Lecture 4: Thoracic wall Flashcards
Identify the structure with the star.
tubercle
Identify the structure with the red arrow
costal groove
articulate with inferior and superior costal facets of adjacent thoracic vertebrae
head
term used to describe a group of disorder that occur when there is compression, injury, or irritation of the brachial plexus and/or subclavian vessels in the lower neck and upper chest
thoracic outlet syndrome
This structure separates the ribs and costal cartilages
intercostal space
__ to ___ are TRUE ribs
1-7
___ to ___ have cartilages attached to cartilages of ribs superior.
8-10
Floating ribs are which number?
11-12
space between the pericardium and the sternum
anterior mediastinum
pericardium and heart lie in this part of the thoracic cavity
middle mediastinum
part of the body between the neck and abdomen including the cavirty enclosed by the ribs, breastbone and dorsal vertebrae and containing the chief organs of circulation and respiration, the chest
the thorax
Identify all the features of the generalized vertebra
see slide 17 thoracic wall MC
which muscle lies between the ribs?
intercostal muscles
function during respiration both by moving the ribs and by helping to keep the intercostal spaces rigid
intercostal muscles
5 muscles included in the intercostal muscles
- ) external intercostal
- ) internal intercostal
- ) innermost intercostal
- ) subcostal
- ) transversus thoracis
elevate ribs during forced inspiration
external intercostals
internal and innermost intercostals are separated from the innermost layer by the ____.
neurovascular bundle
Identify muscles in green
subcostalis
functions to depress ribs
transversus thoracis
where is/are the primary blood supply to the thoracic wall derived from?
aorta and subclavian arteries
most of these veins return blood to the azygous and hemiazygous veins
posterior intercostal veins
an area of the skin supplied by the nerves from a single spinal root
dermatomes
a procedure to remove fluid from the space between the lining of the outside of the lungs and the wall of the chest
thoracentesis
origin is the transverse processes; insertion: rib below b/w tubercle and angle; action: elevates ribs
levator costae
origin: spines of C7-T3; insertion: ribs 2-4; action: elevate ribs
serratus posterior superior
origin: spines of T11-L2; insertion: ribs 8-12; action: depress ribs
serratus posterior inferior
most important muscle of respiration
diaphragm
Identify the structure with the star on the diagram.
serratus posterior inferior
Identify the structure with the star on the diagram.
right crus
Identify the structure with the star on the diagram.
medial arcuate ligament
unites the crura and forms the aortic hiatus
MEDIAN arcuate ligament
what innervates the respiratory diaphragm
phrenic nerve C3, C4, C5 “keep the diaphragm alive”
posterior intercostal veins return blood to ____ and ___ veins
azygos and hemiazygos
flatten the dome of the diaphragm, providing the lung with greater volume for expansion
diaphragmatic plication
increasingly being employed in patients with central respiratory paralysis and upper cervical spinal cord injury to wean patients off mechanical ventilation
phrenic pacing
describe 2 things that happen during INSPIRATION
- ) rib cage expand as rib muscle contract
- ) diaphragm contracts/ moves down
describe 2 things that happen during expiration
- ) ribe cage gets smaller as rib muscles relax
- ) diaphragm relaxes/ moves up
principal muscle involved in INSPIRATION
external intercostals (elevate ribs)
principal muscle(s) involved in expiration
internal intercostal, rectus abdominis, external oblique, internal oblique, transversus abdominis CONTRACT during expiration
superior surface of the diaphgram is supplied by ____ arteries (3)
musculophrenic, pericardiacophrenic, and superior phrenic arteries
the inferior surface of the diaphragm is supplied by ___.
inferior phrenic
Identify the artery by the star on the diagram
musculophrenic artery
Identify the structure labeled by the stars on the diagram
inferior phrenic arteries
superior venous drainage of the diaphragm (3 veins)
musculophrenic, pericardiacophrenic and right superior phrenic
inferior surface venous drainage of diaphragm (2 veins)
right and left inferior phrenic veins
Most veins return blood to the azygous and hemiazygous veins EXCEPT
Left Superior intercostal
ID the structure with the star
left pericardiacophrenic artery
ID the structure with the star
Right pericardiacophrenic artery
What surgical treatment is used to treat pts with severe dyspnea upon excursion (unilateral diaphragmatic paralysis) ?
diaphragmatic plication
What is currently being used to treat bilateral diaphragmatic paralysis and allows pts to speak again and use their olfaction systems?
diaphragm pacing
At what level does the caval hiatus open?
T8
At what level does the esophageal hiatus come out?
T10
At what level does the aortic hiatus come out?
T12
Part of diaphragm that arises from L1-L2 and their intervertebral discs
left crus
arises from L1-L3 and their intervertebral discs
right crus
which diaphragmatic aperture/opening does the azygous vein go into?
aortic hiatus
Which intercostal muscle(s) has actions to both depress and elevate the ribs?
internal intercostal and innermost intercostal muscle
Transversus thoracic attaches to which costal cartilages?
2-6
Most common type of scoliosis
idiopathic scoliosis
may result from traumatic bone callapse, previous mahor back surgery, or osteoporosis
degenerative scoliosis
