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Clinical Anatomy Muscles 1 > Muscles of the Thorax > Flashcards

Muscles of the Thorax Flashcards

1
Q

What are the 3 regions of the Thoracic wall?

A
  1. External intercostal muscles (fibers are directed downward and forward)
  2. Internal intercostal (fibers are directed downward and backward)
  3. Innermost intercostal muscles (forms the deepest layer)
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2
Q

What is the External intercostal muscles?

A
  1. Run inferoanteriorly
  2. From Costal Tubercles
  3. To Costochondral junctions

*Elevate ribs in inspiration

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3
Q

What is the Internal intercostal muscles?

A
  1. Run inferoposteriorly
  2. From Sternum
  3. To Costal angles
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4
Q

What is the Innermost intercostal muscles?

A
  1. Run inferoposteriorly
  2. Middle part of lower intercostal spaces
  3. Between Endothoracic fascia and parietal pleura; Intercostal neurovascular bundle

*Elevate ribs

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5
Q

What is the Transversus thoracis?

A
  1. From: Sternum and lower costal cartilages
  2. To: Upper costal cartilages
  3. Between:
    a. Endothoracic fascia and parietal pleura
    b. Internal thoracic artery
    c. Intercostal neurovascular bundle

*Depresses the ribs

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6
Q

What is the Serratus posterosuperior?

A
  1. Origin: Spinous process (lower cervical/upper thoracic vertebrae)
  2. Insertion: Superior border/external surface of ribs 2-5

*Used for inspiration

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7
Q

What is the Serratus posteroinfeior?

A
  1. Origin: Spinous process (lower thoracic/upper lumbar vertebrae)
  2. Insertion: Inferior border/external surface of ribs 9-12

*Used for expiration

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8
Q

What is Levatores costarum?

A
  1. Origin: Transverse processes
  2. Insertion: Superior border/external surface of ribs below

*Elevates ribs

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9
Q

What is the deepest layer of the thoracic wall?

A

Parietal pleura

*Plural cavity is what separates the visceral and parietal pleura

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10
Q

What is the Subcostal muscle?

A
  1. Lower part of the thorax at the region of the costal angles
  2. Run in the same direction as internal intercostal
  3. Between Endothoracic fascia and parietal pleura; Intercostal neurovascular bundle
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11
Q

What is the Thoracic Diaphragm?

A
  1. The diaphragm is inserted into a central tendon
  2. Origin of the sternal part: Xiphoid process
  3. Origin of the Costal part: Lower 6 ribs, costal cartilages, and Right and left domes
  4. Origin of the lumbar part: Right and left crura (arise from lumbar vertebrae and IV discs)

*Muscular part is replaced by areolar tissue

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12
Q

What is the central tendon?

A
  1. Strong aponeurotic tendon
  2. Cloverleaf-shap
  3. Where the Diaphragm is inserted

*Contains the Caval foramen

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13
Q

What is the esophageal hiatus?

A

Lies in the muscular part of the diaphragm at the level of T10 and transmits the esophagus and vagus nerve

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14
Q

What is the Aortic hiatus?

A

Lies between the two crura at the level of T12 and transmits the aorta, thoracic duct, azygos veins, and greater splanchnic nerve

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15
Q

What is the azygos vein?

A

Receives the hemiazygos and accessory hemiazygosveins and drains into the superior vena cava

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16
Q

What passes through the Large Diaphragmatic aperture?

A
  1. The Central tendon, Esophageal hiatus, and Aortic hiatus pass through the large aperture of the diaphragm
17
Q

What is the right phrenic nerve?

A
  1. From the neck
  2. Supply structures in the abdominal cavity
  3. Passes through the Caval foramen (not the left phrenic nerve)
18
Q

What is the left phrenic nerve?

A

Goes through the small aperture of the diaphragm

19
Q

What passes through the Small diaphragmatic aperture?

A
  1. The greater and lesser splanchnic nerves passes through the small aperture
  2. The Azygos/hemiaygos veins passes the the small aperture
  3. The left phrenic nerve passes through the small aperture
20
Q

What the relationship of the thoracic diaphragm and upper surface?

A
  1. Parietal pleura
  2. Pericardium
  3. Pericardicophrenic ligament
21
Q

What the relationship of the thoracic diaphragm and lower surface?

A
  1. On the right: Liver (right lobe) and Right kidney and suprarenal gland
  2. On the left: Liver(left lobe), stomach, spleen, left colic flexure, and left kidney and suprarenal gland

*Stomach can irritate the diaphragm and causes problems with breathing

22
Q

What is the Bochdalek’s hernia?

A
  1. Posterior lateral (congenital) hernia
  2. Defect on the posterior diaphragm; usually on the left side
  3. Common cause of Pulmonary Hypoplasia (small lung)
  4. Causes respiratory syndromes:
    a. Flat abdomen
    b. Breathlessness
    c. Cyanosis (bluish color)
23
Q

What is Esophageal/hiatal hernia?

A
  1. Sliding hernia when the gastroesophagic junction slides into the thorax
    * Hernia is a protrusion of part of the stomach into the mediastinum through the esophageal hiatus of the diaphragm
24
Q

What is the muscular action of the muscles of the Thoracic wall?

A
  1. Main muscles of INSPIRATION
    * The diaphragm pulls its central tendon down and increases the vertical diameter of the thorax
    * Inspiration: ribs move upward and laterally
25
Q

What is Quiet inspiration?

A
  1. Descends the diaphragm

2. Elevation of the ribs

26
Q

What muscles are used for the elevation of the ribs?

A
  1. External intercostal
  2. Internal intercostal (interchondral part)
  3. Serratus posterosuperior
  4. Levator cosarum
27
Q

What is Forced Inspiration and what 2 muscles are involved?

A
  1. Involves contraction of the intercostal muscles and elevation of the ribs
  2. Muscles involved:
    a. Sternocleidomastoid
    b. Scalene group of muscles
28
Q

What is Quiet Expiration?

A
  1. Is a passive process caused by the elastic recoil of the lungs (quiet inspiration is the contraction)
29
Q

What is Forced Expiration and what 4 muscles are involved?

A
  1. Requires contraction of the anterior abdominal muscles and the internal intercostals
  2. Muscles involved:
    a. Innermost intercostal
    b. Transversus thoracis
    c. Serratus posteroinferior
    d. Abdominal muscles
30
Q

What are Intercostal nerves?

A
  1. Muscular branches
  2. Nerve supply for the thoracic wall (except for Levator costarum: Dorsal rami)
  3. Contains Intercostobrachial nerve (2nd lateral cutaneous branch)
  4. Contain Sensory fibers (branches; supply dermatomes):
    a. Lateral cutaneous branch
    b. Anterior cutaneous branch
31
Q

What are Dermatomes?

A

Is an area of skin innervated by sensory fibers derived from a particular spinal nerve or segment of the spinal cord

32
Q

What is Herpes Zooster?

A
  1. Disease that affects the dorsal root ganglia
  2. Caused by the varicella zoster virus
  3. Leads to inflammation and degeneration of the sensory neuron in a cranial or spinal nerve with the formation of vesicles and inflammation of the skin

*Affects the dermatomes

33
Q

What is a Pleural Tap?

A
  1. Draw fluid from the pleural cavity
  2. At the level of the 6th-8th intercostal spaces just posterior to midaxillary line (widest area)
  3. Close to the superior border of the rib (avoidance of damage to intercostal neurovascular bundle “VAN”)
  • Between Parietal pleura and Internal intercostal membrane
  • Pass through: skin, superficial fascia, serratus anterior, external intercostal, internal intercostal, innermost intercostal, and parietal pleura (Do not go into visceral pleura)

Clinical Anatomy Muscles 1 (3 decks)

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