Anatomy 🫀 Flashcards
What forms the thoracic cage?
is formed of:
• 12 vertebrae (posteriorly)
• 12 pairs of ribs
• Sternum (anteriorly).
What are ribs classified according to?
Ribs are divided according to extent into:
- True ribs: upper 7 (reach the sternum)
- False ribs: lower 5 subdivided into:
1. Vertebrochondral: from 8 to 10 ribs
2. Floating: 11 & 12 ribs
Ribs can be divided according to (structure) into:
- Typical ribs: from 3 to 9.
- Atypical ribs: 1 - 2 - 10 - 11 - 12.
What does each typical rib and the second rib articulate with?
Each typical rib + (2nd rib) articulate with vertebra of the same level & vertebra above
What is the neck of the first rib related to?
is related to (N.A.N):
1. sympathetic trunk
2. superior intercostal artery
3. branch from 1st intercostal nerve
What does the coastal groove on inner surface of ribs contain?
- intercostal vessels & nerve (arranged as Vein. Artery.
Nerve from above downwards)
What are thoracic vertebrae classified into?
Thoracic vertebrae are divided into:
- typical: 2 to 8
- Atypical: 1-9-10-11-12
what forms the thoracic wall?
- It is formed of 12 pairs of ribs & 11 intercostal spaces.
- spaces contain: muscles, vessels, nerves & lymphatics
What are the layers of intercostal muscles?
1) External intercostal muscles.
2) Internal intercostal muscles.
3) Transversus Thoracis: Divided into 3 parts:
a) Subcostalis.
b) innermost intercostal (Intercostals intimi)
c) Sternocostalis
What is the origin, insertion, direction, extant, completed by, nerve and action of external intercostal muscles?
Origin: rib above
Insertion: rib below
Direction: Downward & forward.
Extent: From tubercle of rib posteriorly to costochondral
junction (in front).
Completed by: Continued anteriorly as anterior intercostal membrane
Nerve: Corresponding intercostal nerve
Action: Inspiration (Elevation of ribs)
What is the origin, insertion, direction, extant, completed by, nerve and action of internal intercostal muscles?
Origin: rib above
Insertion: rib below
Direction: Downward & forward.
Extent: From lateral margin of sternum till angle of rib
Completed by: Posterior intercostal membrane
Nerve: Corresponding intercostal nerve
Action: Depression of ribs (expiration)
What is the origin, insertion, direction, extant, completed by, nerve and action of innermost intercostal muscles?.
Origin: rib above
Insertion: rib below
Direction: Downward & backward
Extent: attached between the rib above and the rib below
Nerve: Corresponding intercostal nerve
Action: Depression of ribs (expiration)
What is the origin, insertion, direction, extant, completed by, nerve and action of subcostalis muscle?
Origin: Inner surface of one rib medial to the angle
Insertion: Inner surface of the 2nd or 3rd rib below
Direction: down & medially
Site: posterior of the intercostal space
Nerve: Intercostal nerves.
Action: Depression of the ribs during expiration
What is the origin, insertion, direction, extant, completed by, nerve and action of sternocostalis muscles?
Origin: Back of the lower part of the body of the sternum and xiphoid process
Insertion: Inner surface of costal cartilages from 2nd to 6th
Direction: up & laterally
Site: Anterior of the intercostal space
Nerve: Intercostal nerves.
Action: Depression of the ribs during expiration
What is the definition of intercostal nerves?
ventral rami of upper 11 thoracic spinal nerves (12th = subcostal, below last rib)
What is the number of intercostal nerves?
11, pass in corresponding intercostal spaces.
What are the types of intercostal nerves?
- Typical: from third to sixth as they are distributed, only, in chest
- Atypical: upper 2 & last 5 intercostal nerves
What are the branches of typical intercostal nerves?
1) Rami communicates with sympathetic trunk:
A. It gives a white myelinated ramus communicans (preganglionic) to sympathetic trunk.
B. It receives gray unmyelinated ramus communicans (postganglionic) from the ganglion
2) Muscular branches: to intercostal muscles
3) Collateral branch: Runs along upper border of rib below & Supplies intercostal muscles.
4) Lateral cutaneous branch: Supplies skin on lateral side of chest.
5) Anterior cutaneous branch: Supplies skin on front of chest.
6) Pleural branches: Sensory to parietal pleura
What do atypical intercostal nerves supply?
- 1st intercostal nerve: supplies upper limb
- 2nd intercostal nerve: supplies axilla skin
- Lower five intercostal nerves: They supply skin & muscles of anterior abdominal Wall.
- The 12th thoracic nerve is called subcostal nerve
What is the number, location, origin and termination of anterior intercoastal arteries?
Number: 2 in each space
Location: In upper 9 intercostal spaces
Origin:
1-6: from internal thoracic artery
7-9: from musculophrenic artery
Termination:
Upper anterior: anastomoses with posterior intercostal artery itself.
Lower anterior: anastomoses with collateral branch of posterior intercostal artery
What is the number, location, origin and termination of posterior intercoastal arteries?
“The posterior intercostal arteries give Branches that Anastomose with internal thoracic artery”
Number: 1 in each space
Location: In all intercostal spaces (11 spaces)
Origin:
1 & 2: from superior intercostal artery “SICA” “from subclavian”
- 3-11: from descending thoracic artery
Termination:
Upper anterior: anastomoses with posterior intercostal artery itself.
Lower anterior: anastomoses with collateral branch of posterior intercostal artery
What is the number, location, termination and final termination of anterior intercoastal veins?
Number: 2 in each space
Location: in upper 9 spaces
Termination:
1-6: internal thoracic vein “beside internal thoracic artery”
7-9: vena comitantes of musculophrenic artery
Final Termination:
Internal intercostal vein terminates in the corresponding brachiocephalic vein.
What is the number, location, termination and final termination of posterior intercoastal veins?
Number: 1 in each space
Location: In all intercostal spaces
Termination:
- Right side:-
1st: Rt brachiocephalic vein
2-3: unite to form Rt superior intercostal vein which end into azygos vein. “The arch”
4-11: azygos vein.
- Left side:-
1st: Lt brachiocephalic vein
2-3: unite to form Lt superior intercostal vein which end into Lt brachiocephalic vein.
4-8: superior hemiazygos vein. 9-11: inferior hemiazygos vein.
Final Termination:
Right side: Azygos vein terminates into superior vena cava (sternal angle).
Left side: Hemiazygos veins terminate into azygos vein opposite T8.
What is the origin of azygos vein?
o Common: from the back of I.V.C
o Rare: union of Rt ascending lumbar vein & Rt subcostal vein
What is the termination of azygos vein?
In the S.V.C at the level of the sternal angle.