Anterior Thoracic Wall Anatomy Flashcards
thoracic skeleton consists of
- sternum
- 12 pairs of ribs and costal cartilages
- 12 thoracic vertebra and associated intervertebral discs
intervertebral discs are located between
- vertebrae
sternum composed of
- manubrium
- body
- xiphoid process
sternal angle
also called
- angle of Louis
- articulation between manubrium and the body
rib connected to sternum by
- costal cartilage
sternal angle marks articulation site for
- 2nd rib and costal cartilage
sternal angle directly opposite of
- T4/T5 vertebrae
jugular notch
- concave notch along superior border of manubrium
superior thoracic aperture
- doorway between thoracic cavity and neck
clinicians refer to superior thoracic aperture as
- thoracic outlut
inferior thoracic aperture closed by
separates
- diaphragm
- separates thoracic cavity from abdominal cavity
vertebra consists of
- vertebral body
- vertebral arch
- processes
vertebral body used for
- weight bearing
vertebral arch consists of
- pedicles
- laminae
vertebral arch used for
- protection of spinal cord
shape of vertebral bodies
- heart shaped
facets of vertebral bodies
- 2 costal facets
- superior and inferior
- on each side of body for articulation with head of the rib
transverse processes are
- long and slender
transverse processes have a
- transverse costal facet
transverse costal facet articulates with
- tubercle of a rib
spinous processes
- long and slant inferiorly
articular processes and associated facets articular with
- adjacent vertebrae
three types of ribs
- vertebrocostal
- vertebrochrondal
- vertebral
vertebrocostal articulates with
- sternum via own costal cartilage
vertebrocostal ribs
- true
- 1-7
vertebrochondral ribs
- false
- 8-10
vertebrochondral articulates with
- indirect articulation with sternum via costal cartilage of superior rib
vertebral ribs
- floating
- 11-12
vertebral ribs articulates with
- DO NOT articulate with sternum
- end in posterior abdominal wall
facets of rib head
- superior and inferior
- articulate with bodies of two vertebrae
what is located between two facets of rib
- crest
neck of rib
- slightly constricted area just distal to head
tubercle of rib located at
- junction of neck and shaft
tubercle of rib has a
- facet for articulation with corresponding transverse process of vertebra
shaft
- thin, flat, curved
shaft has a
- costal angle where rib turns anterolateral
- costal groove inferiorly for neurovascular structures
head of typical ribs articulates with
- two vertebrae
- body of numerically corresponding vertebra and also body of vertebra superior to it
tubercle of typical rib articulates with
- numerically corresponding transverse process
joints of thoracic skeleton
- costochondral
- sternocostal
- costovertebral
costochondral joints
- cartilaginous joints between rib and costal cartilage
sternocostal joints
- synovial joints between costal cartilage and sternum
costovertebral joints
- synovial joints between ribs and vertebral column
left auricle is located near which part of thoracic skeleton
- left part of 3rd intercostal space
SVC is located near which part of thoracic skeleton
- right 2nd and 3rd intercostal space
weakest part of ribs is
- anterior to angle
which ribs are the most commonly fractured by crushing injuries or by direct trauma to the chest
- middle ribs
rib fracture complications
- pneumothorax
- injury to abdominal organs
- bleeding
why are fractures very pain
- bone fragments move with respirations
two heads of origin of pectorals major
- clavicular
- sternocostal
pectoralis major inserts into
- the humerus
pectoralis major innervated by
- medial and lateral pectoral nerves
pectoralis minor originates from
- anterior surface of 3rd-5th ribs
pectoralis minor inserts into
- coracoid process of scapula
pectoralis minor job
- stabilizes scapula against thoracic wall
pectoralis minor innervated by
- medial pectoral nerve
serratus anterior muscle originates
- surface of 1st-8th ribs
serratus anterior inserts into
- medial border of scapula
serratus anterior stabilizes
- nad protracts scapula
serratus anterior innervated by
- long thoracic nerve
serratus anterior innervated by
- long thoracic nerve
intrinsic muscles of the thorax
- external intercostals
- internal intercostals
- innermost intercostals
intrinsic muscles of the thorax innervated by
- intercostal nerves
order of neuromuscular structures within the costal groove
- intercostal vein
- intercostal artery
- intercostal nerve
intercostal nerve blocks
- local anesthetic infiltrated around one or several intercostal nerves to provide anesthesia to the thoracic wall
intercostal nerve block used for
- reducing pain associated with fractured ribs or to reduce pain associated with bone cancer within rib cage
how many intercostal msucles
- 11
- one in each intercostal space
external intercostal muscles go
- down and in
- visualized more laterally
internal intercostal muscles go
- down and out
- visualized more medially
intercostal muscles are accessory muscles of
- respiration
innermost intercostals are located on
- inside of thoracic wall
neurovascular plane is located between
- internal and intercostal muscle layer
- AND innermost intercostal layer
where do the intercostal nerves, arteries, and veins traverse?
- neurovascular plane
transversus thoracis muscle located
- inside the thoracic wall just deep to the sternum
intercostal arteries arise from which two major arteries
- thoracic (descending) aorta
- internal thoracic arteries
internal thoracic arteries are branches of
- subclavian arteries
posterior intercostal arteries arise from
- aorta
posterior intercostal arteries anastomose with the
- anterior intercostals
internal thoracic arteries divide into
- musculophrenic (lateral)
- superior epigastric (medial)
internal thoracic artery also known as
- internal mammary artery
what vein is used during a CABG
- great saphenous vein from leg connected to aorta and also connected distal to occlusion/blockage of coronary artery
primary choice for heart surgeon for CABG
- internal thoracic artery
- distal portion sutured to coronary artery downstream of occlusion/obstruction
intercostal veins drain into
- azygos system of veins
- internal thoracic veins
each intercostal nerve courses in the
- costal groove innervating the anterior and lateral body wall and intrinsic thoracic wall muscles
how many intercostal nerves
- 12
intercostal nerves are branches of
- thoracic spinal nerves
intercostal nerve is also known as
- ventral rams of thoracic spinal nerve
thoracic cavity divided into how many compartments
- 3
two lateral compartments contain
- lungs and plurae (serous membranes surrounding the lungs)
central compartment contains the
-mediastnum - contains many major thoracic structures
mediastinum subdivided into
- superior and inferior mediastinum
division between superior and inferior mediastinum called
- thoracic plane
thoracic plane
- imaginary line drawn from sternal angle to T4/T5 vertebral column level
inferior mediastinum subdivided into
- anterior
- middle
- posterior
anterior mediastinum located
- just beneath the sternum
what occupies much of the anterior mediastinum
- the thymus gland
middle mediastinum contains
- pericardium
- heart
- roots of great vessels
posterior mediastinum contains
- esophagus
- descending aorta
- azygos veins
- thoracic duct
- autonomic nerves
what part of the heart is located at the right 4th intercostal
- right atrium
what part of the heart is located in the left fourth intercostal space immediately lateral to the sternal border
- right ventricle
what part of the heart is located in the left 5th intercostal space 3 inches lateral to the sternum
- left ventricle
what is located just anterior to the mid esophagus
- left atrium