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Asthma RCM week 1 > Overview of the anatomy of the thorax > Flashcards

Overview of the anatomy of the thorax Flashcards

1
Q

What does the thoracic skeleton include

A
  • 12 pairs of ribs and costal cartilages
  • !2 thoracic vertebrae and vertebral discs
  • sternum
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2
Q

What are the ribs and cartilages separated by

A

Intercostal spaces

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3
Q

What does the thoracic cavity communicate with the neck and upper limb through

A

Superior thoracic aperture (thoracic inlet)

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4
Q

What is the superior thoracic aperture bounded by posteriorly

A

T1 vertebrae

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5
Q

What is the superior thoracic aperture bounded by laterally

A

First pair of ribs and their costal cartilages

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6
Q

What is the superior thoracic aperture bounded by anteriorly

A

Superior border of the manubrium

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7
Q

What does the thoracic cavity communicate with the abdomen through

A

Inferior thoracic aperture

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8
Q

What do the structures passing from the thorax to the abdomen pass through

A

Diaphragm

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9
Q

What are the three openings of the diaphragm connected to

A

T8
T10
T12

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10
Q

What opening is there in T8 and what passes through it

A

The IVC and the terminal branches of the right phrenic nerve

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11
Q

What is there in T10 and what passes through it

A

Transmits oesophagus, right and left vagus nerves, oesophogeal branches of left gastric vessels

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12
Q

What is there in T12 and what passes through it

A

Transmits descending aorta, thoracic duct, azygos and hemiazygos veins

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13
Q

What is the inferior thoracic aperture bounded by posteriorly

A

T12 vertebrae

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14
Q

What is the inferior thoracic aperture bounded by postolaterally

A

11th and 12th pair of ribs

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15
Q

What is the inferior thoracic aperture bounded by anterolaterally

A

Joined by the costal cartilages of ribs 7-10 forming the costal margin

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16
Q

What is the inferior thoracic aperture bounded by anteriorly

A

Xiphisternal joint

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17
Q

What are the three types of rib

-Which ribs are these

A 
True ribs (1-7)
False ribs (8-10)
Floating ribs (11+12)
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18
Q

What is the difference between false and true ribs

A

in true ribs, they attach directly to the sternum anteriorly through their own costal cartilages, however in false ribs, they have cartilages on their anterior ends that are joined to the cartilage of the rib just superior to them (connections to sternum is indirect)

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19
Q

What are floating ribs

A

Do not connect even indirectly with sternum, but they end in the posterior abdominal musculature

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20
Q

What do typical ribs have

A

Head of rib
Neck of rib
Tubercle of rib
Body of rib

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21
Q

What is the head of rib like

A

HAs two facets separated by crest of the head

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22
Q

What do each facets in the head of the rib connect to

A

One connects with the body of the numerically corresponding vertebra
-One connects with that of the superior vertebra

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23
Q

What is the tubercle of rib and what does it have

A

Lump like enlargement at the junction of neck and body

-Has a smooth articular part for articulating with the corresponding transverse process of the vertebra (via synovial joint) and a rough nonarticular part for a fibrous attachment to the process via the costotransverse ligament Wh

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24
Q

Where is the body of the rib

A

at the angle where the rib begins to turn antolaterally

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25
Q

What is the costal groove

A

In the body of the rib which is a concavity that protects the intercostal nerve and vessels

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26
Q

What are the three parts of the Sternum

A

Manubrium of sternum
Body of sternum
Xiphoid process of sternum (the bit that looks like a tail)

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27
Q

What is the costal margin

A

the lining of the bottom part of the lower ribs

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28
Q

What is the sternal angle

A

the line that separates the manubrium from the body of sternum

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29
Q

what is the costochondral joint

A

The boundary between the ribs and the costal cartilage

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30
Q

What are the two grooves in the first pair of ribs for

A

To allow subclavian vessels to pass through

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31
Q

What separates the two grooves

A

Scalene tubercule

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32
Q

What does the sternal angle show you (angle of Louis)

A

Location of the 2nd rib

Where the trachea branches into bronchi

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33
Q

What notches are on either side of the jugular notch

A

Clavicular notches

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34
Q

Where do the costal cartilages join to

A

Costal notches

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35
Q

What type of joint is the intervertebral joint

A

Symphysis

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36
Q

What are the articulations of the intervertebral discs

A

Adjacent bodies bound together by intervertebral discs

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37
Q

What ligaments are there in intervertebral joints

A

Anterior and posterior longitudinal

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38
Q

What are the joints of the thoracic wall

A
  • Intervertebral joints
  • Costovertebral joints
  • Costotransverse joints
  • Sternocostal
  • Sternoclavicular
  • Costochondral
  • Interchondral (costal cartilages)
  • Manubriosternal
  • Xiphisternal
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39
Q

How can paralysis of the diagram be detected

A

Paralysis of half the diaphragm is seen as the phrenic nerve is damaged. Only one side is paralyzed because the domes of the diaphragm are separated by right and left phrenic nerves

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40
Q

Where is the subclavian artery

A

Artery above the clavicle

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41
Q

What does the subclavian muscle do

A

Attaches to the first rib via their costal cartilages and also attaches to the clavicle. It allows the movement of the first rib during ventilation and also the stabilisation of the clavicle.

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42
Q

What muscles function as accessory muscles of respiration

A

Pec major
Pec minor
Inferior part of serrates anterior
Scalene muscles

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43
Q

How do muscles act as accessory muscles of respiration

A

Help to expand thoracic cavity when inspiration is deep and forceful by fixing the user rubs and enabling the muscles and connecting the ribs below to be more effective in elevating the lower ribs during forced inspiration

44
Q

Anteriorly, what are the fleshy external intercostal muscles replaced by

A

External intercostal membranes

45
Q

Posteriorly, what are the fleshy internal intercostal muscles replaced by

A

Internal intercostal membranes

46
Q

Where are the innermost intercostal muscles only found

A

Most lateral parts of the intercostal space

47
Q

Which intervertebral discs level does the sternal angle articulate with the sternal body

48
Q

What are scapular lines

A

parallel to the posterior media lie and cross the inferior angles of the scapulae

49
Q

Where is the suprasternal plane

A

T2 position

50
Q

Where is the plane of the sternal angle

51
Q

Where is the xiphisternal plane

52
Q

Where is the midaxillary line

A

Straight through the middle of your armpit

53
Q

Why are the intercostal muscles important

A
  • respiration

- keeping the intercostal space rigid

54
Q

What is each lung enclosed within

A

Serous pleural sac

55
Q

What is the pleural sac made of

A

Of 2 continuous membranes

-Visceral and parietal pleura

56
Q

Which pleura covers the lungs

A

Visceral pleura

57
Q

Whichpleura lines the pulmonary cavities (the ribcage)

A

Parietal pleura

58
Q

What is between the two pleura

A

Pleural fluid in pleural cavity

59
Q

Why may you need to insert a needle into an intercostal space

A

TO drain or sample fluid (pleural fluid, blood or pus) from the pleural cavity or to anaesthitise an intercostal nerve

60
Q

Which structures will the needle penetrate to get into the intercostal space

A
  • SKin
  • Superficial fascia
  • serratus anterior muscle
  • Intercosta muscles (all 3)
  • Parietal pleura
61
Q

Where do you insert the needle to get into the pleural cavity

A

In intercostal space 9 in the mid axillary line

62
Q

Boundaries for superior thoracic aperture

A
  • T1 vertebrae
  • Rib 1
  • Costal cartilage 1
  • Superior boundary of the manubrium
63
Q

Boundaries for inferior thoracic aperture

A
  • T12 vertebrae
  • Costal margin
  • ribs 12,11, 10
  • Xiphisternum
64
Q

Which thoracic aperture is more likely to experience problems and why

A

Superior thoracic aperture because its narrower and so structures (nerves and arteries) are more likely to be compressed against e.g. the clavicle or the first rib

65
Q

What is it called when structures are compressed in the superior thoracic aperture

A

thoracic outlet syndrome

66
Q

Which structures are affected in thoracic outlet syndrome

A 
Subclavian artery
Brachial plexus (nerve)
67
Q

Where are the top of the lungs

A

Go above the first rib and into the neck region

68
Q

Which ribs are atypical

69
Q

Which rib is typical

70
Q

What are the two grooves in rib 1

A

Subclavian vein groove

Subclavian artery groove

71
Q

What separates the two grooves on the first rib

A

Scalene tubercle

72
Q

What muscle attaches onto the scalene tubercle

A

Scalene anterior

73
Q

Regions of the vertebrae from top down

A
  • Cervical
  • Thoracic
  • Lumbar
  • Sacral
74
Q

What are the attachments of the pectorals major

A
  • Clavicular head fro medial half of clavicle
  • Sternocostal head from sternum
  • All upper 6 costal cartilages
75
Q

Where do all fibers of the pectoralis major converge

A

Intertubucular groove of humerus

76
Q

Actions of pec major

A
  • Adductor and medial rotator of arm at shoulder joint
  • Flexor when arm extended
  • Extensor when arm is flexed
  • If pectoral girdle is fixed, can also act as an accessory muscle of respiration
77
Q

When can pec major be an accessory muscle of respiration

A

If pectoral girdle is fixed

78
Q

What is the nerve supply for the pec major

A

Medial and lateral pectoral nerves

79
Q

Where are the medial and lateral pectoral nerves found

80
Q

Two heads of the pec major

A

Clavicular head

Sternocostal head

81
Q

Which nerve innervates the clavicular head

82
Q

Which nerve innervates the sternocostal nerve

83
Q

Attachments of pectorals minor

A
  • Coracoid process of scapula

- Ribs 3-5 near cartilage

84
Q

Actions of pec minor

A
  • Depressor of scapula (and hence shoulder)
  • Protractor of scapula
  • can act as an accessory muscle of respiration
85
Q

When can pec minor act as an accessory muscle of respiration

A

If pectoral girdle is fixed

86
Q

what is the nerve supply for pectoral minor

A

Medial pectoral nerve (C8,T1)

87
Q

Where does the base of the breast extend from

A

Ribs 2-6 and from the lateral margin of the sternum to the mid axillary line

88
Q

Where does the axillary tail run in the breast

A

Superiorly and laterally towards the axilla

89
Q

What is the breast

A

Modified sebaceous gland with 15-20 lobes sending lactiferous ducts to the nipple

90
Q

What do the lobes of the breast comprise of

A

Glands and adipose tissue

91
Q

What is the adipose tissue in the breast separated by

92
Q

What is the breast separated from the deeper pectoral muscle by

A

Retromammary space

93
Q

What is the mediastinum

A

Central part of the thoracic cavity that lies between the pleural cavity

94
Q

Where is the diaphragm in relation to the mediastinum

A

inferior part of the mediastinum

95
Q

What is the anterior boundary of the mediastinum

96
Q

what is the posterior boundary of the mediastinum

A

Thoracic vertebral column

97
Q

What is the superior boundary of the mediastinum

A

Thoracic inlet and the root of the neck

98
Q

What is the inferior boundary to the mediastinum

99
Q

Different parts of the mediastinum going from top to bottom

A

Superior
Mediastinum
Inferior mediastinum

100
Q

Which thoracic apertures does the superior parts to the mediastinum comtain

101
Q

Which thoracic apertures does the mediastinum contain

102
Q

which thoracic apertures does the inferior mediastinum contain

103
Q

What does the superior mediastinum contain

A 
Thymus
Great veins (including brachiocephalic)
Phrenic nerves 
Arch of aorta and branches
Internal thoracic arteries
Pulmonary arteries and veins
Vagus nerve
Recurrent laryngeal branches
trachea 
oesophagus
THoracic duct
104
Q

What is the inferior mediastinum divided into

A

Anterior mediastinum
MIddle mediastinum
Posterior mediastinum

105
Q

What does the anterior portion of the inferior mediastinum contain

A
  • Internal thoracic arteries and veins (and anterior intercostal branches)
  • Thymus
  • Sternopericardial ligaments
106
Q

What does the middle portion of the inferior mediastinum contain

A
  • Heart and pericardium
  • Phrenic nerve
  • Pericardiophrenic arteries and veins
  • IVC (inferior vena cava)(diaphragm to right atrium)
107
Q

What does the posterior portion of the inferior mediastinum contain

A
  • Descending aorta and branches
  • Azygos veins
  • Oesophagus
  • Thoracic duct
  • Symphathetic trunks and branches

Asthma RCM week 1 (12 decks)

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