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Anatomy > EXAM3_G19_Thoracic_Wall_Breast > Flashcards

EXAM3_G19_Thoracic_Wall_Breast Flashcards

1
Q

What is the Angle called that starts from your epigastric fossa and opens/runs downward along the lines along the left and right costal margins?

A

Subcostal angle

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2
Q

What is the landmark that marks your xiphoid process? hint- saucer indent

A

Epigastric Fossa

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3
Q

the manubrium U shape is called the

A

Jugular notch

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4
Q

What ribs are considered True ribs?
False ribs?
Floating ribs?

A

Ribs 1-7 True ribs
Ribs 8-10 False ribs
Ribs 11-12 Floating ribs

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5
Q

The cartilage of the false ribs form the Border of cartilage called the?

A

COSTAL MARGIN

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6
Q

What are the two costovertebral articulations (synovial) ?

A
  1. Joint of head of rib

2. Costotransverse Joint

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7
Q

Where does the VAN run on a rib?

A

Costal Groove

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8
Q

Vertebral levels for
Jugular notch
Sternal angle (transverse thoracic plane)
Xiphoid process

A

JN- T2
SA- T4/T5 IVD
XP- T9

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9
Q

What joint articulates with the transverse process and the facet of the rib?

A

Costotransverse joint

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10
Q

Manubrium articulates with what?

A

Clavicles and 1st ribs

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11
Q

What is just lateral to the jugular notch on the manubrium?

A

Clavicular notch

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12
Q

The xiphisternal junction marks what at T9 vertebral level?

A

Inferior border of the heart

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13
Q

The 1st sternocostal joint is different than all the other rib joints, how?

A

Synchondrosis- Bone cartilage Bone

All others are synovial and allow movement

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14
Q

what is the joint between two cartilages of ribs? what type of joint is it?

A

Interchondral joints (synovial)

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15
Q

What is the rib cartilage joint called? what kind of movement?

A

costochondral joints (Normally no movement)

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16
Q

What are the openings of the thoracic rib cage called?

A

Superior thoracic aperture (thoracic inlet)

Inferior thoracic aperture (thoracic outlet)

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17
Q

C3,4,5 keep the diaphragm alive by providing all the motor and MOST of the sensory of the diaphragm. What supplies the rest of the sensory to the diaphragm?

A

Subcostal nerves and Intercostal nerves at the corner edges of the diaphragm where it meets the ribs on the left and right side

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18
Q

Axilla, nipple, and umbilicus are landmarks for what dermatome levels?

A

Axilla- T2
Nipple- T4
Umbilicus- T10

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19
Q

The nerve map = dermatome map in thoracic. WHY?

A

b/c no plexus formation

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20
Q

T4 intercostal nerve branches at the rib angle to form collateral branches. What is the branch called at the Midaxillary line and parasternal line?

A

Lateral cutaneous branch (MAL)

anterior cutaneous branch (PSL)

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21
Q

where do collateral branches of intercostal nerve branch relative to the ribs?

A

rib angle

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22
Q

Anterior rami of t12 spinal nerve does not follow a costal groove so what is it called?

A

Subcostal nerve

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23
Q

The anterior rami of T1-T12 course along the costal groove (PAIRED as VAN). What muscles are they coursing between?

(what is this space called?)

A

Innermost intercostals and internal intercostals

called the NEUROVASCULAR PLANE

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24
Q

Paradoxical movement causes a mediastinal shift due to fractured ribs during inspiration, this is called a ?
Inspiration causes shift ____ from fractured ribs
Expiration causes shift ______ fractured ribs
Deoxy air stuck in lungs- decreases efficiency of respiration

A

Flail
Inspiration force mediastinum away from fracture
Expiration pushed mediastinum toward fracture

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25
Q

During forced inspiration ribs are _____ and muscles ____. conversely during forced expiration ribs are _____ and muscles ____.

A

Elevated- muscles contract-inspiration

Depressed- muscles relax- expiration

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26
Q

What vert level is landmark for CAVAL opening?

A

T8

27
Q

What vert level is landmark for Esophageal Hiatus?

A

T10

28
Q

What vert level is landmark for aortic hiatus? what courses with aorta through this ?

A

T12

azygous vein

29
Q

Muscles from sternum to ribs on the posterior surface of the anterior rib cage?

A

Transversus thoracic

30
Q

Muscles from ribs skipping to superiorly other ribs on anterior side of posterior thoracic rib cage.

these muscles are in the same plane as what muscles?

A

Subcostal muscles

Same plane as innermost intercostal muscles

31
Q

What is the space called between the innermost intercostals and the internal intercostals?

A

Neurovascular plane

32
Q

Innermost intercostals have the same fiber direction as?

A

Interosseous part of internal intercostals

33
Q

What muscles extend from rib angle to costochondral joint (lateral portion of intercostal space)? - seen on the interior of the rib cage.
These muscles have the same fiber direction as what muscles?

A

innermost intercostals

same fiber direction as interosseous part of internal intercostals

34
Q

The internal intercostal muscles have what two parts? What are the functions of each?

A
  1. interchondral part (elevates ribs)

2. interosseous part (depresses ribs)

35
Q

Internal intercostals extend from the sternum all the way to where?

A

rib angle- then medial to rib angle its replaced with a membrane (posterior part of rib cage towards vertebra)

36
Q

The primary rib elevators extend from the vertebrae medially until the _____. where it is replace by the _____ membrane.

A

Costochontral joint then replaced by

EXTERNAL INTERCOSTAL MEMBRANE

37
Q

In normal radiograph, the right hemidiaphragm is slightly higher than the left. During inspiration, the right dome normally intersects ribs____ to ___ at the ____ line.

A

5th - 7th ribs at midclavicular line

38
Q

Lesion to phrenic nerve causes ______ of ipsilateral dome

A

Elevation

39
Q

Anterior Thoracic wall is supplied blood by 3 arteries

A
  1. internal thoracic (branched off of subclavian a)
  2. superior epigastric a. (branch of internal thoracic)
  3. musculophrenic a. (branch of internal thoracic)
40
Q

Thoracic aorta has landmarks what what vert levels?

A

T5-T12

41
Q

Internal thoracic artery has landmarks at what vert levels? What happens at this level?

A 
T6- Branches to 
Superior epigastric (down abs)
Musculophrenic a (follows costal margin laterally)
42
Q

Posterior intercostal arteries mostly originate from thoracic aorta and accompany intercostal nerve, they anastomose with anterior intercostal artery and can form ____ branches. The T12 artery is the ____.

A

collateral

subcostal artery

43
Q

The anterior cutaneous branch (artery) comes from ?

A

Internal thoracic artery (anterior thorax)

44
Q

Anterior intercostal artery is a branch of the ___ a. or the ____ a.

A

internal thoracic artery OR

musculophrenic artery

45
Q

Anterior venous drainage MIBS

A

Musculophrenic > Internal thoracic > brachiocephalic > SVC

46
Q

Posterior venous drainage

A

Subcostal, posterior, anterior intercostals, collaterals, cutaneous Drain into: Azygous> SVC

47
Q

landmark vertebral level for nipples? what is the better estimate?

A

T4 vert level

T4 dermatome is better estimate

48
Q

Accessory nipples called?

Accessory breasts called?

A

Polythelia

Polymastia

49
Q

Mammary gland is a modified ____ gland

A

Modified Apocrine sweat gland

50
Q

Parenchyma of breast is called a

A

Lobule

51
Q

What is the feature of the breast where most breast cancer arises from ?

A

Lactiferous duct

52
Q

What are the enlarged structures in areola that look like papillary muscles?

A

Lactiferous sinus

53
Q

What anchors mammary glands to skin?

A

Suspensory ligaments of cooper

54
Q

Medial artery supply for breast

A

Internal thoracic artery

55
Q

Lateral artery supply for breast

A

Lateral thoracic artery

Posterior intercostal artery

56
Q

Venous drainage of breast

A

Mainly into Lateral thoracic vein

some into- internal thoracic v and posterior intercostal v.

57
Q

What are the anterior, posterior, and lateral lymph nodes in the arm? Where do they drain into?

A

Anterior- pectoral nodes
Posterior- subscapular nodes
Lateral- Humeral nodes
All drain into central nodes>Apical> Supraclavicular>

58
Q

75% of lymph for Axillary nodes (pectoral, humeral, subscapular) flow from nipple to tail and up into the ___

A

central > apical> RLD or TD

59
Q

Remaining lymph from medial breast flows into

A

parasternal nodes or abdominal nodes (contralateral side)

60
Q

What is the tail called of the boob? what % of cancer here?

A

65% axillary tail (upper outer )
Upper inner 15%
Lower inner 5%
Lower outer 10%

61
Q

Blockage of lymph drainage (edema) of breast leads to the orange peel sign which is called?

A

Peau d’ orange

62
Q

Suspensory ligaments pulled by tumor growth causes

A

Large dimpling of the nipple

63
Q

Breast elevation when contracting pectoralis major is indicative of cancer invasion into the….

A

Retromammary space

Anatomy (24 decks)

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