Anatomy of the thorax and upper limbs Flashcards
What do the ribs attach to?
The sternum
Different name for collarbone?
Clavicle
What separates the thorax and abdomen?
The diaphragm
What is the notch at the top of the sternum called?
The jugular notch
What is the movement of the ribcage essential for?
Respiration
The lungs move with the ribcage
How is the heart kept in its exact anatomical position and still able to beat with least possible resistance?
Pericardium (envelope of the heart)
What is the cartilage that connects the ribs to the sternum called?
Costal cartilage
How many pairs of ribs?
12
Which ribs do not have cartilage?
11th and 12th ribs
Which ribs articulate independently with the sternum?
The first 7
Which ribs are called false ribs?
8, 9 and 10
The ones that articulate indirectly with the sternum
Which are the fluctuate ribs?
11 and 12
Where do the vein and arteries that pass above the first rib go?
To the upper limbs
What are three serous membranes of the thorax called?
Pericardium
Pleuras
Peritoneum
What is the upper part of the sternum called?
Manubrium
hat is the middle part of the sternum called?
Body
What is the small bottom part of the sternum called?
Xiphoid process (sword)
What is the bump/angle/connection between the manubrium and body of sternum called?
Sternal angle/ angle of Luis
4 parts of the mediastinum
Superior
Middle
Anterior
Posterior
Where does the inferior mediastinum start?
Middle of T4
Which lung is smaller?
Left
What part of the pleural cavities is not filled during normal, non-forced inspiration called?
Costa-diaphragmatic pleural cavities
What is the main artery in the thorax?
The aorta
What is the posterior most organ in the mediastinum?
The aorta
What is the area below the clavicular called?
Infraclavicular fossa
What rib do you hit when going from the angle of Luis?
The second rib
Which rib is at the apex of the heart?
5th
Which is the shortest rib?
1st
Which is the longest rib?
9th or 10th (they generate most transverse expansion)
How does length of the rib effect the volume when inhaling?
The shorter the rib the less difference in volume
Which ribs are flat?
1st and 2nd
Why are the first and second rib flat?
Muscle attachement from muscles from the neck
Vessels needing to pass above flat surface
What is the point called where the rib bends?
The Rib/costal angle
Are the costal angles vertically aligned?
No
How does the shape of the ribs change going down?
The more lateral the costal angle and the more anteriorly oblique they are oriented
Which direction do the ribs expand when being raised?
Transverse and anterior-posterior increase of diameter
Linear movement made into 3d volume increasing
How is the vertical diameter increased during respiration?
The diaphragm is decreased
What is the 11th and 12th called?
The floating rib
How many joints between rib and transverse process of the vertebrae
2 joints (places they articulate)
Where do the heads of the ribs articulate? (except the first and last)
In between 2 vertebrae (ex 2nd rib between T1 and T2)
Which thoracic muscles do what?
External inspiration
Internal expiration
What are the 3 holes in the diaphragm?
Aortic hiatus
Caval opening
Esophagel hiatus
What happens to the oesophagus during respiration?
It is squeezed by the diaphragm which helps keep the acid from the stomach away from the oesophagus
Where is the neuro intercostal bundle located in relations to the rib?
Below/inferior
How are the bones in the forarm located?
Radius is lateral
Ulnar is medial
What is the shape of the scapula?
Triangular and flat
What keeps the scapula in place?
Muscle
What is working when lifting your arm more than 140 degrees?
The scapula, before that it is the glenoid cavity
What articulates in the acromioclavicular joint?
Calvicle and scapula
What bones form the shoulder gear?
Scapula
Clavicle
Humerus
Only real joint of scapula
Acromioclavicular
What is the scapula thoracic joint?
Soft tissue located between bones
What bone has the glenoid cavity?
The scapula
Where does the scapula articulate with the humerus?
Glenohumeral joint
Why do we use muscles for stability more than ligaments
Ligament are inactive/passive which gives less mobility
Why do ligaments provide less stability?
They are inactive/passive
What kind of joint is the sternoclavicular joint?
A saddle joint
Why does a small angle make a big movement of the clavicle?
Because is it a long bone
Why can the glenoid cavity surface area be so much smaller than the head of the humerus?
Because the two surfaces are always in contact during movement, rotation and translation
Names of the necks of the humerus
Anatomical neck of the humerus
Surgical neck (area where bone is cut by surgeon)
Which is the only “real” neck of the humerus?
Surgical neck
Where is the greater tubercle of the humerus in relation to the lesser
Lateral
What does the greater tubercle “touch” (synovial membrane in between) when the arm is abducted around 110c?
Acromioclavicular joint
What does the greater tubercle touching the acromioclavicular joint make the end of?
End of pure glenoid humerjoint movement
What are the 3 glenohumeral ligament?
Inferior, middle and superior
Which are the thicker part of the glenohumeral joint cavity?
Superior, middle and inferior ligaments
What does coracoid mean (coracoid process)?
Beak of crow
Why is the coracoid process important?
Ligament of scapula attach (coracoacromial ligament) which forms roof of glenohumeral joint
Why is there a ligament between the coracoid process and the rest of the scapula?
To complete the roof of the glenohumeral joint
Where do the extrinsic muscles attach?
In the limb and somewhere else (like spine)
Where do the intrinsic muscles attach?
Only within the limb
What is the most superficial muscle on the shoulder?
Deltoid
What kind of muscle is the pectorals major?
Extrinsic
Superficial
What will the anterior and posterior and lateral part of the deltoid do?
Ant and pos: mostly rotate
Lat: abducting
What are the biceps of the arm called?
Biceps brachii
What does bicep mean?
That it has two heads (short and long head)
Where does the short head of the bicep attach?
The coracoid process
Which head of the bicep has a tendon?
The long head
What does the synovial sheet allow the tendon of the long head of the bicep to do?
Allows tendon to slide while muscle is working
Where does the tendon of the long head of the bicep attach?
Supra glenoid tubercle
Where are intratriccular synovial joints?
Inside the capsule and synovial membrane
Is the long head of the bicep intratricular?
NO
What is the long head of the bicep?
Intracapsular extrasynoval (because the tendon is below the capsule but external of the synovial fluid)
How many heads does the tricep have?
3
Lateral
Medial
Long
What does the tricep do?
Extends elbow
Where does the long head of the tricep attach?
To the scapula
Where does the medial and lateral head of the tricep attach?
Posterior aspect of the humerus
Where does the deltoid attach (originate)?
Clavicle
Acromion
Scapular spine
Where does the bottom of the deltoid attach?
Deltoid tuberosityof the humerus
4 muscles of the rotator cuff
Supraspinatus
Infraspinatus
Teres minor
Subscapularis
Where do the muscles of the rotator cuff origin?
Scapula
Where do the muscle of the rotator cuff have their insertion?
Humerus
What is the Coraco brachialis a flexor of when starting from anatomical position?
The humerus
2 parts of the trapezius
Inferior triangle
Superior trianlge
What is the boney process of the ulnar called?
Olecranon
When does the extension of the elbow stop?
When the olecranon touches the humerus
When the position of the arm/hand is in the anatomical position what is the first finger?
Lateral
What kind of joint is the trochlea joint?
Hinge
When doing pronosupination (flipping the hand) is the elbow working?
No only the radioulnar
What changes the relative position during pronosupination?
The rotation at the distal end as the relative position at the proximal end remains the same despite the rotation
Where are the muscles that control the precise movements with less force of the hand?
In the hand
Where are the muscles that control large and strong movements of the hands located?
In the arm with tendons going to the hand
Where are flexors of the fingers found?
In the anterior compartment of the forarm
Where are the extensors of the fingers found?
In the posterior compartment of the forarm
Where are muscles that do pronation of the arm found?
Anterior compartment of the forarm
Where are muscles that do supination of the arm found?
Posterior compartment of the forarm
Where do the anterior superior muscles of the forearm originate?
The medial epicondyle of the humerus
What are the wrist bones called?
Carpal bones
What are the finger bones called?
Phalanges
What are the bones between the phalanges and the carpal bones called?
Metacarpal
Which bones contributes most to the wrist joint? Radius or Ulna?
Radius
What creates the carpal tunnel?
The ligament connecting the pisiform and tubercle of trapezium above the rest of the carpal bones creating a tunnel
How many saddle joints in the hand?
1, carpometacarpal joint of the thumb
Allows for the movement of the thumb
What is the name of the ligament that forms the carpal tunnel?
Flexor retinaculum
What allows for individual movements of the tendons in the hand?
Each tendon has an envelope of synovial sheet
3 groups of intrinsic muscles of the hand
Thenar eminence (towards thumb)
Hypotenar eminence (towards 5th finger)
Metacarpal (palmar)
What are the boundaries of the thoracic wall?
Inferior border of the neck and thoracoabdominal line
Does the thoracic cavity have different boundaries from those of the wall?
Yes
Superiorly: goes beyond the inferior border of the neck, reaching supraclavicular fossae
Inferiorly corresponds to the diaphragmatic cupula located above the thoracoabdominal line
What is the thoracic wall formed by?
Skin, muscles and bony skeleton
What kind of bones are ribs?
Flat bone
Why are ribs considered flat bones and not long bones?
Because they consist of an external lamina of compact bone tissue covering spongy bone
Have a neck and a body
Where is the tubercle of the rib found?
Between the neck and the body
Which part of the ribs articulate with the spine?
The head of the ribs
What kind of surfaces does the body of the rib have?
Convex external surface
Concave internal surface
Which border of the body of the rib is blunt and which is sharp?
The superior border is blunt
The inferior border is sharp
What is the place of the rib where vessels and nerves run called?
The costal groove
What does the tubercle of the ribs articulate with?
The facet of the transverse process of the vertebra
What does the head of the rib articulate with?
The inferior facet articulates with the body of the vertebrae
And the superior facet articulates with the disc
Which ribs only have one head?
1st, 10th, 11th and 12th
Shape of the costal cartilage
The body is flattened
Has two extremities, one lateral and one medial
Which are the most fragile ribs?
The central ribs
Which is the weakest point of the ribs?
Right in front of the costal angle
What kind of bone does the sternum contain?
Trabecular bone which is extensively vascularised and covered by a layer of compact bone
What are the ridges of the sternum where it connects with costal cartilage called?
Costal notches
Why can the clavicle not be considered a long bone?
Because it contains a medullary cavity and it’s ossification occurs like that of flat bone
What does the superior base of the sternal facet in the clavicle articulate with?
The manubrium of the sternum
What does the acrominal facet on the acrominal end of the clavicle articulate with?
The acromion of the scapula
Which ribs does the scapula cover?
The 3rd to the 7th
Is the costal (anterior) surface of the scapula concave or convex?
Concave
From where on the scapula does the subscapularis originate?
The subscapular fossa
From where on the scapula does the supraspinatus originate?
The supraspinous fossa
From where on the scapula does the infraspinatus originate?
The infraspinous fossa
What is the medial border of the scapula parallel to?
Vertebral column
At the level of which rib is the inferior angle of the scapula located?
7th
Why are the superior, inferior borders and the surface of the spine of the scapula rough?
Due to presence of muscular insertions
Which is the longest bone of the upper limb?
Humerus
What is the body of the humerus called?
Diaphysis
What are the two enlarged ends of the humerus called?
Epiphyses
What does the proximal epiphyses of the humerus articulate with?
Glenoid cavity of the scapula
What does the distal epiphysis of the humerus articulate with?
Ulna and radius
How many surfaces of the humerus can be described? Their names
3
Anterolateral
Anteromedial
Posterior
On which epiphyses of the humerus is the groove for the ulnar nerve found?
The distal epiphyses
Where on the humerus is the coroners process of the ulna when the elbow joint is flexed?
The coronoid fossa
Where on the humerus is the coroners process of the ulna when the elbow joint is extended?
Olecranon fossa
Which is the lateral bone of the forearm?
The radius
What does the radius articulate with distally?
Carpal bones
How many surfaces does the shaft (body) of the radius have?
3 (anterior, posterior and lateral)
Which end of the radius is more voluminous?
The distal end
Which end of the ulna is more voluminous and resembles a large hook?
The proximal
What bones are the hand composed of?
Carpal, metacarpals & phalanges
What is the carpus?
Bony complex consisting of 8 short bones (carpals) that articulate with eachother & the forearm & metacarpals
Which is the smallest carpal bone?
Pisiform
Which carpal articulates with the first metacarpal?
The trapezium
Which is the largest carpal bone?
The capitate
What does the skeleton of the metacarpus consist of?
5 long bones (the metacarpals)
How are the metacarpals numbered?
Lateromedial / radioulnar (thubms is 1st, pinkey is 5th )
Structure of metacarpals
Base (proximal)
Shaft (body)
Head (distal)
What does the base of the metacarpals articulate with?
The bones of the distal row of the carpus
What does the head of the metacarpals articulate with?
The proximal phalanges of the fingers
How many surfaces does the shaft (body) of the metacarpals have? & how are they named?
3
Dorsal
Lateral
Medial
How many phalanges are there?
14
How many phalanges in each finger?
2 in the thumb
3 in the last four fingers
What type of bones are phalanges?
Long bones
What is the head replaced with in the distal phalanges ?
The tuberosity of the distal phalanx
What does the tuberosity of the distal phalanx accommodate?
The nail
How many surfaces does the shaft of the phalanges have ?
2 (dorsal & palmar)
Different name for shoulder girdle
Pectoral girdle
Which joints are included in the pectoral girdle?
Sternoclavicular & acromioclavicular synovial joints
Syndesmoses represented by the coracoacromial, superior transverse scapular & inferior transverse scapular ligaments
What does the sternoclavicular joint join?
The sternal/medial end of the clavicle to the manubrium of the sternum
What movements does the sternoclavicular joint allow for? (5)
Protraction (forward)
Retraction (backward)
Elevation
Depression
Rotation
How many degrees of freedom and how many movements does the sternoclavicular joint allow for?
3 degrees of freedom
6 types of movements
What kind of joint is the acromioclavicular joint?
Plane joint
What kind of movements does the acromioclavicular joint allow for?
Small sliding movements which change the amplitude of the angle between the scapula & clavicle
Why is the scapulothoracic joint not a true anatomical joint but a functional joint?
Because the surfaces in relation to each other aren’t bony
How many degrees of freedom does the glenohumeral joint posses?
3
Which ligament originates from the superior part of the glenoid cavity and inserts on the anatomical neck of the humerus?
The superior glenohumeral ligament
Which ligaments originates from the anterior contour of the glenoid cavity and leads to the base of the lesser tubercle?
The middle glenohumeral ligament
Which ligament originates from the anteroinferior contour of the glenoid cavity and leads to the surgical neck of the humerus?
The inferior glenohumeral ligament
Which tendons form the rotator cuff?
Supraspinatus
Subscapularis
Infraspinatus
Tres minor
Fused together with the external surface of the joint capsule
Where do most dislocations of the shoulder happen and why?
Anteriorly
Because it’s most unstable anteroinferiorly
How many joints in the elbow joint?
3
How many joint capsules in the elbow joint?
1
Why is the elbow joint one of the most stable joints?
Because it is one of the most congruent
What kind of joint is the humeroulnar?
Hinge joint
What kind of joint is the humeroradial joint?
Condylar
What kind of joint is the proximal radioulnar joint?
Pivot
What does the humeroulnar joint allow for?
Flexion and extension
What bone is the olecranon a part of?
The ulna
What kind of movement does the humeroradial joint allow for?
Flexion, extension and rotation during pronosupination
What kind of movement does the proximal radioulnar joint allow for?
Rotational movements of the radius on the ulna (pronosupination)
What is the extension of the joint capsule to the neck of the radius called?
Sacciform recess of the elbow joint
What kind of joint is the distal radioulnar joint?
Monoaxial pivot joint
What kind of joint is the wrist joint?
Condylar
Does the ulna participate in the wrist joint?
No
Does the pisiform participate in the wrist joint?
No
What kind of joints are the carpal joints?
Plane joints
4 thoracoappendicular muscles
Pectoralis major
Pectoralis minor
Serratus anterior
Subclavius
Where do the thoracoappendicular muscles originate?
Ribs and sternum
Where do the thoracoappendicular muscles insert?
Pectoral girdle and humerus
Action of the pectorals major
Adducts and internally rotates the glenohumeral joint
Indirectly lowers the scapula
Where is the pectorals minor located in relations to pectorals major?
Below
Action of the pectorals minor?
Lowers the scapula
Where do muscles of the shoulder originate and insert?
Originate: pectoral girdle
Insert: humerus
Which is the deepest of the anterior muscles of the forearm?
Pronator quadratur
Which muscles act during supination?
Supinator
Biceps brachii
Which muscles act during pronation?
Pronator teres
Pronator quadratura
On which side of the hands are the muscles found?
The palmar side
Does the latissimus doors insert on the humerus?
Yes
