Lecture 14: Thoracic osteology and wall Flashcards

1
Q

Components of thoracic cage

A

12 thoracic vertebrae
12 pairs of ribs and costal cartilages
Sternum
Intercostal muscles

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2
Q

Lateral mammary rami

A

From lateral cutaneous branches of intercostal arteries to lateral part of gland

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3
Q

Nipple, areola, lactiferous lobules drain into

A

Subareolar lymph node

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4
Q

Fatty tela subcutanea

A

Adipose tissue deep to fibrous layer

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5
Q

Medial mammary rami

A

From 2nd-4th anterior perforating arteries to deep medial part of gland

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6
Q

Bicuspid heart sound

A

Fifth intercostal space about 10cm to left of sternal midline

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7
Q

Rib tubercle articulates with

A

Transverse process of same number vertebra

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8
Q

Bifurcation of the trachea

A

Between sternal angle and T4/5 vertebral level

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9
Q

Sternal angle

A

Marks rib 2

Lies at level of T4-5 intervertebral disc

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10
Q

Contents of intercostal space include

A

Intercostal vein
Intercostal arteries (anterior and posterior)
Intercostal nerves

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11
Q

Vertebra prominens

A

First spinous process to be palpaged (C7)

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12
Q

Vertebrosternal ribs

A

1-7

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13
Q

Rib head

A

Two articular facets for articulation with costal demifacets on adjacent thoracic vertebrae

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14
Q

Inferior boundary thoracic cage

A

Twelfth thoracic vertebra
Twelfth pair of ribs/costal cartilages
Xiphisternal joint
Larger of the two openings

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15
Q

Pulmonary valve heart sound

A

Can be heard at the second intercostal space along left side of sternum

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16
Q

Internal intercostals

A

Begin at lateral edge of sternum and extend toward vertebral column
Deep fascia extends to vertebrae as internal intercostal membrane
Fiber direction is inferiorly and posteriorly

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17
Q

Innervation of upper thorax

A

T1-5

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18
Q

Costal cartilage slope

A

Takes upward slope

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19
Q

Innervation of clavicular and scapular region of upper thorax

A

C3-4

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20
Q

Angle of louis

A

Area at which the manubrium articulates with the body of the sternum

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21
Q

Sternal end level compared to vertebral end

A

Sternal end is at a lower level than the vertebral end

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22
Q

Anterior perforating arteries to breast

A

From internal thoracic artery to medial part of gland

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23
Q

Manubriosternal joint type

A

Symphysis

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24
Q

Vertebrochondral ribs

A

8-10

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25
Q

Innervation of xiphoid process region

A

T6

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26
Q

Fibrous tela subcutanea

A

Connective tissue layer surround the entire gland

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27
Q

Lateral mammary artery

A

From lateral thoracic artery to inferior part of gland

28
Q

Venous drainage from breast

A

Mainly to axillary vein via lateral thoracic veins and medial mammary veins
Some drainage to internal thoracic vein via anterior intercostal veins
Especially important due to role in metastasis of cancer

29
Q

Contents of intercostal space protected by

A

Groove on inferior border of each rib

30
Q

Subareolar plexus drains into

A

Lateral lymphatic trunk

Medial lymphatic trunk

31
Q

Posterior intercostal arteries arise from and give off

A

PIA 1&2 arise from costocervical trunk
3-12 are segmental branches from descending aorta
Posterior arteries give off lateral cutaneous branch

32
Q

Tricuspid valve

A

Projected to the fifth intercostal space on right side

33
Q

Rib tubercle

A

Articulates with transverse process of vertebra with same number

34
Q

Suspensory ligament of cooper

A

Bundles of collagen fibers in dermis and hypodermis

35
Q

Innervation of lower thorax and lateral/anterior abdominal wall

A

T7-12

36
Q

Perilobular and interlobular lymphatic vessels drain into

A

Subareolar plexus

37
Q

Mammary glands are

A

Modified sweat glands

38
Q

Rib head articulates with

A

Demifacets of its own number vertebra and the vertebra above, as well as intervertebral disc between

39
Q

75% of lymph from breast drains into

A

Axillary lymph nodes

40
Q

Intercostal nerves description 1st, 2nd, 12th, branches

A

IC Nerves have lateral and cutaneous branches
Most of the first intercostal nerve joins the brachial plexus and has no anterior cutaneous branches
Lateral cutaneous branch of the 2nd intercostal nerve supplies the floor of the axilla
Lateral cutaneous branch of the subcostal (12th IC) nerve supplies the skin over the gluteal region

41
Q

Transversus thoracis

A

Four or five slips that originate from the inferior sternum and extend superolaterally to internal surface of upper ribs

42
Q

Vertebral ribs

A

11-12

43
Q

Medial/lateral lymphatic trunks drain into ___ which drain into

A

Pectoral group of axillary lymph nodes into subclavian lymphatic channels

44
Q

Innermost intercostals

A

Incomplete layers with fibers arranged in a more horizontal pattern

45
Q

Infrasternal angle

A

Important in CPR
Depression between is the infrasternal fossa
Xiphisternal joint within fossa is at level of the body of T9

46
Q

Aortic valve heart sound

A

Can be heard at the second intercostal space on the right side of sternum

47
Q

Anterior axillary line formed by

A

Lower border of pectoralis major

48
Q

First rib shallow groove for subclavian vein is ______ to tubercle

A

Anterior to tubercle

49
Q

Posterior axillary line formed by

A

Tendon of latissimus dorsi

50
Q

First rib shallow groove for subclavian artery is _______ to tubercle

A

Posterior to tubercle

51
Q

External intercostals

A

Extend from vertebrae posteriorly to junction of ribs and intercostal cartilages
Deep fascia continues to sternum and forms external intercostal membrane
Fiber direction is inferiorly and anteriorly

52
Q

First rib scalene tubercle

A

For insertion of scalenus anterior muscle

53
Q

Scapular line

A

Vertical line running through inferior angle of scapula

54
Q

Apex heart beat

A

Fifth intercostal space along midclavicular line about 8.5cm from adult midline

55
Q

Intercostal nerves derived from, how many

A

Ventral ramus of a spinal nerve

12 pairs

56
Q

Remaining lymph of breast drains into

A

Parasternal and abdominal lymph nodes

57
Q

Costal margin superior and inferior marks

A

Superior marked by 7th cartilage

Inferior marked by 10th cartilage

58
Q

Most prominent spinous process

A

T1

59
Q

Anterior intercostal arteries arise from and give off

A

Branch of the internal thoracic arteries

Give off anterior cutaneous branches

60
Q

Rib shaft- costal groove contains what, listed superior to inferior

A

Intercostal vein- most superior
Intercostal artery
Intercostal nerve- most inferior
Shaft angles downward

61
Q

Innervation of breast tissue

A

Lateral mammary nerve
Anterior branches of lateral cutaneous branches of intercostal nerves
Lateral branches of anterior cutaneous branches of intercostal nerve
Supraclavicular nerves

62
Q

Mammary gland rests on, innervated by, retromammary space is,

A

Pectoral fascia above pec major
IC nerves 4-6
Potential space between breast and pec fascia

63
Q

Breast extends from

A

2nd-3rd rib superiorly to 6-7th costal cartilage inferiorly

From lateral border of sternum to beyond the anterior axillary fold

64
Q

Xiphoid process marks

A

Level of dermatome 6

65
Q

Superior boundary thoracic cage

A

First thoracic vertebra
First pair of ribs and costal cartilages
Manubrium