Chest wall and diaphragm Flashcards
functions of the chest wall
respiration
protection
muscle attachments
area in-between lungs?
mediastinum
what covers the lungs
pleura
what covers the heart
pericardium
what is T1, rib 1 and the superior aspect of the sternum boundaries for?
superior thoracic aperture (opening at top of thoracic cavity)
what are the boundaries of the inferior thoracic aperture and what is this almost completely covered by
11th and 12th ribs, costal margin
covered by diaphragm
characteristics of thoracic vertebrae
heart shaped body
costal facets
transverse costal facets
small vertebral foramen
long spinous process
3 categories of ribs
true: 1-7 articulate directly with sternum via costal cartilage
false: 8-10 articulate via costal margin
floating: 11-12 don’t articulate with sternum
atypical and typical ribs?
typical: 3-9
atypical: 1, 2, 10, 11, 12
features on typical ribs?
head
neck
tubercle
angle
subcostal groove
features on first rib not present on others?
scalene tubercle (between grooves)
groove for subclavian artery (more posterior) and vein (more anterior)
what muscle attaches to the scalene tubercle
anterior scalene muscle
features on the sternum?
body
manubrium
xyphoid process (inferior)
sternal angle (between body and manubrium
which ribs articulate with the sternum at the sternal angle? What vertebral level does it indicate?
2nd ribs
vertebral level T4/5
what other structures are located at the sternal angle
junction between ascending/arch/descending aorta
bifurcation of trachea
costovertebral joints?
costotransverse joint
joints of heads of ribs
joints between ribs and sternum? which ribs?
sternocostal/sternochondral (?)
ribs 1-7
joints fusing lower costal cartilages and costal margin?
interchondral
what movement causes increase in vertical dimension of the thoracic cage
inferior movement of diaphragm
what movement causes increase in transverse dimension of thoracic cage
bucket handle motion of ribs
what movement causes increase in anterior/posterior dimension of thoracic cage
pump handle action of sternum
features of the thoracic diaphragm?
right and left domes
central tendon
oesophageal hiatus
aortic hiatus
what attaches the diaphragm to the lumbar vertebrae
crura (left and right)
where do different structures pass through the diaphragm
inferior vena cava - T8 through central tendon (caval opening)
oesophagus - T10 through oesophageal hiatus
aorta - T12 through aortic hiatus
what innervates the diaphragm? roots?
motor and sensory - phrenic nerves (c3,4,5)
sensory - intercostal and subcostal nerves (peripheral parts)
what also passes through openings in the diaphragm
caval opening - phrenic nerves
oesophageal hiatus - vagus nerve
aortic hiatus - azygous vein, thoracic duct
which artery runs deep to each side of the sternum
internal thoracic artery
which artery runs through the thoracic cavity with the phrenic nerve
pericardiacophrenic artery
which nerve runs through the thoracic cavity with the pericardiacophrenic artery
phrenic nerve
what does the internal thoracic artery split into in the abdomen
musculophrenic and superior epigastric artery
which arteries branch off from the abdominal aorta and run along the abdominal side of the diaphragm
inferior phrenic arteries
which arteries supply the diaphragm?
superior phrenic
musculophrenic
inferior phrenic
pericardiacophrenic
lower internal intercostal arteries
muscles in intercostal space and their action?
external intercostal (elevate ribs for inspiration)
internal intercostal (depress ribs for active expiration)
innermost intercostal (depress ribs for active expiration)
innermost intercostal muscles features
same orientation to internal intercostal
deep to neurovascular bundle
only found laterally
where are the external and internal intercostal muscles not present and replaced by membrane
external - not present anteriorly
internal - not present posteriorly
accessory muscles of respiration?
pectoralis major
scalenus anterior (anterior scalene muscle)
serratus anterior
sternocleidomastoid
exterior intercostal muscle orientation?
points forward and down - ‘hand in pocket’
what is found between internal and intercostal muscles
intercostal neurovascular bundle
where in the intercostal space is the neurovascular bundle found?
superior portion, along subcostal groove
what is found in the neurovascular bundle?
anterior and posterior intercostal arteries/veins
intercostal nerves
where do the intercostal arteries arise from
anterior - internal thoracic artery or musculophrenic artery
posterior - thoracic aorta
where do the intercostal veins drain
anterior - internal thoracic vein or musculophrenic vein
posterior - azygous system
where do the intercostal nerves come from
anterior rami of thoracic spinal nerves
