A9 Anatomy of the Thoracic Wall Flashcards
Costovertebral Joints
facets on thoracic vertebrae, correspond to rib number above the vertabra
articulate to two vertebra and transverse process of lower rib
-synovial joints allow small rotational movement of ribs during respiration, appears as small capsul
Ribs
12 ribs,
1-7 vertebrocostal (True) ribs
8-10 vertebrochondral (false) ribs
11 & 12 vertebral (floating) ribs
body, angle
tubercle (bump by fact for transverse process
neck
head
costal grooves
costal cartiage
between rib and sternum
costochondral joints
interchondral joints
increases mobility
Fractures of the ribs
fracture of first rib can endanger neurovascular supply to upper extremity
middle ribs most commonly fractured
flail chest: fracture of adjacent ribs intwo or more places,
- affects both inspiration and expiration
- negative pressure pulls in, pos pressure bulges out
Sternum
Manubrium (suprasternal (jugular) notch (T2)
-articulates with clavicle and rib 1
body (T5-T9)
- sternal angle at T4 T4T5 IVD
- articulates with Rib 2
Xiphoid Process
-T10 vertebral level
Xiphisternal junction at T9
Munubriosternal joint: T4/T5-aortic arch
look at transverse plane slide
Sternocostal articulations
costal cartilages
- bridge between anterior ends of ribs and ternum
- hyaline cartilage
- costochondral joints: flexibility but no movment
sternocostal joints: between costal cartilage and sternum
-synovial joins allow for movement (except for 1st sternocostal joint which is synchondrosis)
costal margin
cartilages of rubs 7-10
superior thoracic aperture (opening at top)
-T2 1st ribs, manubrium
pass through: trachea, esophagus, nerves, major vessels
Thoracic outlet syndrome
family of disorder which never fibers andor blood vessels are comprised at some point between the base of the neck and axilla, either neurological or vacular depending on loss of function, compromise both is rare
inferior thoracic aperture
bottom opening
T12, ribs 11,12, costal cartilage 7-10 xiphisternal jxn
closed by diaphragm
AORTA/esophagus, IVC
rib movement
pump/handle
bucket handle
muscles involved in respiration
serratus posterior superior
serratus posterior inferior
-both involved in proprioception more than just elevation
levator costarum: elevation
Intercostal muscles (between) (criss cross) -innervation: intercostal nerves (anterior Rami)
Intercostal muscles
major role player to allow flex
-external intercostal: elevate, stabilize, non muscular membrane anteriorly
- internal intercostal muscle
- depress ribs, stabilize
Innermost intercostal muscle: depress, stabilize
-non muscular membrane internally
diaphragm
dome shaped, central tendon, primary muscle of respiration
PA: right and left crura of diaphragm
rightL esophageal hiatus
both from aortic hiatus
-look at slide for crura?
Inn: motor and cental sensory: Phrenic nerves (C3-C5
peripheral sensory
innervation by intercostal nerves
-Phrenic paralysis, collapse?
openings in diaphragm
caval haitus: IFVC T8
esophageal hiatus: esophagus: T10
aortic hiatus: aorta thoracic duct, azygous vein T12
Innervation of thoracic wall
Anterior Rami: T1-T11, T12 is subcostal
Internal/innmerost costals
costal groove,
collateral branch at angle of rib
motor to intercostal muscles
terminal sensory branches
-run with dermatomes (anterior and posteror branching)
