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(J) Anatomy Test 2 > Lecture 14 - Thoracic Osteology and Wall Structure > Flashcards

Lecture 14 - Thoracic Osteology and Wall Structure Flashcards

1
Q

What does the thoracic cage consist of?

A
  • 12 thoracic vertebrae
  • 12 pairs of ribs and respective costal cartilage
  • sternum
  • intercostal muscles
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2
Q

What defines the superior and inferior boundaries of the thoracic cage?

A

Superior:

  • first thoracic vertebrae
  • first pair of ribs and costal cartilages
  • manubrium

Inferior:

  • twelfth thoracic vertebrae
  • twelfth pair of ribs and costal cartilages
  • xiphisternal joint
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3
Q

What are the parts of the sternum and their features?

Slide 6-7

A

Manubrium:

  • articulates with sternal body at sternal angle (angle of Louis)
  • superior jugular notch
  • concave surfaces for clavicle
  • concave surfaces for first rib

Sternal body:
-four fused sternebrae

Xiphoid process:
-fibrocartilage expansion of sternum into abdominal musculature

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4
Q

What landmark is associated with the xiphoid process?

A

-dermatome T6

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5
Q

What are the types of ribs?

A

Vertebrosternal ribs:
-1-7

Vertebrochondral ribs:
-8-10

Vertebral ribs (floating):
-11-12
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6
Q

What are the parts of the ribs and their features?

A

Head:

  • two articular facets for articulation with costal demifacets
  • bony crest between facets connects to intervertebral space

Neck:
-between head and tubercle

Tubercle:
-articulates with transverse process of vertebra of same number

Shaft:

  • angle
  • sternal extremity
  • costal grove containing intercostal vein, artery and nerve (sup. to inf.)
  • slopes downward

Costal cartilage:
-angles upward

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9
Q

What unique features does the first rib have?

A
  • more flattened and horizontal
  • scalene tubercle (insertion of scalenus anterior)
  • groove for subclavian vein (anterior to tubercle)
  • shallow groove for subclavian artery (posterior to tubercle)
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10
Q

What is the typical rib articulation?

A
  • head articulates with demifacets of vertebrae of same number the one above
  • head articulates with intervertebral disc
  • tubercle articulates with transverse process of vertebra of the same number
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11
Q

What are the surface landmarks of the throacic wall? (Non-cardiac) (6)

(Slide 18 and 20)

A

Jugular notch (root of neck)

Sternal angle:
-marks rib 2 (level of T4-5)

Bifurcation of the trachea:
-between sternal angle and T4-5 vertebral level

Posterior thorax (scapula):

  • scapular spine is at level of 3rd rib and T7
  • inferior scapular angle at level of 7th rib, spine of T7, body of T9

Costal margin:

  • superior marked by 7th cartilage
  • inferior marked by 10th cartilage

Infrasternal angle:
-important in CPR

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12
Q

What are the surface landmarks of the thoracic wall? (Cardiac) (5)

(Slide 18-19)

A

Apex heart beat:
-5th intercostal space 8.5 cm from midline

Aortic valve heart sound:
-2nd intercostal space on right side of sternum

Pulmonary valve heart sound:
-2nd intercostal space on left side of sternum

Tricuspid valve heart sound:
-projected to 5th intercostal space on right side of sternum

Bicuspid valve heart sound:
-projected to 5th intercostal space 10cm to left of midline

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13
Q

What lines of orientation are there on the thorax?

A

Midsternal line

Midclavicular line

Scapular line:
-runs vertically through inferior angle

Anterior axillary line:

  • downward from anterior axillary fold
  • formed by lower border of pectoralis major

Posterior axillary line:

  • downward from anterior axillary fold
  • formed by tendon of latissimus dorsi

Midaxillary

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14
Q

What cutaneous levels of innervation supply the thorax and what what regions do they supply?

A

Clavicular and scapular regions:
-C3-4

Upper thorax:
-T1-5

Xiphoid process:
-T6

Lower thorax and anterior/lateral abdominal wall:
-T7-12

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15
Q

Describe the typical thoracic vertebra.

A
  • heart-shaped centrum (body)
  • centrum notched on left sides for descending aorta
  • intervertebral discs (1/4 of length)
  • superior and inferior costal demifacets (T2-T9)
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16
Q

What are the atypical thoracic vertebra?

A

T1:
-superior costal facet (not demifacet)

T10:
-one pair of costal facets located partly on body and partly on pedicle

T11 and T12:
-one pair of costal facets located on pedicles

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17
Q

What is the arterial supply and venous drainage of the pectoral region?

A

-axillary artery and vein

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18
Q

Describe the muscle layers in the intercostal space.

Slide 43

A

External intercostals:

  • extends from vertebrae to junction of ribs and intercostal cartilage
  • deep fascia forms external intercostal membrane
  • fiber direction is inferior and anterior

Internal intercostals:

  • extends from sternum to vertebral column
  • deep fascia forms internal intercostal membrane
  • fiber direction is inferior and posterior

Innermost intercostals:
-incomplete layers with fibers arranged horizontally

Transversus thoracis:
-4-5 strips that originate from sternum and extends towards internal upper ribs

19
Q

Where are the intercostal spaces and what occupies the spaces?

A

-formed by a groove in the inferior border of each rib

Contents (superior to inferior):

  • intercostal vein
  • intercostal artery (consists of anterior and posterior arteries)
  • intercostal nerve.
20
Q

Describe the structure of the mammary gland.

A
  • 15-20 lobes consisting of several lobulues
  • lobes are separated by septa
  • each lobe give off a lactiferous duct which converge at the nipple
  • lactiferous sinus is a dilation of the ducts near the nipple
  • suspensory ligaments attach the gland to the skin
21
Q

Describe the arterial supply to the breast.

Slide 57

A

Anterior perforating arteries:

  • from internal thoracic artery
  • medial gland

Medial mammary rami:

  • from anterior perforating arteries
  • deep medial gland

Lateral mammary artery:

  • from lateral thoracic artery
  • to inferior gland

Lateral mammary rami:

  • from intercostal arteries
  • lateral gland
22
Q

Describe the venous drainage from the breast.

Slide 58

A
  • mainly to axillary vein via lateral thoracic vein and medial mammary vein
  • some to internal thoracic via intercostal veins
23
Q

Describe the lymphatic drainage drainage of the breast.

Slide 60

A
  • perilobular and interlobular lymph vessels
  • > subareolar plexus
  • > lateral/medial lymphatic truck
  • > pectoral axillary lymph nodes
  • > subclavian lymphatic channels
24
Q

What nerves innervate the breast?

A
  • lateral mammary nerve (T2-6)
  • anterior lateral cutaneous branches of intercostal nerves
  • medial mammary nerve (T2-6)
  • lateral anterior cutaneous branches of intercostal nerves
  • supraclavicular nerves

(J) Anatomy Test 2 (13 decks)

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