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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
What is the costal groove
In the body of the rib which is a concavity that protects the intercostal nerve and vessels
26
What are the three parts of the Sternum
Manubrium of sternum Body of sternum Xiphoid process of sternum (the bit that looks like a tail)
27
What is the costal margin
the lining of the bottom part of the lower ribs
28
What is the sternal angle
the line that separates the manubrium from the body of sternum
29
what is the costochondral joint
The boundary between the ribs and the costal cartilage
30
What are the two grooves in the first pair of ribs for
To allow subclavian vessels to pass through
31
What separates the two grooves
Scalene tubercule
32
What does the sternal angle show you (angle of Louis)
Location of the 2nd rib | Where the trachea branches into bronchi
33
What notches are on either side of the jugular notch
Clavicular notches
34
Where do the costal cartilages join to
Costal notches
35
What type of joint is the intervertebral joint
Symphysis
36
What are the articulations of the intervertebral discs
Adjacent bodies bound together by intervertebral discs
37
What ligaments are there in intervertebral joints
Anterior and posterior longitudinal
38
What are the joints of the thoracic wall
- Intervertebral joints - Costovertebral joints - Costotransverse joints - Sternocostal - Sternoclavicular - Costochondral - Interchondral (costal cartilages) - Manubriosternal - Xiphisternal
39
How can paralysis of the diagram be detected
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
40
Where is the subclavian artery
Artery above the clavicle
41
What does the subclavian muscle do
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.
42
What muscles function as accessory muscles of respiration
Pec major Pec minor Inferior part of serrates anterior Scalene muscles
43
How do muscles act as accessory muscles of respiration
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
Anteriorly, what are the fleshy external intercostal muscles replaced by
External intercostal membranes
45
Posteriorly, what are the fleshy internal intercostal muscles replaced by
Internal intercostal membranes
46
Where are the innermost intercostal muscles only found
Most lateral parts of the intercostal space
47
Which intervertebral discs level does the sternal angle articulate with the sternal body
T4-5
48
What are scapular lines
parallel to the posterior media lie and cross the inferior angles of the scapulae
49
Where is the suprasternal plane
T2 position
50
Where is the plane of the sternal angle
T4/5
51
Where is the xiphisternal plane
T9
52
Where is the midaxillary line
Straight through the middle of your armpit
53
Why are the intercostal muscles important
- respiration | - keeping the intercostal space rigid
54
What is each lung enclosed within
Serous pleural sac
55
What is the pleural sac made of
Of 2 continuous membranes | -Visceral and parietal pleura
56
Which pleura covers the lungs
Visceral pleura
57
Whichpleura lines the pulmonary cavities (the ribcage)
Parietal pleura
58
What is between the two pleura
Pleural fluid in pleural cavity
59
Why may you need to insert a needle into an intercostal space
TO drain or sample fluid (pleural fluid, blood or pus) from the pleural cavity or to anaesthitise an intercostal nerve
60
Which structures will the needle penetrate to get into the intercostal space
- SKin - Superficial fascia - serratus anterior muscle - Intercosta muscles (all 3) - Parietal pleura
61
Where do you insert the needle to get into the pleural cavity
In intercostal space 9 in the mid axillary line
62
Boundaries for superior thoracic aperture
- T1 vertebrae - Rib 1 - Costal cartilage 1 - Superior boundary of the manubrium
63
Boundaries for inferior thoracic aperture
- T12 vertebrae - Costal margin - ribs 12,11, 10 - Xiphisternum
64
Which thoracic aperture is more likely to experience problems and why
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
What is it called when structures are compressed in the superior thoracic aperture
thoracic outlet syndrome
66
Which structures are affected in thoracic outlet syndrome
``` Subclavian artery Brachial plexus (nerve) ```
67
Where are the top of the lungs
Go above the first rib and into the neck region
68
Which ribs are atypical
1-2 | 11-12
69
Which rib is typical
8
70
What are the two grooves in rib 1
Subclavian vein groove | Subclavian artery groove
71
What separates the two grooves on the first rib
Scalene tubercle
72
What muscle attaches onto the scalene tubercle
Scalene anterior
73
Regions of the vertebrae from top down
- Cervical - Thoracic - Lumbar - Sacral
74
What are the attachments of the pectorals major
- Clavicular head fro medial half of clavicle - Sternocostal head from sternum - All upper 6 costal cartilages
75
Where do all fibers of the pectoralis major converge
Intertubucular groove of humerus
76
Actions of pec major
- 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
When can pec major be an accessory muscle of respiration
If pectoral girdle is fixed
78
What is the nerve supply for the pec major
Medial and lateral pectoral nerves
79
Where are the medial and lateral pectoral nerves found
C5-8 | T1
80
Two heads of the pec major
Clavicular head | Sternocostal head
81
Which nerve innervates the clavicular head
Lateral
82
Which nerve innervates the sternocostal nerve
Medial
83
Attachments of pectorals minor
- Coracoid process of scapula | - Ribs 3-5 near cartilage
84
Actions of pec minor
- Depressor of scapula (and hence shoulder) - Protractor of scapula - can act as an accessory muscle of respiration
85
When can pec minor act as an accessory muscle of respiration
If pectoral girdle is fixed
86
what is the nerve supply for pectoral minor
Medial pectoral nerve (C8,T1)
87
Where does the base of the breast extend from
Ribs 2-6 and from the lateral margin of the sternum to the mid axillary line
88
Where does the axillary tail run in the breast
Superiorly and laterally towards the axilla
89
What is the breast
Modified sebaceous gland with 15-20 lobes sending lactiferous ducts to the nipple
90
What do the lobes of the breast comprise of
Glands and adipose tissue
91
What is the adipose tissue in the breast separated by
Septa
92
What is the breast separated from the deeper pectoral muscle by
Retromammary space
93
What is the mediastinum
Central part of the thoracic cavity that lies between the pleural cavity
94
Where is the diaphragm in relation to the mediastinum
inferior part of the mediastinum
95
What is the anterior boundary of the mediastinum
Sternum
96
what is the posterior boundary of the mediastinum
Thoracic vertebral column
97
What is the superior boundary of the mediastinum
Thoracic inlet and the root of the neck
98
What is the inferior boundary to the mediastinum
Diaphragm
99
Different parts of the mediastinum going from top to bottom
Superior Mediastinum Inferior mediastinum
100
Which thoracic apertures does the superior parts to the mediastinum comtain
T1+T2
101
Which thoracic apertures does the mediastinum contain
T3+T4
102
which thoracic apertures does the inferior mediastinum contain
T5-T9
103
What does the superior mediastinum contain
``` 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
What is the inferior mediastinum divided into
Anterior mediastinum MIddle mediastinum Posterior mediastinum
105
What does the anterior portion of the inferior mediastinum contain
- Internal thoracic arteries and veins (and anterior intercostal branches) - Thymus - Sternopericardial ligaments
106
What does the middle portion of the inferior mediastinum contain
- Heart and pericardium - Phrenic nerve - Pericardiophrenic arteries and veins - IVC (inferior vena cava)(diaphragm to right atrium)
107
What does the posterior portion of the inferior mediastinum contain
- Descending aorta and branches - Azygos veins - Oesophagus - Thoracic duct - Symphathetic trunks and branches

Asthma RCM week 1 (12 decks)

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