Neurovasculature Flashcards

1
Q

The muscles of the thoracic wall

A
  • Intercostal muscles
  • transverses thorasis
  • Subcostals
  • serratus posterior superior
  • serratus posterior inferior
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2
Q

External intercostal muscles:

  • Muscle fiber direction
  • superior and inferior attachment
  • Action
A
  • inferomedial (hands in pockets)
  • Superior: Inferior margin of rib above
    Inferior: superior margin of rib below
  • Elevate ribs during passive inspiration
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3
Q

How does the external intercostal muscle attach to the sternum (and at what region does the change occur)

A

Attaches to the sternum via the External Intercostal membrane which arises at the costochondral joint. If the external intercostal membrane is reflected, the internal intercostals will be seen

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4
Q

Internal intercostal muscles:

  • fibre direction in relation to external intercostal muscles
  • superior and inferior attachment
  • action of muscle
A
  • perpendicular to external intercostal muscles (superolateral direction- wakanda forever)
  • superior: Inferior boarder of rib below
    Inferior: superior boarder of rib above
  • depress rib cage in forced expiration
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5
Q

What structure/s can be used to differentiate/see the internal intercostal muscle from the innermost intercostal muscle

A

Neurovascular bundle

Running in all intercostal spaces as VAN (vein, artery, nerve)

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6
Q

What separates the parietal pleura from the intercostal muscles

A

Endothoracic fascia

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7
Q

Intercostal veins:

  • how many posterior?
  • how many anterior?
  • how many subcostal?
A
  • 11 pairs posterior
  • 9 pairs anterior
  • 1 pair subcostal
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8
Q

Where do the 1st intercostal veins drain into?

A

Left and right brachiocephalic veins

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9
Q

Where do the Left superior intercostal veins drain into?

A

Left brachiocephalic vein

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10
Q

Which intercostal veins form the left and right superior intercostal veins

A

Left superior ICVs:
left ICV 2,3,4

Right superior ICVs:
Right ICV 2,3,4

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11
Q

Where do the right superior ICVs drain to?

A

Azygos vein

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12
Q

What are the 2 veins received by the Left brachiocephalic vein?

A
  1. Internal jugular vein

2. Left Subclavian vein

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13
Q

Where does the azygos vein drain into and at what level does it enter this structure?

A

Superior vena cava

Level of T4

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14
Q

At what level does the azygos vein begin?

A

Level of L1/L2 at the region between the right subcostal vein and the right ascending lumbar vein

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15
Q

What vein is important for connection the inferior vena cava and superior vena cava to ensure that if the Inferior VC was obstructed, there would be alternate routes of drainage

A

Azygos vein

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16
Q

What are the 2 main tributaries of the azygos vein, which veins do they drain and how do they reach the azygos vein?

A

Hemiazygos:

  • Left ICVs 9-10
  • cross over at T8/ T9

Accessory hemiazygos vein

  • Left ICVs 5-8
  • cross over at T7/ T8
17
Q

Which are the 3 main arteries from which the Intercostal arteries arise?

A
  1. Thoracic aorta
  2. Subclavian artery
    (Those are the major ones)
  3. Axillary artery
18
Q

Which 2 intercostal arteries are branches of the Thoracic aorta?

A
  1. Posterior intercostal arteries (3-11)

2. Subcostal artery (12)

19
Q

Which intercostal artery is a branche of the SUPERIOR INTERCOSTAL ARTERY that arise from the Costocervical trunk of the Subclavian artery?

A
  1. Posterior intercostal artery (1+2)
20
Q

What is the other artery that is a branch of the subclavian artery?

A

Internal thoracic artery

21
Q

What are the 5 branches of the Internal thoracic artery?

Mom Swallowed Ancient Pineapple Sauce

A
  1. Musculophrenic artery
  2. Superior Epigastric artery
  3. Anterior Intercostal arteries (AICAs 1-6)
  4. Perforating branches
  5. Sternal artery
22
Q

Describe the branches of the Anterior Intercostal Arteries

A

Upper 6:
- Branches of Internal thoracic artery which is a branch of the subclavian artery

AICAs 7-9:
- Branches of Musculophrenic artery which is a branch of the Internal Thoracic artery

23
Q

In relation to the Anterior Intercostal Arteries, which 2 arteries branch from the Internal thoracic artery and at what level does this bifurcation/branching take place?

A
  1. Musculophrenic artery
    - branches of AICAs 7-9
  2. Superior Epigastric artery
    - supply the rectus abdominus muscles and proceed inferiority to anastomose with the inferior Epigastric artery

The bifurcation takes place at the 6th intercostal space

24
Q

Where do the Posterior Intercostal arteries anastomose with the 2 Anterior intercostal arteries that supply the intercostal spaces (anteriorly)

A

Anteriorly at the Costchondral junction

25
Q

Where are the 1st and 2nd Anterior Intercostal Arteries found?

A

Endothoracic Fascia

26
Q

Do the 10th and 11th intercostal spaces have anterior intercostal arteries?

A

No, they only have posterior intercostal arteries