphragm
