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Anatomy - Thorax > Chapter 3 - Walls of Thorax > Flashcards

Chapter 3 - Walls of Thorax Flashcards

1
Q

Name the intercostal muscles

A
  1. External intercostal
  2. Internal intercostal
  3. Transversus thoracis - subcostalis + intercostalis intimi + sternocostalis
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2
Q

Extent of external intercostal muscles

A
  • From tubercle of rib posteriorly to costochondral junction anteriorly
  • Between costochondral junction to sternum replaced by external intercostal membrane
  • Posterior part continuous with superior costotransverse ligament
  • Fibres run downwards, forwards and medially
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3
Q

Extent of the internal intercostal muscles

A
  • From lateral border of sternum to angle of rib
  • Continues as internal intercostal membrane which is continuous with superior costotransverse ligament
  • Fibres run downwards, backwards and laterally
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4
Q

Extent of transversus thoracis muscle

A

Subcostalis - Posterior part of lower intercostal spaces
Intercostalis intimi - Middle 2/3rds of all spaces
Sternocostalis - Anterior parts of upper spaces

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5
Q

Intercostal nerves distribution

A
  • They are ventral primary rami of T1-T11 spinal N
  • All supply intercostal spaces
  • Upper 2 also supply upper limb
  • Lower 5 also supply abdominal wall
  • 3-6 Typical intercostal N
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6
Q

Intercostal N relations

A
  • Passes below neck of rib and enters costal groove
  • Posterior part: between pleura and internal intercostal membrane
  • Anterior part: between intercostalis intimi and internal intercostal muscle
  • In the front, pierces intercostal muscles and forms ANTERIOR CUTANEOUS N
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7
Q

Muscular branches of intercostal N

A
  1. Supply intercostal muscles, serratus posterior superior

2. Collateral branch arises near angle of rib and supplies neurovascular space

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8
Q

Sensory branches of intercostal N

A
  1. Main and collateral branch supply pleura and periosteum
  2. Lateral cutaneous branch near angle of rib supplies skin
  3. Anterior cutaneous branch near sternum supplies skin
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9
Q

Intercostobrachial N

A
  • It is the lateral cutaneous branch of 2nd intercostal N.

- Supplies skin of floor of axilla and upper medial part of arm

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10
Q

Boundaries of typical intercostal space

A

Superior: Costal groove of rib above
Inferior: Upper border of rib below
Anterior: Sternum
Posterior: Thoracic vertebra

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11
Q

Contents of typical intercostal space

A
  1. Intercostal muscles
  2. 2 anterior intercostal A and V
  3. Posterior intercostal A and V
  4. Intercostal N and collateral branch
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12
Q

Origin of posterior intercostal A

A

1-2: superior intercostal A -> costocervical trunk -> subclavian A
3-11: descending thoracic aorta

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13
Q

Course of posterior intercostal A

A
    • Right A pass behind esophagus, thoracic duct, azygos vein and sympathetic chain
    • Left A pass behind hemiazygos vein and sympathetic chain
  2. In intercostal space, intercostal V and N are present above and below resp.
  3. Ends at costochondral unction by anastamosing with upper anterior intercostal A
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14
Q

Branches of intercostal A

A
  1. Dorsal: to skin of back and vertebrae
  2. Collateral: anastamoses with lower anterior intercostal A
  3. Muscular: to intercostal muscles, pectoral, serratus anterior
  4. Lateral cutaneous: accompanies LCN
  5. Mammary: from 2,3,4 to mammary gland
  6. Right bronchial: from 3rd right PIA
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15
Q

Anterior intercostal A

A
  1. 2 in each space: upper and lower
  2. 1-6 from internal thoracic A
  3. 7-9: from musculophrenic A
  4. End at costochondral junction
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16
Q

Anterior intercostal V

A
  1. 1-3 drain into internal thoracic V
  2. 4-6 into vena comitantes of internal thoracic A
  3. 7-9 into vena comitantes of muculophrenic A
17
Q

Posterior intercostal V on left side

A

1- Left brachiocephalic
2,3,4- Superior intercostal -> left brachiocephalic
5-8 - Accessory hemiazygos
9-11 - Hemiazygos

18
Q

Posterior intercostal V on right side

A

1- Right brachiocephalic
2,3,4 - Superior intercostal -> azygos
5-11 - Azygos

19
Q

Relations of internal thoracic A

A 
ABOVE 1ST RIB
It runs behind
1. Sternal end of clavicle
2. Internal jugular V
3. Brachiocephalic V
4. 1st costal cartilage
5. Phrenic N
BELOW FIRST RIB
Anteriorly:
1. Pectoralis major
2. 1-6 costal cartilages
3. External intercostal membranes
4. Internal intercostal muscles
5. 1-6 intercostal N

Posteriorly:

  1. Endothoracic fascia
  2. Pleura
  3. Sternocostalis
20
Q

Branches of internal thoracic A

A
  1. Pericardiacophrenic: to pericardium and pleura
  2. Mediastinal: to thymus, mediastinum fat
  3. 2 anterior intercostal A at each space
  4. Superior epigastric A: enters rectus sheath
  5. Musculophrenic A: runs behind 7,8,9 costal cartilages and gives 2 intercostal branches at each space. Perforates diaphragm near 9th CC
21
Q

Formation of azygos V

A
  • Union of:
    1. Lumbar azygos
    2. Right subcostal
    3. Ascending lumbar
  • Occupies posterior medistinum and joins superior vena cava
  • Enters thorax by passing through aortic opening
22
Q

Relations of azygos V

A

Anteriorly: Oesophagus
Posteriorly: Thoracic vertebrae, Right posterior intercostal V
Right: Right lung, pleura
Left: Thoracic duct, Aorta, Trachea, Vagus

23
Q

Tributaries of azygos V

A
  1. Right superior intercostal V
  2. 5-11 right posterior intercostal V
  3. Hemiazygos V
  4. Accessory hemiazygos V
  5. Right bronchial V
24
Q

Hemiazygos V

A
  • Formed by union of:
    1. Left lumbar azygos
    2. Left ascending lumbar
    3. Left subcostal
  • Pierces crus of diaphragm, ascends on left side of vertebra, overlapped by aorta, joins azygos
  • Gives 9-12 left posterior intercostal V
25
Q

Accessory hemiazygos V

A
  • Begins in 4/5th intercostal space
  • At level of 8th space, turns right, passes behind aorta and thoracic duct and joins azygos
  • Gives 5-8 left posterior intercostal V
26
Q

Branches of thoracic sympathetic trunk

A

LATERAL
-Grey rami communicans supply skin

MEDIAL

  1. Upper 5-pulmonary, cardiac, aortic an doesophageal branches
  2. Lower 7-Greater, Lesser and least splanchnic N
27
Q

Greater splanchnic N

A
  • 5-9

- ends in coelic ganglio, aorticorenal ganglion, suprarenal gland

28
Q

Lesser splanchnic N

A
  • 10,11

- Coeliac ganglion

Anatomy - Thorax (8 decks)

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