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
What muscle is continuous with the fibres of the external IC muscle?
External oblique
26
INTERNAL INTERCOSTAL
O - Inferior border of superior rib I - Superior border of inferior rib A - Depresses rib, decreasing thoracic volume In - T1-11 intercostal nerves
27
In which direction do the fibres of the internal IC muscle run?
Infero-posteriorly
28
Internal IC muscle contracts during which phase of breathing?
Expiration
29
What muscle is continuous with the fibres of the internal IC muscle?
Internal oblique
30
INNERMOST INTERCOSTAL
O - Inferior border of superior rib I - Superior border of inferior rib A - Depresses rib, decreasing thoracic volume In - T1-11 intercostal nerves
31
What structure separates the internal and innermost IC muscles?
IC neurovascular bundle
32
TRANSVERUS THORACIS
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
33
What muscle is the transversus thoracis continuous with?
Transversus abdominus
34
What artery runs inferiorly inbetween sternum and transversus thoracis muscle?
Internal thoracic artery
35
What are the 8 layers of the thorax?
``` External IC Internal IC IC neurovascular bundle Innermost IC Endothoracic fascia Parietal pleura Visceral pleura Lung ```
36
Describe the position of the subcostalis muscles...
Found in inferior thoracic wall | Run from internal surface of one rib to the second and third rib below
37
What is the function of the subcostalis muscle
Elevates the ribs to assist with inspiration
38
In what way to the fibres of the subcostalis muscle run?
Infero-posteriorly | same as internal IC
39
PECTORALIS MAJOR
O - clavicular and sternocostal heads I - IT groove of humerus A - elevates the ribcage In - lateral and medial pectoral nerve
40
PECTORALIS MINOR
O - 3rd to 5th rib I - coracoid process A - elevates the ribcage In - median pectoral nerve
41
SERRATUS ANTERIOR
O - medial border of scapula I - ribs 1 -8 A - elevates the ribcage In - long thoracic nerve
42
SCALENES (anterior, medius and posterior)
3 paired muscles running from C3-7 to the 1st/2nd rib Innervated by cervical and brachial plexi Aid heavy inspiration
43
STERNOCLEIDOMASTOID
``` 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
In what aspect of the IC space does the neurovascular bundle run?
Upper
45
What is the structural organisation of the neurovascular bundle components? (superior to inferior)
Vein Artery Nerve
46
From what nerves are the IC nerves formed?
Ventral rami of T1 to T11 and subcostal nerve from T12
47
What are the 5 branches of IC nerve?
``` Rami communicantes Collateral Muscular Lateral subcutaneous Anterior subcutaneous ```
48
What structure does the rami communicantes branch supply?
Thoracic sympathetic ganglion
49
What structures do the lateral subcutaneous branch supply?
Lateral aspects of thorax/abdomen
50
What structures do the anterior subcutaneous branch supply?
Anterior aspects of thorax/abdomen
51
What structures does the collateral branch supply?
IC muscles and parietal pleura
52
What structures does the muscular muscular branch supply?
IC muscles
53
How many types of intercostal artery are there?
2 | anterior and posterior
54
From where do the posterior intercostal arteries arises?
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
From where to the anterior intercostal arteries arise?
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
Into what vessel do the anterior IC veins drain?
Internal thoracic vein/musculophrenic vein
57
Into what vessel do the posterior IC veins drain?
Azygous vein
58
What are the three origins of the diaphragm?
Anterior - xiphoid process Lateral - lower 6 costal cartilages Posterior - L1,2,3
59
Where does the diaphragm insert?
Central tendon
60
What nerve innervates the diaphragm?
Phrenic nerve C3-5
61
What effect does diaphragm contraction have on the thoracic cavity and hence thoracic pressure?
Increases size of thoracic cavity and decreases thoracic volume
62
What structures pass through the aortic hiatus? What vertebral level is this?
``` Aorta Azygous vein Thoracic duct Sympathetic trunk T12 - aortic hiatus has 12 letters ```
63
What structures pass through the esophageal hiatus? At what vertebral level?
Esophageous Vagus nerve T10
64
What structure pass through the vena cava foramen? At what vertebral level?
Inferior vena cava Branches of phrenic nerves T8
65
How many domes does the diaphragm have?
2
66
What is the endothoracic fascia?
A thin layer of loose connective tissue that separates the innermost IC muscle from the parietal pleura
67
What are the four regions of parietal pleura?
Costal Diaphragmatic Mediastinal Cervical
68
What are the names of the two pleural recesses?
Costodiaphragmatic (fills during lung expansion) | Costomediastinal
69
What nerve innervates the costal and cervical parietal pleura?
intercostal nerve
70
What nerve innervates the mediastinal and diaphragmatic parietal pleura?
phrenic nerve
71
What is a pleural reflection? are the names of the 3 parietal plural reflections?
Sternal Costal Vertebral A curvature that occurs when a fold is made in the pleura to allow a change of direction
72
What are the 2 main differences between parietal and visceral pleura?
Parietal pleura thicker | Visceral pleura not sensitive to pain, temperature and touch
73
What is the innervation and blood supply of the visceral pleura?
Innervated by pulmonary plexus | Bronchial arteries
74
What is bucket handle movement? What ribs move in this way?
Increase in lateral thoracic diameter caused by rib elevation False ribs 7-10
75
What is pump handle movement? What ribs move this way?
Increase in anteroposterior thoracic diameter caused by rib elevation True ribs 2-6
76
How many anterior intercostal arteries supply each IC space?
2
77
What type of joints are the sternocostal joints?
Plane synovial
78
During expiration, what height does the left diaphragm dome reach?
5th IC space
79
During expiration, what height does the right dome of diaphragm reach?
5th rib
80
As well as the phrenic nerve, which other nerve supplies innervation to the inferior aspect of the diaphragm?
Subcostal nerve
81
What are the four mediastinal compartments?
Superior | Inferior (anterior, middle, posterior)
82
What nerve does the left recurrent laryngeal nerve branch from?
Vagus nerve
83
What structure does the recurrent laryngeal nerve supply?
Larynx
84
Name the contents of the superior mediastinum (2 vessels, 4 nerve structures, 4 other structures- 10 in total)
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
Name the contents of the anterior mediastinum
Thymus Sternopericardial ligaments Internal thoracic arteries
86
List the contents of the the middle mediastinum (5 structures, 3 nerves)
``` Heart/pericardium Tracheal bifurcation Ascending aorta Pulmonary trunk Tracheobronchial lymph node ``` superior vena cava Superficial and deep cardiac plexi Phrenic nerve
87
List the contents of the posterior mediastinum (1 nerve, 4 structures)
Descending aorta Oesophagus Thoracic duct Azygous vein Sympathetic trunk Vagus nerve
88
What are the four branches of the descending (thoracic) aorta?
Posterior intercostal Bronchial (supply bronchi) Superior phrenic Oesophageal
89
What is the splanchnic nerve?
A branch of the thoracic sympathetic trunk that carry sympathetic signals to the abdominal organs