GA1 - Thoracic Cage and Pectoral Region Flashcards
Function of thoracic and pectoral regions
breathing; protection of vital organs; conduit
Components of thoracic and pectoral region
12 thoracic vertebrae; ribs and intercostal muscles; sternum
anterior median (midsternal) line
anatomical position - cuts body in half (right and left)
midclavicular lines
bilateral through clavicles
anterior/posterior axillary line
bilateral to the midaxillary line
midaxillary line
cuts body into anterior and posterior on the lateral side of the body; lateral cutaneous nerves; branches of intercostal nerves
surface landmarks - lines
help locating structures; reference points
superior thoracic aperature borders
T1, 1st rib, jugular notch
what runs through the superior thoracic aperature
trachea, esophagus, carotid artery, subclavian artery, nerves: vagus, phrenic; sympathetic chain ganglia
inferior thoracic aperature borders
T12, 12th rib, xiphosternal joint
what runs through the inferior thoracic aperature
descending aorta, esophagus, inferior vena cava, sympathetic chain, phrenic nerve and vagus nerve
head of ribs attaches to the
vertebral body
costal tubercle attaches to the
transverse process
neck of rib causes
slight constriction
costal angle is the
sharp bend in the rib
ribs are _____ bones
flat
vertebrae are _____ bones
irregular
scapula is a ______ bone
flat
3 components to the sternum
manubrium, body, xiphoid process
body of sternum in males
2x as big as manubrium
body of sternum in females
less than 2x as big as manubrium (smaller)
xiphoid process ossifies in early
40s
costochondritis
inflammation at costochondral junction; dancers and contact sports; no swelling
Tietze’s Syndrome
inflammation of costochondral junction
rib dislocation
cartilage separates from sternum
rib separation
cartilage and rib separate
rachitic rosary
vitamin D deficiency - causes rickets in children; end of ribs enlarge at the costochondral junction
cleidocranial dysostosis
no clavicles; attaching to 1st rib
pectus excavatum
funnel chest; sunken appearance of chest
pectus carinatum
pigeon breast; overgrowth of ribs
Thoracic Outlet Syndrome (TOS) causes
cervical rib, tumors/enlarged lymph nodes or costoclavicular syndrome
cervical rib due to TOS
extra rib from C7
Costoclavicular syndrome due to TOS
diminishe spaced between clavicle and 1st rib compressing brachial plexus or subclavian artery
location of the breast - overlies? transversely extends? vertically extends?
subcutaneous, overlied deep fascia covering the pec major and serratus anterior; transversely extends from lateral border of the sternum to the midaxillary line; vertically extends from 2nd to 6th ribs
tissue of the breast
adipose and glandular tissue; variable amount of fat
axillary tail
extends laterally
retromammary space
space between breast and deep fascia of pec major; to easily move
suspensory ligaments of cooper
keeps the breast up or droopy if they lose tightness
lactiferous ducts
15-20 channels to the sinuses
lactiferous sinuses
15-20 dialated end nearer the nipple
sebaceous gland of montgomery
bumbs on areola to lubricate the nipple
mammary glands
modified sweat gland
blood supply of the breast (3)
branches of the internal thoracic artery; lateral thoracic and thoracoacromial arteries; posterior intercostal arteries in the 2nd, 3rd and 4th ICS
intercostal thoracic artery is a branch of the
subclavian artery
intercostal thoracic artery branches into
PAMS: pericardial (phrenic), anterior intercostal, musculophrenic, superior epigastric
posterior intercostal arteries are bracnhes of the
thoracic aorta
lateral thoracic and thoracoacromial arteries are branches of
axillary artery
venous drainage of the breast through
axillary vein and internal thoracic veins
Lymphatic drainage of the breast
subareolar lymphatic plexus
75% of lymph from breast, especially lateral quadrants, drains to
the axillary lymph nodes
most of the remaining lymph, particularly the medial quadrants, either drains to _____ or ____
parasternal nodes or the other breast
lymph from the lower quadrants drain into the
inferior phrenic nodes
Upper Lateral quadrant, Upper medial quadrant, and left lateral quadrant drain to the
axillary lymph
upper medial and lower medial drain to
the parasternal nodes or other breast
lower lateral and medial drain to
inferior phrenic nodes
right lower lower medial can drain to
the liver
knowing where the lymph drains from the breast can
predict where cancer cells metastasize or infection
nerve supply to the breast
lateral and anterior cutaneous branches of the 4th to 6h intercostal nerves
nerves of the breast convey ____ fibers to the skin of the brast and _____ fibers to the blood vessels in the breast and smooth muscles in the overlying skin and nipple
sensory; sympathetic
sympathetic fibers of the breast cause
the contraction of the errector pilli musclees and glands
symoathetic fibers cause vasoconstriction of cutaneous blood vessels
to divert blood away from skin to go to muscles
sympathetic fibers cause vasoconstriction of cutaneous blood vessels so that
blood goes to the skeletal muscles
polythelia
extra nipples (2+)
polymastia
extra breast
amastia
no breasts
breast cancer - “dimpling”
suspensory ligaments of cooper can retract pulling the skin
gynecomastia
male developing breasts
gynecomastia caused by
hormonal imbalance, steroids, in Kleinfelters
Carcinoma - abnormal contours
breast is no shaped right
Carcinoma - nipple retraction and deviation
nipple starts to turn inward
Carcinoma - Peau d’orange sign
edema of the skin; obstruction of the lymphatic structures due to the cancer; tiny pores; leathery texture; orange skin
what causes an increased thoracic volume
increase side to side diameter, A-P diameter (external intercostal and internal intercostal) and vertical length (diaphragm)
an increased thoracic volume causes
lungs to passively expand and air rushes in through trachea
diaphragm rises when
relaxed
intercostal nerves are derived from
the thoracic spinal nerves
ventral rami of T1-T11 form the
intercostal nerves between innermost and internal intercostal
ventral ramus of T12 forms the
subcostal nerve
dermatomes
bandlike skin areas each supplied by a single spinal nerve
typical intercostal nerves
3-6
intercostal nerves 3-6 branches (5)
rami communicantes, collateral branches, lateral cutaneous, anterior cutaneous, muscular
atypical intercostal nerves
1 and 2
thoracoabdominal nerves
7-11
subcostal nerve
12
arterial supply to thoracic wall
thoracia aorta, subclavian artery and axillary artery
anastomosis
direct connection of 2 arteries or 2 nerves with capillaries
joints have high ____ network
anastomotic
thoracic wall venous drainage - posterior intercostal veins drain mostly into the
azygos venous system
thoracic wall venous drainage - anterior intercostal veins drain into the
internal thoracic vein
thoracic wall venous drainage - anterior and posterior intercostal veins _____ with each other
anastomose
