chest wall and the anatomy of ventilation Flashcards
how many joints does ribs articulate with vertebrae and what are these joints called
- articulates at 2 distinct joints
- known as costal joint
- for typical ribs head of the rib articulates with the inferior costal facet of the numerically corresponding vertebrae as well as the superior costal facet of the superior vertebrae. Also a joint between the rib and the transverse costal facet (costotransverse joint)
- for atypical ribs the head of the rib only articulates with the numerically corresponding vertebrae not also with the one above it
what does auscultation asses
- air flow in lungs
what is the aim of percussion of the thorax
- to detect sounds in lungs and ether the lungs are filled e.g. with air, fluid solid
- air (resonant sound)
- fluid (dull sound)
- solid (flat sound)
how is the thoracic cavity divided
- pleural cavity- contais left and right lung
- mediastinum- contains the heart, trachea, oesophagus, blood vessels, nerves and is found between the two pleural cavities
what is the anatomy of the pleural cavity and the two layers plus what is the role of the pleural cavity
- parietal pleura lines the thoracic wall
- visceral pleura lines the lungs
- pleural cavity found between the two layers filled with fluid
- acts as a lubricant and provided surface tension which prevents lungs rom collapsing
how is the lungs positioned in thorax
- posteriorly exceeds just above the clavicle and goes all the way down to 10th rib, pleura can reach 12th rib
- anteriorly goes down to 6th ribcage and pleura to 7th
what muscle is the diaphragm made of and what nerves stimulate the diaphragm
- skeletal striated muscle
- innervated by phrenic nerve either via the somatic nervous system or autonomic nervous system
what are the three openings of the diaphragm
- caval opening within the central tendon which the inferior vena cava and branches of phrenic nerves pass
- oesophagus opening (through muscular part) which the oesophagus passes, left and right vagus nerves and lymphatic vessels
- aortic opening through tendinous arch which the aorta, azygos vein and thoracic duct pass
where does the intercostal muscles occupy and the three layers of the intercostal muscles
- occupy the intercostal spaces
- three layers which include the external intercostal, inner intercostal and innermost intercostal
- innervated by intercostal nerves
- blood supply is intercostal veins and intercostal arteries
what is the artery supply of the intercostal muscles and where do the intercostal arteries arise from
- posterior and anterior intercostal arteries
- anterior intercostal arteries arises from internal thoracic artery which arises from subclavian arteries
- posterior intercostal arteries arise from either the supreme intercostal arteries or the thoracic aorta
what is the venous system of the intercostals and what veins do they drain into
- posterior and anterior intercostal veins
- anterior intercostal veins drain into internal thoracic vein
- posterior intercostal veins drain into azygos system which eventually drains into superior vena cava
what does herpes zoster infect
- reactivation known as shingle
- found in spinal ganglion
- affect a single dermatome
what lymph nodes does the lymphatics of the chest wall and parts of the mediastinum drain into
- paravertebral nodes
- parasternal nodes
- paramammary nodes
- these than drain into either the right lymphatic duct or thoracic duct
where does the thoracic duct/ right lymphatic duct drain lymph into the venous system
- junction between internal jugular and subclavian vein
where is the veins, arteries and nerves in the intercostal muscles
- in the costal groove
- order VAN (top to bottom)
- between internal intercostal muscle and inner most intercostal muscle
what muscles are used for forced inhalation
- as well as the contraction of diaphragm and external intercostal muscles during forced inhalation accessory muscles such as the pectorals and sternocleidomastoid muscles contract
what muscles contract during forced exhalation
- abdominal wall muscles
- internal intercostal muscles
what are the anatomical structures of the breast
- outer surface consists of the nipple and areola (pigmented area surrounding the nipple)
- subcutaneous tissue found just under the skin which is made of connective tissue (superficial fascia), fat and blood vessels
- mammary glands
- lactiferous ducts and sinus
- stroma- more connective tissue which is more deeper than subcutaneous tissue and surrounds the mammary glands
- pectoral fasica
- pectorals major
- clavipectoral fasica
- pectorals minor
-retromamary space (space between pectoral fascia and deep layer of superficial fascia)
how is the mammary glands divided in breast
- divided into lobes, which divide into lobules
- alveoli found at end of lobules
- alveoli site where milk is produced
- lactiferous ducts drain milk from alveoli to nipple
- lactiferous sinus stores the milk/ acts as a reserve just before it enters/leaves the nipple
where is the rib in terms of rib level
- between 3rd and 7th rib
- nipple aligned with 4th rib
-anchored by suspensory ligaments
where does 75% of lymph in the breast drain into
axillary lymph nodes via the anterior pectoral lymph node
where do majority of cancers develop
upper outer quadrant due to large amount of glandular tissue
how does cancer in breast spread
- along lymph passages
- typical spread is superior and laterally to axillary lymph passages via anterior pectoral lymph nodes
