Anatomy of the thorax Flashcards

1
Q

What is the name given to ribs 1-7? What do they articulate with?

A

True ribs

Sternum

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2
Q

The term ‘false ribs’ refer to what ribs? What do they articulate with?

A

8-10

Articulate with sternum indirectly via costal cartilage

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3
Q

What is the name given to ribs 11-12? Why?

A

Floating ribs

No articulation with the sternum

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4
Q

What ribs are defined structurally as ‘typical ribs’? How many articular facets does a typical rib have?

A

Ribs 3-9

2 articular facets

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5
Q

The costotransverse joins is the name given to the articulation between which two structures?

A

Tubercle of rib and transverse costal facet of thoracic vertebrae

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6
Q

Describe the structures that make up the costovertebral joint…

A

Articulation between the two articular facets on the head of the rib, and the superior and inferior demifacets on the thoracic vertebral body

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7
Q

Costotranverse and costovertebral joints are both what type of joints?

A

Plane synovial joints

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8
Q

What ribs can be structurally classified as atypical?

A

Ribs 1,2, 10, 11 and 12

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9
Q

What are the defining features of rib 1? (4 defining features)

A

-Short and wide
-Only one articular facet
-Superior surface has two grooves in which subclavian
vessels sit
-Tubercle in-between the two grooves is attachment site
for scalene muscle

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10
Q

What are the defining features of rib 2?

A

Roughed tubercle on superior surface is where serratus anterior attaches

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11
Q

What are the defining features of rib 10?

A

Only 1 articular facet

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12
Q

What are the defining features of ribs 11 and 12? (2 features)

A
  • Only 1 articular facet

- No neck

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13
Q

What type of cartilage is costal cartilage?

A

Hyaline type II

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14
Q

How many thoracic vertebra are there?

A

12

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15
Q

What are the defining features of thoracic vertebra? (3 features)

A

-Heart shaped vertebral body
-2 demifacets on vertebral body that articulate with ribs
-Transverse costal facets found on transverse processes
of T1-T10

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16
Q

In total, how many articulating surfaces is present on each vertebra?

A

4

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17
Q

What are the borders of the superior thoracic aperture/thoracic inlet?

A

A - sternal manubrium
P - T1
Lateral - medial margins of 1st rib

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18
Q

What are the borders of the inferior throacic aperture/thoracic outlet?

A

A - costal margin
P - T10
Lateral - ribs 11 and 12

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19
Q

What are the 4 thoracic cage muscles?

A

External intercostals
Internal intercostals
Innermost intercostals
Transversus thoracis

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20
Q

What are the 5 accessory muscles of breathing?

A
Pectoralis major
Pectoralis minor
Scalene
Serratus anterior
Sternocleidomastoid
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21
Q

What are the 4 muscles of expiration?

A

Rectus abdominus
Transverse abdominus
Internal oblique
External oblique

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22
Q

EXTERNAL INTERCOSTAL

A

O - Inferior border of superior rib
I - Superior border of inferior rib
A - Elevates rib, increasing thoracic volume
In - T1-11 intercostal nerves

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23
Q

The external IC muscle contracts during which phase of breathing?

A

Inspiration

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24
Q

In what direction do the fibres of the external IC muscle run?

A

Antero-inferiorly

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25
Q

What muscle is continuous with the fibres of the external IC muscle?

A

External oblique

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26
Q

INTERNAL INTERCOSTAL

A

O - Inferior border of superior rib
I - Superior border of inferior rib
A - Depresses rib, decreasing thoracic volume
In - T1-11 intercostal nerves

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27
Q

In which direction do the fibres of the internal IC muscle run?

A

Infero-posteriorly

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28
Q

Internal IC muscle contracts during which phase of breathing?

A

Expiration

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29
Q

What muscle is continuous with the fibres of the internal IC muscle?

A

Internal oblique

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30
Q

INNERMOST INTERCOSTAL

A

O - Inferior border of superior rib
I - Superior border of inferior rib
A - Depresses rib, decreasing thoracic volume
In - T1-11 intercostal nerves

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31
Q

What structure separates the internal and innermost IC muscles?

A

IC neurovascular bundle

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32
Q

TRANSVERUS THORACIS

A

O - posterior surface of inferior sternum
I - costal cartilages of ribs 2-6
A - Depresses the ribcage, decreasing thoracic volume
In - T1-11 IC nerves

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33
Q

What muscle is the transversus thoracis continuous with?

A

Transversus abdominus

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34
Q

What artery runs inferiorly inbetween sternum and transversus thoracis muscle?

A

Internal thoracic artery

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35
Q

What are the 8 layers of the thorax?

A
External IC
Internal IC
IC neurovascular bundle
Innermost IC
Endothoracic fascia
Parietal pleura
Visceral pleura
Lung
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36
Q

Describe the position of the subcostalis muscles…

A

Found in inferior thoracic wall

Run from internal surface of one rib to the second and third rib below

37
Q

What is the function of the subcostalis muscle

A

Elevates the ribs to assist with inspiration

38
Q

In what way to the fibres of the subcostalis muscle run?

A

Infero-posteriorly

same as internal IC

39
Q

PECTORALIS MAJOR

A

O - clavicular and sternocostal heads
I - IT groove of humerus
A - elevates the ribcage
In - lateral and medial pectoral nerve

40
Q

PECTORALIS MINOR

A

O - 3rd to 5th rib
I - coracoid process
A - elevates the ribcage
In - median pectoral nerve

41
Q

SERRATUS ANTERIOR

A

O - medial border of scapula
I - ribs 1 -8
A - elevates the ribcage
In - long thoracic nerve

42
Q

SCALENES (anterior, medius and posterior)

A

3 paired muscles running from C3-7 to the 1st/2nd rib
Innervated by cervical and brachial plexi
Aid heavy inspiration

43
Q

STERNOCLEIDOMASTOID

A
O - sternal head > manubrium of sternum
      clavicular head > mid clavicle
I - mastoid process of temporal bone
A - elevates thorax, increasing thoracic volume
In - accessory nerve
44
Q

In what aspect of the IC space does the neurovascular bundle run?

A

Upper

45
Q

What is the structural organisation of the neurovascular bundle components? (superior to inferior)

A

Vein
Artery
Nerve

46
Q

From what nerves are the IC nerves formed?

A

Ventral rami of T1 to T11 and subcostal nerve from T12

47
Q

What are the 5 branches of IC nerve?

A
Rami communicantes
Collateral
Muscular
Lateral subcutaneous
Anterior subcutaneous
48
Q

What structure does the rami communicantes branch supply?

A

Thoracic sympathetic ganglion

49
Q

What structures do the lateral subcutaneous branch supply?

A

Lateral aspects of thorax/abdomen

50
Q

What structures do the anterior subcutaneous branch supply?

A

Anterior aspects of thorax/abdomen

51
Q

What structures does the collateral branch supply?

A

IC muscles and parietal pleura

52
Q

What structures does the muscular muscular branch supply?

A

IC muscles

53
Q

How many types of intercostal artery are there?

A

2

anterior and posterior

54
Q

From where do the posterior intercostal arteries arises?

A

Superior thoracic branch of costocervical trunk (branch of subclavian artery) supply IC1 and 2
All other IC spaces supplied by branches from thoracic aorta

55
Q

From where to the anterior intercostal arteries arise?

A

1st 6 IC spaces - branches of internal thoracic artery
2nd 6 IC spaces - branches of musculophrenic artery

(internal thoracic branches into superior epigastric and musculophrenic at level of 6th IC space)

56
Q

Into what vessel do the anterior IC veins drain?

A

Internal thoracic vein/musculophrenic vein

57
Q

Into what vessel do the posterior IC veins drain?

A

Azygous vein

58
Q

What are the three origins of the diaphragm?

A

Anterior - xiphoid process
Lateral - lower 6 costal cartilages
Posterior - L1,2,3

59
Q

Where does the diaphragm insert?

A

Central tendon

60
Q

What nerve innervates the diaphragm?

A

Phrenic nerve C3-5

61
Q

What effect does diaphragm contraction have on the thoracic cavity and hence thoracic pressure?

A

Increases size of thoracic cavity and decreases thoracic volume

62
Q

What structures pass through the aortic hiatus? What vertebral level is this?

A
Aorta
Azygous vein
Thoracic duct
Sympathetic trunk
T12 - aortic hiatus has 12 letters
63
Q

What structures pass through the esophageal hiatus? At what vertebral level?

A

Esophageous
Vagus nerve
T10

64
Q

What structure pass through the vena cava foramen? At what vertebral level?

A

Inferior vena cava
Branches of phrenic nerves
T8

65
Q

How many domes does the diaphragm have?

A

2

66
Q

What is the endothoracic fascia?

A

A thin layer of loose connective tissue that separates the innermost IC muscle from the parietal pleura

67
Q

What are the four regions of parietal pleura?

A

Costal
Diaphragmatic
Mediastinal
Cervical

68
Q

What are the names of the two pleural recesses?

A

Costodiaphragmatic (fills during lung expansion)

Costomediastinal

69
Q

What nerve innervates the costal and cervical parietal pleura?

A

intercostal nerve

70
Q

What nerve innervates the mediastinal and diaphragmatic parietal pleura?

A

phrenic nerve

71
Q

What is a pleural reflection? are the names of the 3 parietal plural reflections?

A

Sternal
Costal
Vertebral

A curvature that occurs when a fold is made in the pleura to allow a change of direction

72
Q

What are the 2 main differences between parietal and visceral pleura?

A

Parietal pleura thicker

Visceral pleura not sensitive to pain, temperature and touch

73
Q

What is the innervation and blood supply of the visceral pleura?

A

Innervated by pulmonary plexus

Bronchial arteries

74
Q

What is bucket handle movement? What ribs move in this way?

A

Increase in lateral thoracic diameter caused by rib elevation
False ribs 7-10

75
Q

What is pump handle movement? What ribs move this way?

A

Increase in anteroposterior thoracic diameter caused by rib elevation
True ribs 2-6

76
Q

How many anterior intercostal arteries supply each IC space?

A

2

77
Q

What type of joints are the sternocostal joints?

A

Plane synovial

78
Q

During expiration, what height does the left diaphragm dome reach?

A

5th IC space

79
Q

During expiration, what height does the right dome of diaphragm reach?

A

5th rib

80
Q

As well as the phrenic nerve, which other nerve supplies innervation to the inferior aspect of the diaphragm?

A

Subcostal nerve

81
Q

What are the four mediastinal compartments?

A

Superior

Inferior (anterior, middle, posterior)

82
Q

What nerve does the left recurrent laryngeal nerve branch from?

A

Vagus nerve

83
Q

What structure does the recurrent laryngeal nerve supply?

A

Larynx

84
Q

Name the contents of the superior mediastinum (2 vessels, 4 nerve structures, 4 other structures- 10 in total)

A

Arch of aorta (BC trunk, L common carotid and L subclavian)
Superior vena cava (azgous vein, BC veins)

Vagus nerve (inc recurrent laryngeal)
Sympathetic trunk
Superficial and deep cardiac plexi
Phrenic nerve

Thoracic duct
Oesophagus
Thymus
Trachea

85
Q

Name the contents of the anterior mediastinum

A

Thymus
Sternopericardial ligaments
Internal thoracic arteries

86
Q

List the contents of the the middle mediastinum (5 structures, 3 nerves)

A
Heart/pericardium
Tracheal bifurcation
Ascending aorta
Pulmonary trunk
Tracheobronchial lymph node

superior vena cava
Superficial and deep cardiac plexi
Phrenic nerve

87
Q

List the contents of the posterior mediastinum (1 nerve, 4 structures)

A

Descending aorta
Oesophagus
Thoracic duct
Azygous vein

Sympathetic trunk
Vagus nerve

88
Q

What are the four branches of the descending (thoracic) aorta?

A

Posterior intercostal
Bronchial (supply bronchi)
Superior phrenic
Oesophageal

89
Q

What is the splanchnic nerve?

A

A branch of the thoracic sympathetic trunk that carry sympathetic signals to the abdominal organs