MSK Flashcards
What type of joints are the costochondral joints?
primary cartilaginous (hyaline) joint
Primary cartilaginous joints (= synchondroses): A plate of hyaline cartilage connects the bones at the joint. Only hyaline cartilage is involved, and the joints are immoveable
What type of joint joins the first rib to the sternum?
primary cartilaginous (hyaline) joint
Primary cartilaginous joints (= synchondroses): A plate of hyaline cartilage connects the bones at the joint. Only hyaline cartilage is involved, and the joints are immoveable
What type of joints are the sternocostal joints?
synovial joints
except the first rib, this is a primary cartilaginous (hyaline) joint
What make up the intercostal nerves?
arive from Anterior rami of spinal nerves T1-T11: Intercostal nerves
The intercostal nerves are part of the somatic nervous system,
carry motor fibres to intercostal muscles
sensory fibres from skin and parietal pleura
sympathetic fibres to body wall structures via white rami communicantes or grey rami communicantes
What is the subcostal nerve?
ventral ramus of T12
Where does lymph from the thoracic wall drain?
Thoracic lymph nodes Axillary, subcapsular, pectoral, parasternal, intercostal and diaphragmatic lymph nodes
- *anteriorly** → parasternal nodes → drain bronchomediastinal trunks
- *posteriorly**→ intercostal nodes→ drain to thoracic duct inferiorly or bronchomediastinal trunk superiorly
more superficial structures e.g. skin and breast drain to axillary nodes
Name the 3 notches on the manubrium of the sternum
central suprasternal or jugular notch
two lateral clavicular notches
What type of joint is the articulation between the manubrium and the body of the sternum?
secondary cartilaginous joint (fibrocartilage, symphysis)
it forms the sternal angle of Louis
What numbers are the atypical ribs?
The atypical ribs : 1st, 2nd, and the 10th – 12th ribs
characterized with the following features:
Have one or two facets, and a rough area on the superior surface,
- 2nd rib has tuberosity for serratus anterior
- 11 and 12 are floating ribs, they lack a neck and tubercle and their heads only articulate with corresponding vertebrae
What is pump handle movement of respiration?
increases the antero-posterior diameter of the thorax with consequent increase in volume of thorax
What is bucket handle inspiration?
increases the lateral thoracic diameter
only takes placed in forced inspiration
it can only take place with ribs 8,9,10 that have the flat costotransvere joint that allows the tubercle to glide
Where would you insert a chest drain?
necessary in cases of pneumothorax, pleural effusion, empyema and postoperatively following thoracic surgery
- incision is made just anterior to the midaxillary line in the
- 5th or 6t**h intercostal space,
important to place the tube in line with the superior border of the rib. avoiding neurovascular bundle (intercostal nerve, vein and artery) passes along the costal groove, inferior border of rib. This positioning minimises the risk of damage to surrounding structures.
What branches come off an intercostal nerve?
anterior and lateral cutaneous branches to overlying skin
collateral branches that run at the upper border of the rib below
Where are anterior and posterior intercostal arteries derived from?
anterior intercostal arteries derived from internal thoracic
posterior intercostal arteries derived from branches of the subclavian and the aorta
Where does blood from the intercostal regions drain?
anteriorly to the internal thoracic and intercostal spaces 4-11 drain to azygos vein on right side and hemiazygos on the left side
1st space posteriorly drains to brachiocephalic vein
2nd and 3rd space form superior intercostal vein
What is the blood supply and drainage of the thymus?
internal thoracic and inferior thyroid arteries
venous drainage to left brachiocephalic vein
