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Thoracic Wall > Muscles (VAN) Thoracic Wall > Flashcards

Muscles (VAN) Thoracic Wall Flashcards

1
Q

clavicles

A

near manubrium of sternum

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2
Q

sternum

A

T2-T10 vertebral level

  • manubrium
  • body of sternum
  • Xyphoid process
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3
Q

manubrium

A

T3-T4 vertebral level

  • anterior to arch of aorta and beginning portion of superior vena cava
  • Jugular notch at T2 vertebral level
  • Sternal angle (manubriosternal joint) where 2nd rib attaches
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4
Q

sternal body

A

T5-T9 vertebral level

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5
Q

Xiphoid process

A

T10 vertebral level

  • articulates with rib 7
  • Xiphisternal joint at T9
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6
Q

costal margins

A

joined costal margins of 7-10 ribs

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7
Q

true ribs (vertebrocostal)

A

1-7

-attach directly to sternum

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8
Q

false ribs (vertebrochondral)

A

8-10

-indirectly to sternum

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9
Q

floating ribs (free, vertebral)

A

11-12

-no sternal connection

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10
Q

head of rib

A

articulates with superior costal face of same numbered vertebrae and inferior costal facet of vertebrae superior to rib (rib 2 articulates with T2 and T1)
-leads to bucket-handle and pump-handle movement

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11
Q

tubercule of rib

A

b/w neck and body

-articulates with transverse process of same numbered vertebrae

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12
Q

costal groove of rib

A

inferior border of rib, protects neurovascular bundle

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13
Q

first rib

A

groove on superior surface for subclavian v. and a. separated by (anterior) scalene tubercule

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14
Q

fracture ribs

A

usually 3-8 just anterior to angle of rib

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15
Q

dislocation of rib

A

costal cartilage dislocation from sternum (sternocostal joint)
-interchondral joints displaced

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16
Q

superior thoracic aperture

A
  • surrounded by T1 vertebrae, 1st pair of ribs, and superior border of manubrium (T3 so two levels lower than posterior border)
  • inlet: food, venous blood, vagus nerve, phrenic nerve
  • outlet: neurovascular structures to head and upper limb
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17
Q

inferior thoracic aperture

A

thoracic outlet

  • surrounded by T12 vertebrae, 11th/12th ribs, costal margins, xiphisternal joint
  • food, vagus nerve, arterial blood in aorta
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18
Q

anterior scalene

A
  1. C3-C6 to scalene tubercule of rib 1
  2. fix ribs 1 and 2 in forceful inspiration
  3. C3-C6 spinal nerves
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19
Q

middle scalene

A
  1. C3-C7 to rib 1
  2. fix ribs 1 and 2 in forceful inspiration
  3. C3-C6 spinal nerves
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20
Q

posterior scalene

A
  1. C5-C7 to rib 2
  2. fix ribs 1 and 2 in forceful inspiration
  3. C3-C6 spinal nerves
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21
Q

pectoralis major

A
  1. clavicle, sternum to 7th rib, costal cartilages, bicipital groove of humerus
  2. adducts arm, forward, and rotates medially
  3. medial pectoral (C8-T1 spinal nerves) and lateral pectoral nerves (C5-C7 spinal nerves)
  4. pectoral branch of thoroacromial a. and internal thoracic a.
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22
Q

serratus anterior

A
  1. ribs 1-9, vertebral border of scapula
  2. protracts and rotates scapula
  3. long thoracic nerve (C5-C7 spinal nerves)
  4. lateral thoracic artery
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23
Q

subclavius

A
  1. upper part of rib 1 to clavicle (costoclavicular space)
  2. pulls clavicle down and forward
  3. C5-C6 spinal nerves from brachial plexus
  4. clavicular branch of throacromial a.
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24
Q

pectoralis minor

A
  1. ribs 3-5, coracoid process of scapula
  2. pulls scapula forward and down
  3. medial pectoral nerve (C8-T1 spinal nerves)
  4. thoroacromial a. intercostal arteries, lateral thoracic artery
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25
external intercostals
- tubercules of ribs to costochondral junction - elevate ribs and sternum (inspiration) - intercostal nerves
26
internal intercostals
- sternum to angles of ribs - replaces posteriorly with internal intercostal membrane - depress ribs and sternum (expiration) - intercostal nerves
27
innermost intercostals
- separated from inner intercostal muscles by intercostal nerves and vessels - later-most segment of intercostal spaces - intercostal nerves
28
flail chest
paradoxical motion fie to segment of thoracic wall moving freely -at least 3 ribs broken in 2+ places
29
supreme intercostal artery
- branch of costocervical trunk of subclavian artery | - supplies 1st and 2nd posterior intercostal arteries
30
thoracic aorta
supplies 3rd-11th and subcostal (12th) posterior intercostal arteries
31
posterior branch of posterior intercostal arteries
spinal cord, vertebral column, back muscles, skin
32
collateral branch of posterior intercostal arteries
crosses intercostal space to superior border of rib
33
internal thoracic artery
supplies anterior intercostal arteries (2 per ICS, 1-9) - go to intercostal muscles, overlaying skin, parietal pleura - inner surface of thoracic wall lateral to sternum
34
subclavian
into thorax posterior to clavicle - inner surface of thoracic wall lateral to sternum - branches into costocervical trunk (into supreme intercostal artery) and interior thoracic arteries
35
cutaneous branch of internal thoracic artery
perforate muscles and supply anterior midline
36
musculophrenic branch of internal thoracic artery
terminal, along costal cartilage, supplies lower anterior intercostal arteries (7-9)
37
superior epigastric branch of internal thoracic artery
terminal branch
38
superior vena cava
venous plexuses to posterior intercostal veins to azygous venous system to superior vena cava
39
brachiocephalic vein
first posterior intercostal vein drains into this
40
superior intercostal vein
2-3 posterior intercostal veins drain into this - R superior intercostal v. into azygous into superior vena cava - L superior intercostal v. into L. braciochephalic vein into superior vena cava
41
internal thoracic vein
into anterior intercostal veins
42
thoracic spinal nerves
12 pairs
43
intercostal nerve
anterior rami T1-T11
44
subcostal nerve
anterior ramus T12
45
posterior rami
supply joints, deep back muscles, skin of back
46
rami communicantes branch of intercostal nerves
sympathetic nerves to vessels, glands, smooth muscles
47
collateral branches of intercostal nerves
arise near angle of rib and go along superior superior margin of their inferior rib to supply intercostal membranes and parietal pleura
48
muscular branches of intercostal nerves
supply intercostal, subcostal, transversus thoracis, levatorres coststum, serratus posterior muscles
49
lateral cutaneous branches of intercostal nerves
- along midaxillary line - divide into anterior and posterior to supply skin of lateral and thoracic abdominal walls - 4-6 supply lateral mammary nerve
50
anterior cutaneous branches of intercostal nerves
- parasternal line - into medial and later branches - supply anterior skin of thorax and abdomen - 4-6 supply medial mammary nerve
51
intercostal nerve block
anesthetic around intercostal nerve and collateral branches | -two or more nerves anesthetized to completely lose sensation
52
chest tube
drainage tube inserted in intercostal space immediately superior to rib - to evacuate a pneumothorax: anterosuperiorly - fluid collections: posteroinferiorly
53
thoracic outlet syndromes
compression of neurovascular structures
54
anterior scalene syndrome
brachial plexus and subclavian artery between anterior and middle scalene
55
costoclavicular syndrome
brachial plexus and subclavian artery and vein between first rib and clavicle
56
pectoralis minor syndrome
-most common | brachial plexus and axillary artery and vein between pectoralis minor and rib cage
57
compression of sensory nerves
tingling, numbness, loss o sensation, pain
58
compression of motor nerves
muscle weakness
59
artery compression
dec. strength of radial pulse
60
vein compression
swelling of upper limb
61
cervical ribs
supernumary ribs arising from C7 that may compress subclavian artery
62
retromammary space
plane between mammary glands and pectoral fascia
63
pectoral fascia
superficial to pec. major, part of bed of breast
64
boundaries of breast
rib 2-6, nipple and level 4 ICS
65
axillary process (Tail of Spence)
angles towards axilla and may be confused as tumor when enlarging during menstrual cycle
66
lactiferous ducts
lobules to lobes to single duct
67
lactiferous sinus
dilated portion of lactiferous duct deep to areola, opens to nipple
68
sensory ligaments of breast
attatches mammary gland to skin, supports its lobes and lobules, runs between skin and deep fascia, well developed in superior part
69
polymastia
supernumary breast that may appear along embryonic mammary crest
70
polythelia
accessory nipples
71
nerves of breast
medial and lateral mammary branches from the anterior and lateral cutaneous branches of intercostal nerves 4-6 - pass through pectoral fascia - sympathetic fibers go to blood vessels and smooth muscle
72
subareolar lymphatic plexus
afferents from nipple, areola, lobules of gland
73
axillary lymph nodes
1. anterior/pectoral nodes 2. afferents from lateral breast quadrant 3. efferents to clavicular nodes (infa and supra) then to subclavian lymph trunk
74
parasternal nodes
1. along internal thoracic vessels 2. affterents from medial breast quadrants, medial chest wall, upper abdominal wall, upper surface of liver 3. efferents to bronchomediastinal trunk
75
abdominal nodes (Phrenic nodes)
1. along upper diaphragam 2. afferents from inferior breast quadrant, liver, abdominal wall, diaphragm 3. efferents to parasternal and posterior mediastinal nodes
76
breast cancer
1. near nipple 2. lactiferous ducts/sinus 3. gland tissue (dimples caused by shortening of suspensory ligaments
77
edema in breast cancer
excess fluid in subQ tissues cases nipple deviation and thickened appearance of skin
78
Peau d'orange in breast cancer
puffy, orange peel pore like skin
79
mammogram
1/9 develop breast cancer, so radiographic exam scans breasts -carcinoma appears as large jagged density

Thoracic Wall (1 decks)

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