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Bloc B - Respiration > Anatomy thoracic wall Sept27 M3 > Flashcards

Anatomy thoracic wall Sept27 M3 Flashcards

1
Q

thoracic cage top and bottom openings

A

superior thoracic aperture (thoracic inlet) and inferior thoracic aperture (thoracic outlet)

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2
Q

Structure in front and in back of thoracic cage

A

Front: sternum (or breast bone)
Back: Thoracic spine

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3
Q

Total number of ribs

A

12

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4
Q

Angle at bottom of rib cage in front below sternum

A

Infrasternal angle

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5
Q

3 categories of ribs

A

True ribs, false ribs, floating ribs

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6
Q

which ribs are true + definition

A

I to VII. Direct insertion to sternum via costal cartilage

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7
Q

which ribs are false + definition

A

VIII to X. Indirect insertion on sternum via costal margin

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8
Q

def. of costal margin

A

Merging of costal cartilage of ribs VII to X

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9
Q

which ribs are floating + def

A

XI and XII. No insertion on sternum

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10
Q

3 portions of a rib from posterior to anterior

A

Head (and neck), body, costal cartilage

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11
Q

Structure found on rib’s neck + its def

A

Tubercle: protrusion to the back where there’s an articular facet

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12
Q

How many articular FACETS and where

A
  1. One on tubercle and two on head, separated by crest
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13
Q

Two things to denote on body of rib and where

A 
Costal angle (initial curling of the rib in the back)
Costal groove on interior and inferior surface
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14
Q

3 articular surfaces of ribs and where attach (+ anterior or posterior)

A

costal cartilage (A, sternum)
head of the rib (P, vertebrae)
Tubercle of the rib (P, vertebrae)

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15
Q

4 gross structures of a vertebra

A 
Spinous process (back, goes downwards), transverse process (back, one on each side, horizontal)
vertebral foramen (middle hole)
vertebral body (front)
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16
Q

How many thoracic vertebrae

A

12

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17
Q

how many facets on one side of a vertebra for RIB articulation and where

A

three. two on side in middle between VB and TP (one upwards, one downwards)
third on one TP (transverse process)

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18
Q

Posterior joint def

A

joint between rib and vertebra

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19
Q

two posterior joints names

A

costovertebral joint and costotransverse joint

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20
Q

costovertebral joint def + where are facets

A

articulation of rib with vertebral body of rib on same level and the VB of one above it (vertebral facets behind VB, rib facets of the head)

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21
Q

costotransverse joint def + where are facets

A

between tubercle of rib and transverse process of vertebra on same level.

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22
Q

name of ligament near costotransverse joint and what it does

A

Superior costotransverse ligament joins transverse process and head-neck or rib

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23
Q

which ribs are atypical ribs

A

I,II,X,XI,XII

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24
Q

why rib I atypical (4)

A

Short, flat, horizontal
No costal groove
Grooves and scalene tubercle on top
Only articulates with vertebra at same level

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25
Q

Special structures found only on rib 1 (3)

A

two grooves on superior surface for large arteries and veins to pass separated by scalene tubercle

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26
Q

why rib II atypical (1) + how compares to rib I’s length

A

short, flat, horizontal.

Twice length of rib I but still not enough to be normal

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27
Q

why rib X atypical (1)

A

only articulates with vertebra at same level (not also with one above it)

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28
Q

why ribs XI and XII atypical (4)

A

no tubercles or necks
short
no costotransverse joint
Only articulates with vertebra at same level

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29
Q

which ribs articulate only with vertebra at same level

A

I, X, XI, XII

II is only atypical that doesn’t fit here

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30
Q

which ribs have no costal groove

A

I

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31
Q

which ribs are short

A

I,II,XI,XII

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32
Q

which ribs are flat and horizontal

A

I, II

33
Q

which ribs have no tubercle and neck and costotransverse joint

A

XI, XII

34
Q

sternum three parts top to bottom

A

manubrium, body of the sternum, xiphoid process

35
Q

characteristic on top of manubrium and its level

A

Jugular notch (TII)

36
Q

joint between manubrium and body of sternum (two names) + level

A 
Manubriosternal joint (or sternal angle) 
(TIV/TV)
37
Q

Joint between body of sternum and xiphoid process: name and level

A

Xiphisternal joint (TIX)

38
Q

3 muscle layers of intercostal muscles and orientation

A

External intercostal muscles (inf, ant)
Internal intercostal muscles (sup, ant)
Innermost intercostal muscles (sup, ant)

39
Q

where external intercostal muscles start and end

A

inferior surface of a rib and superior surface of rib below

40
Q

where internal and innermost intercostal muscles start and end

A

superior surface of a rib and inferior surface of one above

41
Q

what external intercostal transform into as you move to front

A

transform into external intercostal membrane

42
Q

Muscle in rib cage other than intercostals and goes from where to where

A

Transversus thoracis: goes from body of sternum and xiphoid process to ribs 2 to 6

43
Q

diaphragm three portions

A

right dome, central tendon, left dome

44
Q

diaphragm particularity about levels of domes

A

right dome a little above rib 5 (bc of liver)

left dome a little below rib 5

45
Q

Innervation of diaphragm

A

Right phrenic nerve: right dome

Left phrenic nerve: left dome

46
Q

origin of the right and left phrenic nerves

A

nerves on levels C3,C4 and C5 of spinal cord join to form right and left phrenic nerves

47
Q

Primary muscle involved in resting inspiration

A

diaphragm

48
Q

mechanic movement axis in respiration allowed by diaphragm

A

superior inferior movement

49
Q

primary muscle involved in resting expiration

A

none

50
Q

muscles involved in forced inspiration and what they do to rib cage

A

external intercostal muscles - increase volume

51
Q

muscles involved in forced expiration and what they do to rib cage

A

internal and innermost intercostal muscles and transversus thoracis

52
Q

how external intercostals work (given their orientation)

A

their orientation allows them to pull on rib below to elevate it

53
Q

two axes of movement allowed by intercostal muscles and transversus thoracis

A

allow anterior posterior movement (elevation, depression) and lateral movement (expansion and compression on the side)

54
Q

Disposition of neurovascular supply between intercostal muscles. MAIN branches (not forget there are other ones)

A

On inferior surface of rib, between innermost and internal muscles, from top to bottom, vein and artery protected by costal groove and then nerve

55
Q

Arterial supply to front of rib cage (start from left ventricle)

A

left ventricle-arch of aorta-thoracic aorta and subclavian artery on each side-internal thoracic artery on each side

rib 1 to 7: internal thoracic artery-anterior intercostal artery
rib 8 to 11: internal thoracic artery-musculophrenic artery-anterior intercostal artery
rib 12-thoracic aorta-subcostal artery

56
Q

other name for internal thoracic artery

A

mammary artery

57
Q

name of artery that goes from bottom of internal thoracic artery (its continuation) to the gut

A

superior epigastric artery

58
Q

arterial supply to posterior rib cage (start from left ventricle)

A

left ventricle-arch of aorta-thoracic aorta-posterior intercostal artery

59
Q

Interaction between anterior and posterior intercostal arteries

A

Have anastomoses, linking it into one circular supply to a rib

60
Q

direction in which anterior and posterior arteries travel between ribs

A

anterior artery: front to back

posterior artery: back to front

61
Q

venous drainage of anterior rib cage

A

rib 1-7: anterior intercostal vein, internal thoracic vein, brachiocephalic trunk, superior VC
rib 8-11: anterior intercostal vein-musculophrenic vein
rib 12: subcostal vein(?) or musculophrenic vein(?)

62
Q

venous drainage of posterior rib cage on left and right side

A

left: left posterior intercostal veins-hemiazygos vein (on left side)-azygos vein (on right side)-SVC
right: right posterior intercostal veins-azygos vein (on right side)-SVC

63
Q

name of vein on the front of the body that comes from gut to join interior thoracic vein

A

superior epigastric vein

64
Q

name of spinal nerves emerging at a vertebral level and which one goes to rib

A

dorsal ramus and ventral ramus (which goes to rib)

65
Q

Name of nerve travelling between ribs the rib

A

intercostal nerve

66
Q

Name of two nerves that emerge and deviate from between ribs and where they do so

A

Lateral cutaneous nerve (between back and the side of the rib)
Anterior cutaneous nerve

67
Q

What cutaneous nerves do

A

Provide sensory info to skin of chest

68
Q

which nerves are intercostal and which are subcostal + their spinal level

A

intercostal from one below rib 1 to one below rib 11 (T1-T11)
subcostal for 1 below rib 12 (T12)

69
Q

how many cervical levels to the spinal cord

A

7

70
Q

How many spinal nerves emerge from cervical vertebrae

A

8

71
Q

Transition in location of spinal nerves explanation

A

Cervical spinal nerves emerge above the cervical vertebra of their level (number)
Thoracic spinal nerves emerge below spinal vertebra of their level
Nerve emerging between C7 and T1 is called C8

72
Q

how to differentiate nerve numbers from bones numbers

A

bones: roman numerals

73
Q

name of hole from which a spinal nerve emerges

A

intervertebral foramen

74
Q

location of intervertebral foramen

A

right above a vertebra, between the VB and the transverse process of the one above

75
Q

Dermatome def

A

Area of skin innervated by single spinal nerve

76
Q

Area of skin innervated by T4

A

Nipple

77
Q

Area of skin innervated by T6

A

Skin over xiphoid process

78
Q

Area of skin innervated by T10

A

Umbilicus

79
Q

What causes shingles and how

A

varicella-zoster virus, attacks T5, rash on T5 level below nipple

Bloc B - Respiration (36 decks)

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