Bony Thorax pt. 1 Flashcards
Marks the median aspect of the sternum
Midsternal Line
Midpoint of the clavicle and a perpendicular line drawn down to the waist.
-Slightly medial to the nipple
Midclavicular Line
Have patient abduct arm, go to midpoint of axillary floor (Fascia) and extend line down midline of the chest wall on the medial side
Midaxillary Line
Have patient abduct arm, go to fold formed by the Pectoralis Major m. and draw a line down from the top of that fold
Anterior Axillary line
Have patient abduct arm, go to fold that is formed by the Latissimus Dorsi m. and the Teres Major m. Draw a line down from that fold
Posterior Axillary Line
Line draw that just barely touches the transverse processes of the thoracic vertebra.
-2, one on each side (R and L)
-1st rib to bottom rib
Paravertebral Line
A good place to listen to lung sounds on the back. Space where muscles aren’t covering on the wall of the thorax.
-Right below the Inferior angle of the scapula
Triangle of Auscultation
Which 3 muscles form the Triangle of Auscultation?
Lower Trapezius, Latissimus Dorsi, and Rhomboid Major muscles
Males and Females have 12 pairs of _____ and 11 pairs of Intercostal Spaces
-Some people have a 13th rib (bad, can compress vessels that normally go through that opening)
-ICS are named after the rib above them.
-Below the 12th rib is the subcostal space
-Contain costal cartilage that allows the ribs to articulate with the sternum
Ribs
Has 3 parts:
-Manubrium
-Body
-Xiphoid (piece sticking out at the bottom)
Sternum
Scapula overlie ribs ___ to about ribs ____/_____.
2 to 6/7
A bean-shaped opening in the superior portion of the thorax.
Superior Thoracic Outlet (Inlet or Aperture)
A very wide opening bounded by the Costal Margin (Begins with the 7th rib and ends with the 12th rib at about L2).
Inferior Thoracic Outlet (Inlet or Aperture)
Iliac crest comes to about ____
L4
Composed of 2 parts:
-Right Hemi____ comes higher than the left hemi____ due to the liver lying underneath it, pushing it up.
-As you breathe in, this flattens. As you exhale, it returns to normal position
-Supports the heart and lungs. Covers the Inferior Thoracic Outlet, supporting the structures resting on top of it.
Diaphragm
Divot on top of the Manubrium of the sternum formed by attachment on either side by the Sternocleidomastoid muscle.
Suprasternal Notch (Jugular Notch)
Found on the sides of the Suprasternal Notch on the Manubrium. A right and left attachment for the clavicle to the manubrium
-Important joint for upper extremity movement: Sternoclavicular Joint
Clavicular Notch
Found on the sides of the Manubrium of the sternum
-First rib articulates cleanly with the Manubrium
Notch for the Costal Cartilage of the 1st Rib
Formed by the Body and Manubrium of the sternum articulating together.
-Slight bend occurs
-The manubrium and the body each contribute a demifacet that come together to form a wedge shaped depression that accommodates the costal cartilage of the 2nd rib.
Manubriosternal Joint/Sternal Angle/Angle of Louis
Articulates with the demifacet of the manubrium and body of the sternum
2nd rib
Contains notches (demifacets) for the 3-6th ribs costal cartilages.
Body of the Sternum
Used to be a joint formed by cartilage, but as you age into teenage years, it ossifies.
-Easy to break off
-The location of the articulation of the 7th rib
Xiphisternal Joint (Body of the sternum and the Xiphoid Process)
The body of the sternum and the xiphoid process for a little cup when they come together that accommodates the costal cartilage for the _____ rib
7th rib
True Ribs
1-7
Attach (via their costal cartilage) directly to the sternum
True Ribs
False Ribs
8-10
Attach to the sternum via the costal cartilage of the 7th rib
False Ribs
Floating Ribs
11-12
Ribs that do not attach to the sternum, but instead the ends are tipped with cartilage and hang loose. they are attached to the vertebral column, but the sternal end just comes to a stop.
Floating Ribs
Typical Ribs
Ribs 3-9
All look alike, can’t differentiate between them
-Head: Wedge shaped
-Neck
-Tubercle: bump with facet (tubercular facet - articulates with the facet on the transverse process of the thoracic vertebra)
-Angle: sharp turn
-Costal Groove: runs underneath rib, cradles the intercostal vein/artery/nerve
-Sternal Extremity: has costal cartilage to articulate with the sternum
Typical Ribs
Short, stubby, and flatter than the other ribs
-No angle, C-Shaped
-Scalene Tubercle: bump where the Anterior and Middle Scalene muscles attach
-No costal groove (even though it does have intercostal vessels and nerves)
-Kidney bean shaped
Rib 1
Flat rib, but not the most flat. Angle is closer to the tubercle
Rib 2
Rib that does not have an articular facet on its tubercle, since it doesn’t articulate with the transverse process of the vertebrae
-False rib, doesn’t attach directly to the sternum
Rib 10
Ribs do not have a tubercle, since there is no articulation
Ribs 11-12
Rib that does not have a tubercle AND does not have a costal groove. V/A/N are located more out in the abdomen
Rib 12
Gliding, Plane type of movement
-Contain demifacets: Superior and Inferior
-Bodies fit together and demifacets make a cup that accommodates the head of the rib
-Rib is named in terms of the lower vertebra of the two it fits on
Vertebrocostal Joints
Joints found in Ribs 1-9
-Tubercle articulates with the facet of the transverse process of the lower of the two ribs
-Ex: Rib 7 fits in between T6 and T7
Transversocostal Joints (Gliding Joints)
Cartilaginous Joints that allow the chest wall to expand as you breathe. Similar to the vertebral joints
-No movement, just expansion/retraction of the chest wall
Sternocostal Joints (Chondrosternal Joints)
