Lecture 4: Thoracic wall Flashcards

1
Q

Identify the structure with the star.

A

tubercle

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2
Q

Identify the structure with the red arrow

A

costal groove

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3
Q

articulate with inferior and superior costal facets of adjacent thoracic vertebrae

A

head

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4
Q

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

A

thoracic outlet syndrome

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5
Q

This structure separates the ribs and costal cartilages

A

intercostal space

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6
Q

__ to ___ are TRUE ribs

A

1-7

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7
Q

___ to ___ have cartilages attached to cartilages of ribs superior.

A

8-10

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8
Q

Floating ribs are which number?

A

11-12

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9
Q

space between the pericardium and the sternum

A

anterior mediastinum

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10
Q

pericardium and heart lie in this part of the thoracic cavity

A

middle mediastinum

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11
Q

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

A

the thorax

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12
Q

Identify all the features of the generalized vertebra

A

see slide 17 thoracic wall MC

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13
Q

which muscle lies between the ribs?

A

intercostal muscles

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14
Q

function during respiration both by moving the ribs and by helping to keep the intercostal spaces rigid

A

intercostal muscles

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15
Q

5 muscles included in the intercostal muscles

A
  1. ) external intercostal
  2. ) internal intercostal
  3. ) innermost intercostal
  4. ) subcostal
  5. ) transversus thoracis
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16
Q

elevate ribs during forced inspiration

A

external intercostals

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17
Q

internal and innermost intercostals are separated from the innermost layer by the ____.

A

neurovascular bundle

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18
Q

Identify muscles in green

A

subcostalis

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19
Q

functions to depress ribs

A

transversus thoracis

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20
Q

where is/are the primary blood supply to the thoracic wall derived from?

A

aorta and subclavian arteries

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21
Q

most of these veins return blood to the azygous and hemiazygous veins

A

posterior intercostal veins

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22
Q

an area of the skin supplied by the nerves from a single spinal root

A

dermatomes

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23
Q

a procedure to remove fluid from the space between the lining of the outside of the lungs and the wall of the chest

A

thoracentesis

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24
Q

origin is the transverse processes; insertion: rib below b/w tubercle and angle; action: elevates ribs

A

levator costae

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25
Q

origin: spines of C7-T3; insertion: ribs 2-4; action: elevate ribs

A

serratus posterior superior

26
Q

origin: spines of T11-L2; insertion: ribs 8-12; action: depress ribs

A

serratus posterior inferior

27
Q

most important muscle of respiration

A

diaphragm

28
Q

Identify the structure with the star on the diagram.

A

serratus posterior inferior

29
Q

Identify the structure with the star on the diagram.

A

right crus

30
Q

Identify the structure with the star on the diagram.

A

medial arcuate ligament

31
Q

unites the crura and forms the aortic hiatus

A

MEDIAN arcuate ligament

32
Q

what innervates the respiratory diaphragm

A

phrenic nerve C3, C4, C5 “keep the diaphragm alive”

33
Q

posterior intercostal veins return blood to ____ and ___ veins

A

azygos and hemiazygos

34
Q

flatten the dome of the diaphragm, providing the lung with greater volume for expansion

A

diaphragmatic plication

35
Q

increasingly being employed in patients with central respiratory paralysis and upper cervical spinal cord injury to wean patients off mechanical ventilation

A

phrenic pacing

36
Q

describe 2 things that happen during INSPIRATION

A
  1. ) rib cage expand as rib muscle contract
  2. ) diaphragm contracts/ moves down
37
Q

describe 2 things that happen during expiration

A
  1. ) ribe cage gets smaller as rib muscles relax
  2. ) diaphragm relaxes/ moves up
38
Q

principal muscle involved in INSPIRATION

A

external intercostals (elevate ribs)

39
Q

principal muscle(s) involved in expiration

A

internal intercostal, rectus abdominis, external oblique, internal oblique, transversus abdominis CONTRACT during expiration

40
Q

superior surface of the diaphgram is supplied by ____ arteries (3)

A

musculophrenic, pericardiacophrenic, and superior phrenic arteries

41
Q

the inferior surface of the diaphragm is supplied by ___.

A

inferior phrenic

42
Q

Identify the artery by the star on the diagram

A

musculophrenic artery

43
Q

Identify the structure labeled by the stars on the diagram

A

inferior phrenic arteries

44
Q

superior venous drainage of the diaphragm (3 veins)

A

musculophrenic, pericardiacophrenic and right superior phrenic

45
Q

inferior surface venous drainage of diaphragm (2 veins)

A

right and left inferior phrenic veins

46
Q

Most veins return blood to the azygous and hemiazygous veins EXCEPT

A

Left Superior intercostal

47
Q

ID the structure with the star

A

left pericardiacophrenic artery

48
Q

ID the structure with the star

A

Right pericardiacophrenic artery

49
Q

What surgical treatment is used to treat pts with severe dyspnea upon excursion (unilateral diaphragmatic paralysis) ?

A

diaphragmatic plication

50
Q

What is currently being used to treat bilateral diaphragmatic paralysis and allows pts to speak again and use their olfaction systems?

A

diaphragm pacing

51
Q

At what level does the caval hiatus open?

A

T8

52
Q

At what level does the esophageal hiatus come out?

A

T10

53
Q

At what level does the aortic hiatus come out?

A

T12

54
Q

Part of diaphragm that arises from L1-L2 and their intervertebral discs

A

left crus

55
Q

arises from L1-L3 and their intervertebral discs

A

right crus

56
Q

which diaphragmatic aperture/opening does the azygous vein go into?

A

aortic hiatus

57
Q

Which intercostal muscle(s) has actions to both depress and elevate the ribs?

A

internal intercostal and innermost intercostal muscle

58
Q

Transversus thoracic attaches to which costal cartilages?

A

2-6

59
Q

Most common type of scoliosis

A

idiopathic scoliosis

60
Q

may result from traumatic bone callapse, previous mahor back surgery, or osteoporosis

A

degenerative scoliosis