lecture 1: Orientation, Imaging and Thoracic Wall Flashcards
***what are the 3 planes and show a diagram
- sagittal divides body into the left and right halves - frontal divides the body into anterior and posterior - horizontal divides body into superior and inferior
what do they following terms mean? Anterior/Posterior Superior/Inferior Medial/Lateral Proximal/Distal Superficial/Deep
Anterior- front of body Posterior - back of the body Superior- on the top of the body Inferior- on the bottom of the body Medial- in the middle of Lateral - on the side of Proximal- closer to the origin of the structure Distal - further from the origin of the structure Superficial- on the surface Deep - within the surface
what do the following terms mean: cranial ? rostral ? caudal?
cranial - towards the head rostral - towards the mouth or nose caudal - towards the tail
what does palmer mean? what does dorsal mean?
on palm/front of the hand on back of the hand
what does plantar mean? what does dorsal mean?
on the sole of the foot on the back of the foot
what plane are CT scans?
transverse plane however some are of the frontal plane
what is flexion? what is extension?
– muscle contracting – muscle relaxing
what is abduction? what is adduction?
- away from midline - towards midline
***what is lateral flexion?
bending in a lateral direction
***what is protraction? what is retraction?
****- anterior movement - posterior movement
what is medial rotation? what is lateral rotation?
movement inside movement outside
what is dorsiflexion? what is plantar flexion?
- towards dorsum of foot - towards plantar surface of foot
what is radial deviation?
wrist movement towards either bone
what is pronation? what is supination?
– palmar surface points inferiorly - palmar surface points superiorly
***what is inversion? what is eversion?
– foot rotating internally – foot rotating externally
structure of the thoracic skeleton ?
refer to netters flashcard 3-1
what does the thoracic skeleton basically contain?
- 12 thoracic vertebrae - 12 pairs of ribs and costal - cartilages - Sternum bone
what are the articulations of the thorax?
- sternoclavicular joint - sternocostal joints - costochondrial joints
**** what is the structure of the thoracic vertebrae?
****
*** structure of a rib?
*****
what are the true ribs ? what are the false ribs? what are the floating ribs?
- ribs 1-7 - direct interaction with sternum - ribs 8-10 - indirect - ribs 11-12 - no interaction
what does the costal groove mark? what does it feel like?
- Costal groove marks the inferior margin of the internal surface of the rib. - The inferior edge is sharp as it is tapered to allow passage of some structures
what is the structure of the sternum?
Manubrium (1st costal cartilage attaches) Body Xiphoid process
what happens at the sternal angle?
bifurcation of trachea and pulmonary trunk, beginning and termination of arch of aorta
what is a symphasis and what is it made up of?
Symphysis = fibrocartilaginous fusion between two bone Symphysis between vertebral bodies = Hyaline cartilage + Intervertebral disc
*** is the intervertebral disc made up of?
- Anulus fibrosus (collagen – limits rotation) - Nucleus pulposus (gelatinous – absorbs compression forces)
****what makes up a zygapophysial joint?
= Inferior Articular Process + Superior articular process
how does the position of the zygapophysial joints change in the following places ? cervical? thoracic? lumbar?
cervical: zygapophysial joints slope inferiorly from anterior to posterior allows flexion and extension thoracic: the joints are oriented vertically and limit flexion and extension, but facilitate rotation lumbar: joint surfaces are curved adjacent processes interlock therefore a limited range of movement
what do the two surfaces on the head of the rib articulate with?
- Superior facet on rib head -> Inferior demifacet on body of the vertebra ABOVE - Inferior facet on rib head -> Superior demifacet on body of its own vertebra
what is a Costotransverse joint ?
= synovial joint between - Tubercle of rib - Transverse process of its own vertebra
what movement does the costovertebral joints and related ligaments allow?
- necks of the ribs either to rotate around their longitudinal axes ( upper ribs) - to ascend and descend relative to the vertebral column ( lower ribs) overall allows the alteration of the thoracic cavity during breathing
which vertebrae articulate with the ribs differently?
- the head of rib I does not articulate with vertebra CVII; - vertebra TX articulates only with its own ribs so has no no inferior demifacets - vertebrae TXI and TXII articulate only with the heads of their own ribs -they lack transverse costal facets
structure of costovertebral joints?
refer to netter flashcard 3-2
****what are the sternocostal joints?
- 1st costal cartilages manubriosternal joint
Fibrocartilaginous joint 2nd costal cartilage sternal angle
- 7th costal cartilage body-xiphoid (xiphisternal joint) -
8th – 10th costal cartilages cartilage above (interchondral joints)
Interchondral joints provide indirect anchorage to the sternum and contribute to the formation of a smooth inferior costal margin.
what does the thoracic inlet formed of?
- T1 - 1st ribs - manubrium
***show the structure of the thoracic inlet? what are the main vessels?
***** - Common carotid artery, jugular vein, subclavian artery and vein)
where does the apex sit?
apex of the lung is 3cm above the clavicle - the apex is superior to the clavicle
where do veins sit compared to arteries?
veins are anterior to arteries
****show diagram of costal margin :
*****
what is an intercostal space?
space between adjacent ribs
what does the intercostal space contain?
- MUSCLES External intercostal muscle Internal intercostal muscle Innermost intercostal muscle - NEUROVASCULAR BUNDLE
****what are the directions of the intercostal muscles?
- external intercostal? - start at lower edge of rib - extend towards sternum - internal intercostal? - start at the sternum - extends towards the spinal cord outwards
what do the externals do? what do the internals do? what do the innermost intercostals do?
’up and outward’ = inspiration Pull ribcage downward = forced expiration they are not very important
what are the intercostal muscles innervated by?
- 11 pairs intercostal nerves T1-T11 + 1 subcostal vein - Mixed (= motor + sensory) - motor to thoracic wall muscles - sensory from skin to pleura
what is the segmental arrangement of the nerves ?
Strip of skin and muscles innervated by single spinal nerve
what is a dermatome?
strip of skin innervated by single spinal nerve
what are the branches of the intercostal nerves?
- The lateral cutaneous branch is the largest branch - divides into the anterior and posterior branch that innervate the overlying skin
what is the arrangement of the neurovascular bundles?
- vein - artery - nerve Vein, artery & nerve run in the costal groove nerve is most at risk
****show a diagram of the arrangement of the neurovuscular bundles between the ribs?
****
where do posterior intercostal arteries branch from?
aorta
where do anterior intercostal arteries branch from?
internal thoracic artery - Internal thoracic artery arises from the subclavian arteries in the root of the neck
what are x rays what are the three colours of xrays ? what are they caused by??
X-Ray = Ionising Radiation Most X-rays pass through - black 50% passes through - grey Few X-rays pass through - white
show a chest xray
