Overview of the Thorax Flashcards

1
Q

What forms the thoracic cage?

A

12 pairs of ribs
Sternum
Costal cartilages
12 thoracic vertebrae

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2
Q

What are the costocartilages attached to?

A

The sternum and the ribs

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3
Q

What are the components of the sternum?

A

Jugular notch (on the manubrium)
Clavicular notch (on the manubrium)
Manibrium
Sternal angle (between the manibrium and the body)
Body
Xiphisternal junction (between xiphisternal and the body)
Xiphoid Process

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4
Q

What are the special features of the thoracic vertebrae?

A
  1. Long inferiorly angled spinous processes
  2. Costal facets (except the last 2 or 3 thoracic vertebrae) which exist on the transverse process.
  3. Two demifacets located laterally on the bodies of vertebrae T2-T9
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5
Q

Which thoracic vertebrae bodies contain demifacets?

How many are there? How do they articulate with the ribs.

A

T2-T9.

There is a superior demifacit and an inferior demifacet.

The superior facet articulates with the head of the corresponding rib (i.e same rib number), while the inferior facet articulates with the head of the rib below it (higher number)

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6
Q

How does the head of the rib articulate with the thoracic vertebrae? What are the parts of the head of the rib?

A

There is an:

  1. Inferior articular facet
  2. Superior articular facet

The inferior facet corresponds with the vertebrae of its same number, while the superior facet corresponds with the vertebral body above it.

Therefore, if we are dealing rib 7 the inferior aspect of the rib will articulate with vertebral body 7 while the superior aspect will articulate with the vertebral body above it (lower number) 6

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7
Q

Which ribs are considered typical ribs?

A

T3-T9

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8
Q

Which ribs are considered True ribs?

A

First rib through the 7th rib

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9
Q

Which ribs are considered false ribs? What does it mean to be a false rib?

A

Ribs eight through ten. It means they don’t have their own insertion on to a costocartilage. Instead they share a costacartilage.

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10
Q

Which ribs are considered atypical ribs?

A

1, 2, 10, 11, and 12

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11
Q

What are the components of the first rib? (atypical)

A
  1. Scalene tubercle

2. Single facet for articulation only with T1 vertebrae

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12
Q

What are the components of the second rib? (atypical)

A

Tubercle for origin of serratus anterior muslce

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13
Q

What are the components of the tenth rib? (atypical)

A

Only one facet for articulation with only one vertebrae

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14
Q

What are the components of the 11th and 12th rib? (atypical)

A

They have no necks or tubercles
They are free floating
They articulate with only one vertebrae

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15
Q

What Thoracic bodies are at the same level as the manibrium?

A

T3 and T4

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16
Q

Where can the jugular notch be palpated?

A

Palpated at the T2 vertebral level

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17
Q

Where can the sternal Angle (of Louis) be palpated?

A

Palpated at the vertebral T4 level

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18
Q

Where is the Xiphoid process located?

A

Located at the level of T10

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19
Q

What is the most anterior part of the bony part of the chest?

A

Sternal angle (manubriosternal joint)

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20
Q

How does communication occur between the thoracic cavity and the abdomen and neck?

A

Through the Superior and Inferior Thoracic aperture.

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21
Q

What are the structures passing through the superior thoracic aperture?

A

Trachea
Esophagus
Nerves
Blood Vessels that either supply or drain the head and neck.

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22
Q

What are the structures passing through the inferior thoracic aperture?

A
Inferior Vena Caval Hiatus (T8)
Esophageal Hiatus (T10)
Aortic Hiatus (T12)
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23
Q

What are the various intercostal muscles? (4)

A
  1. External Intercostal
  2. Internal Intercostal
  3. Innermost Intercostal
  4. Transversus Thoracic
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24
Q

Which intercostal muscle is on the inside of the rib cage?

A

Transverse Thoracis

25
Q

What is the function of the external intercostal muscle?

A

Raises ribs on inspiration

26
Q

What is the function of the internal intercostal muscles?

A

Lowers the ribs on expiration

27
Q

What is the function of the innermost intercostal muscles?

A

Raises the ribs on inspiration

28
Q

Which muscle fibers are oriented in a hands in pocket way?

A

External intercostal muscles

29
Q

Which muscle fibers are oriented in a hands in back pocket way?

A

Innermost intercostal muscles

30
Q

Which muscle fibers are oriented in a praying hands way?

A

Internal intercostal musclt

31
Q

List intercostal muscles from anterior to posterior

A
  1. External Intercostal
  2. Internal Intercostal
  3. Innermost Intercostal
32
Q

Which muscle is the most powerful respirator?

A

The diaphragm

33
Q

What nerve is the Diaphragm innervated by?
What does it attach to?
Where does it insert?

A

The phrenic nerve
Xiphoid process, lower 6 costal cartilages, and the L1-L3 vertebrae
The central tendon

34
Q

What inserts into the central tendon? What happens to it?

A

The Diaphragm. It functions to draw the central tendon down and forward during inspiration

35
Q

What are the three main openings in the diaphragm?

A
  1. Inferior vena cava (T8)
  2. Esophagus (T10)
  3. Aorta (T12)

Note: They are also in order from anterior to posterior

Remember the mneumonic
I Ate Ten Eggs At Noon

36
Q

What are the movements of the thoracic cage?

A

Vertical Movement
Transverse Movement
Anteroposterior Movement

37
Q

What ribs does the anteroposterior use when moving?

A

Uses ribs 2-6 at the costal verterbral joints. pump handle motion down

38
Q

What movement is caused by the movement of the diaphragm?

A

Vertical movement

39
Q

Bucket handle motion causes which movement?

A

Intercostal muscle movement

40
Q

Where does the INTERCOSTAL vein, nerve, and artery of the thoracic wall exist?

A

Between the ribs on each rib (inferior rin and superior rib) always in the V, A, N order, that is the Vein touches the rib.

41
Q

What does the intercostal nerve communicate with?

A

Rami communications via the sympathetic trunk

42
Q

Where does anastomoses of the intercostal arteries takes place?
Posterior Wall?
Anterior Wall?

A

On both sides of the sternum.

Posterior Wall: Posterior intercostals
Anterior Wall: Anterior intercostals

43
Q

Where do the posterior intercostal arteries come from?

A

They are branches of the aorta and costocervical trunk

44
Q

Where do the anterior intercostal arteries come from?

A

They are branches of the internal thoracic and musculophrenic arteries.

45
Q

How do the intercostal veins run in comparison to the intercostal arteries?

A

They run in the opposite direction

46
Q

Describe the intercostal venous system.

A

There are two veins on the left side called Inferior and Superior Hemizygous veins and one on the right side called the Azygous vein.

All dump into the Azyogous vein

47
Q

What percent of muscles does the ventral rami innervate?

A

95%

48
Q

What muscle group does the dorsal rami innervate?

A

The true back muscles

49
Q

What nerve are intercostal muscles innervated by?

A

The ventral rami of the thoracic spinal nerves

50
Q

What is the landmarks for the clavicles and the jugular notch?

A

C4

51
Q

What is the landmarks for the sternal angle?

A

T2 dermatome

52
Q

What is the landmarks for the nipples?

A

T4 dermatome

53
Q

Mediastinum information. What is the dividing factor?

A

The sternal angle divides the two halves.

  1. Superior Mediastinum
  2. Inferior Mediastinum (superior to the diaphragm)
    - Anterior Mediastinum
    - Middle Mediastinum
    - Posterior Mediastinum
54
Q

What can be found in the Superior Mediastinum?

A
Thymus
Brachiocephalic veins
Superior Vena Cava
Phrenic Nerve
Vagus Nerve
Aortic arch and branches
Trachea
Esophagus
55
Q

What can be found in the Anterior Mediastinum?

A

Thymus

Sternopericardial ligaments

56
Q

What can be found in the Middle Mediastinum?

A

Pericardial cavity/heart
Great vessels
Phrenic nerve
Roots of the lungs

57
Q

What can be found in the posterior Mediastinum?

A
Esophagus
Descending Aorta and branches
Azygous vein
Thoracic Duct
Sympathetic Chain
Splanchnic nerve
58
Q

Discuss the vagus nerve plexus.

A

There is a vagus nerve plexus around the esophagus that continue around the heart and lungs.

Left side: covers more of the anterior
Right side: covers more of the posterior

59
Q

Where does the phrenic nerve go?

A

Straight to the diaphragm