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CRAAB 1 > Ach: Anterior Thoracic Wall > Flashcards

Ach: Anterior Thoracic Wall Flashcards

1
Q

When looking at the sternal angle, you know it is a clinical landmark for….

A

second rib and second intercostal space

T4/T5 plane
mediastinum
aortic arch
tracheal bifurcation
SVC entering the pericardium 
superior limit of the pulmonary trunk
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2
Q

How many ribs/vertebra make up hte bony thorax?

A

12 ribs
12 vertebra
sternum

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3
Q

What are the “true ribs”?

A

1-7

articulate with sternum by costal cartilages

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4
Q

What are the “false ribs”? Which connect to costal cartilage of rib above?

A

8-12

8-10

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5
Q

What are the floating or free ribs?

A

11, 12

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6
Q

What are the main components of a rib?

A

Facets- articulate with the vertebral bodies
Head
Neck
Tubercle- articulates with the transverse process
angle
costal groove

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7
Q

Where is the weakest part of a rib?

A

anterior to it’s angle

middle ribs break most often

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8
Q

The facets on the head of the rib articulate with?

A

body of the corresponding vertebra and the vertebra above

superior and inferior facet

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9
Q

Facet on the tubercle articulates with what?

A

Tip of corresponding transverse process

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10
Q

What do the costal cartilages articulate with?

A

1-7 sternum

8-10 adjacent costal cartilages

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11
Q

Facets on the head of rib 7 and the facet of the tubercle articulate with what vertebra?

A

Vertebra 7 and 6

Transverse process of rib 7

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12
Q

How many vertebra and intervertebral disks are there?

A

12

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13
Q

What is the thoracic inlet?

A

Border between the neck and thorax

manubrium
1st ribs
T1 vertebra

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14
Q

What is the thoracic outlet and what marks this location?

A

border between thorax and abdomen

costal margins of 12th ribs and the costal cartilages of ribs 7-11

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15
Q

The thoracic outlet is the origin for the…

A

respiratory diaphragm

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16
Q

How does the chest increase in vertical diameter?

A

Contract the diaphragm

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17
Q

How does the chest increase the transverse diameter?

A

BUCKET HANDLE

movement of ribs up and out

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18
Q

How does the chest increase the anterioposterior diameter?

A

PUMP HANDLE

raise sternum and anterior ends of ribs

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19
Q

How do you breathe?

A

Thoracic cage moves>
increases/decreases the intrathoracic volume>
pressure change>
air follows decrease in pressure

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20
Q

What is the superior thoracic aperture (thoracic inlet)? Boundaries?

A

Communicates with the root of the neck

T1
1st ribs and costal cartilage
Manubrium

21
Q

What is the inferior thoracic aperture (thoracic outlet)? Boundaries?

A

Diaphragm closes the aperture
Openings in the diaphragm allow communication with the abodomen

T12
12th pair of ribs and costal margins
xiphesternal joint

22
Q

How many layers of muscle fill the intercostal space?

A

3

23
Q

Where does VAN (intercostal vein, artery, nerve) lie?

A

subcostal groove under the lower border of the upper rib

24
Q

How many pairs of external intercostal muscles are there? How do they lie? Do the reach the sternum?

A

11 pair

Fibers slant DOWNWARD and FORWARD from rib above to rib below

NO

25
Q

How many pairs of internal intercostal muscles are there? How do they run?

A

11 pair

Fibers run DEEP to and at RIGHT ANGLES to the external intercostals

26
Q

How do external and internal intercostals differ in what they’re replaced by?

A

external- replaced by EXTERNAL intercostal membrane ANTERIORLY

internal- replaced by INTERNAL intercostal membrane POSTERIORLY

27
Q

What do the innermost intercostal muscles cover?

A

The middle half of intercostal spaces

28
Q

What are the actions of intercostal muscles?

A

WIDEN intercostal spaces
keep intercostal spaces RIGID during respiration
ELEVATE or DEPRESS ribs

29
Q

What forms the intercostal nerves?

A

Ventral rami of the first 11 thoracic nerves as they enter the intercostal spaces

30
Q

What forms the subcostal nerve?

A

Ventral ramus of the 12th nerve

lies INFERIOR to the 12th rib

31
Q

A ganglion of the sympathetic trunk is associated with each ventral ramus. It connects to the nerve via rami communicantes. What is the difference between white ramus and gray ramus?

A

white- conveys preganglionic sympathetic fibers to the ganglion (myelinated)

gray- conveys postganglionic sympathetic fibers from the ganglion into the intercostal nerve (unmyelinated)

32
Q

What are the typical branches of an intercostal nerve?

A 
rami communicantes
collateral branches
lateral cutaneous branches
anterior cutaneous branches
muscular branches to the intercostal muscles
33
Q

What nerves supply the abdominal musculature, pleura, periotoneum and skin?

A

Nerves from T7-12

Motor innervation: intercostal muscles

Sensory innervation: skin and pleura

34
Q

What nerves supply the nipple and the umbilicus respectively?

A

T4

T10

35
Q

How many arterial sources are there for each intercostal space? What are they?

A

2 that form an anastomoses

Posterior intercostal artery (branches of the thoracic aorta)
Anterior intercostal arteries in spaces 1-6 (branches of internal thoracic artery which branches from the subclavian)

36
Q

Where does the internal thoracic artery run?

A

posterior to costal cartilage and lateral to sternum

37
Q

What are the branches off the internal thoracic artery?

A

Pericardiacophrenic- accompanies phrenic nerve
musculophrenic- supplies spaces 7-9
superior epigastric- diaphgram and superior abdominal wall
anterior intercostal arteries

38
Q

Where do they anterior intercostal veins drain?

A

into the itnernal thoracic veins

39
Q

What systems do the posterior intercostal veins drain into?

A

azygos and hemiazygos system of veins

40
Q

What is thoracic outlet syndrome?

A

Clinical syndromes caused by congenital or acquired compression of brachial plexus/subclavian veins passing through thoracic outlet to the upper limb

41
Q

What are sxs of brachial plexus compression?

A

Pain
paresthesia
numbness of upper limbs

42
Q

What are sxs of subclavian artery compression?

A

ischemia
pallor
coolness
decrease in limb pulses

43
Q

What are sxs of subclavian vein compression?

A

swelling
pain
venous thrombosis

44
Q

From how many ossification centers does the bony thorax develop? When does it fuse?

A

6 ossification centers
fuse around age 25
xiphoid process fuses 30-40

45
Q

What is a symphysis and what are examples of it?

A

secondary cartolaginous joint
bones are joined by fibrocartilage

sternal angle
pubic symphpysis
joints between intervertebral discs

46
Q

What is a synchondrosis?

A

primary cartilaginous joint
bones united by hyaline cartilage temporarily then converted to bone

xiphesternal joint

47
Q

What do the external intercostal muscles do?

A

Elevates ribs

forced INSPIRATION

48
Q

What do the internal intercostal muscles do?

A

Depresses ribs

forced EXPIERATION

CRAAB 1 (11 decks)

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