pk Flashcards
What are the two types of intercostal arteries?
Posterior intercoastal artery
Anterior intercostal artery
What are the two posterior intercoastal arteries?
Superior intercostal artery
Descending (thoracic) aorta
Where does the superior intercostal artery originate from?
What does it supply?
Originate: Costocervical trunk (of subclavian artery) (bc costco is superior to any other supermarket chain) (cervical bc it is up)
Supply: The first 2 intercoastal spaces
What does the Descending thoracic aorta supply?
What is special about the 12th rib?
Supply: 3rd - 11th intercostal space and below 12th rib (subcostal artery)
(bc it doesn’t have a inercostal space)
What are the two anterior intercoastal arteries?
Internal thoracic artery (from the subclavian artery) (bc the thorax is anterior, and the the intercostal spaces are internal)
Musculophrenic artery (a branch of the internal thoracic artery)
Where does the internal thoracic artery originate from?
What does it supply?
Originate: from subclavian artery
Supply: 1st-6th (bc it is the main so it is going to supply the top (6))
Where does the Musclophernic artery originate from?
What does it supply?
Originate: from internal intercostal artery
Supply: 7th-9th
What part of the subclavian artery does the Internal thoracic artery branch from?
What its branches?
Branches from: First part of the subclavian artery
Internal thoracic artery branches:
Musculophrenic artery
Superior epigastric artery
Pericardiacophrenic artery
Perforating arteries
Anterior intercostal arteries
What does the Anterior intercostal arteries supply?
1st-6th intercostal
What does the perforating arteries follow?
What gland does it supply?
Follows: The terminal branches of the corresponding intercostal nerves
Supplies: Mammary gland
(bc it is like performance rating, so if you’re goin to rate something, you have to follow it to know how good it is, it has to see how good the nerves are performing, and terminal, bc when something is being performance rated, it has to be at its terminal speed)
What does the Pericardiacophrenic artery follow?
What does it supply?
Follows: phernic nerve
Supplies: Pericardium
Where does the Superior epigastric artery enter?
What does it supply?
Enter: Rectus sheath
Supplies: Upper half of rectus abdominis muscle
(makes sense, bc epigastric so near the stomach, so abdomen, superior so the upper part of the rectus abdominis muscle)
Where does the Musculophrenic artery run around?
What does it supply?
Run around: the costal margin of the diaphragm.
Supply:7th-9th intercostal spaces and diaphragm
What is the Coarctation of the aorta? What is the cardinal clincal (diagnosis) sign?
What is a identification point of it in an xray picture?
It is congenital narrowing in the aorta just after the left subclavian artery branches
Diagnosis: Higher blood pressure in the upper limbs than lower limbs (bc of the fact that the heart has to push harder)
Xray: serrated appearance of inferior borders of ribs (rib notching)
What is collateral circulation?
The intercostal arteries provide an alternate route for blood flow between the internal thoracic artery and the thoracic aorta to provide blood supply to the lower body.
What are the two types of intercostal Veins
Anterior intercostal
veins
Posterior intercostal
veins
WHat do the Posterior intercostal
veins supply?
to azygos or
hemiazygos veins
(bc hemi engines make a load roar from posterior (exhaust) and vein bc it releases CO2)
WHat do the anterior intercostal
veins supply?
internal
thoracic or musculophrenic veins (same as arteries)
What are the two major lymphatic vessels that recive lymph from all over the body?
Thoracic duct
Right lymphatic duct
Where do the right lymphatic and thoracic ducts drain into?
Right; The junction where the right subclavian and right internal juglar veins meet.
Thoracic; The junction where the Left subclavian and Left internal juglar veins meet.
(veins bc it takes them from tissues, so the oxyen is already emptyed)
How does the thoracic duct begin? what is that begining called?
What major structure does it pass through?
Begins: As a dilated sac called the cisterna chyle
Pass through: aortic opening
Where does the thoracic duct enter the thorax? Where and how does it ascend? Where does it join the blood vascular system?
Enter: In the posterior mediastenium (right of the aorta) (bc it passes behind the heart, so posterior)
Ascend: posterior and left to the esophagus (makes sense bc it is smaller so it will be behind it)
Join: left venous angle
What are the tributaries of the thoracic duct at the root of the neck?
Left jugular vein
Left subclavian vein
Left bronchomediastinal trunk
Do the anterior primary rami of the thoracic spinal nerves form plexuses?
No, they do not form plexuses but instead come out individually as intercostal nerves.
What is the anterior primary ramus of T12 called?
Subcostal nerve (bc it is under the 12th rib where no intercostal space exists)
What does each intercostal nerve supply? (skin and muscle)
Skin: Dermatomes
Muscles: Myotome
What is the dermatomal distribution of the nipple area? (what spine segment)
From T4
What do the Gray and white rami communicantes do in relation to intercostal nerves?
Connect the intercostal nerves to the sympathetic trunk
Where does the anterior and lateral cutaneous branch into?
to adjacent skin of thorax and abdomen parietal pleura,
parietal peritoneum, peripheral portions of the diaphragm
(bc these areas are often cut (stabbed) so it makes sense )
What do typical motor intercostal nerves branch into?
intercostal and
anterior abdominal wall muscles
(bc you typically see anterior abdominal wall intercostal as well muscles bc mototr)
Where do the collateral branches arise? Where do they descend? What does it help in supplying?
Arise: near
the angles of the ribs
Descend: descend to course along the superior margin of the lower rib
Help in supplying: intercostal muscles and pariteal pleura
(bc there is sometimes collateral damage that is caused near the angle of the rib)
What does T1 give off a branch to?
Brachial plexus
What does T2 give off a branch to?
intercostobrachial nerve
medial cutaneous n. of the arm
In coronary artery disease pain is reffered along which nerve? To which limb is it referred to?
Along: intercostobrachial nerve
Limb: Medial side of the upper limb
What is herpes zoster? What causes it? What are the symptoms? How does it cause those symptoms? What are some of the visual symptoms?
It is: viral
disease of spinal ganglia
Cause: reactivation of the varicella-zoster virus (VZV), or chickenpox virus
Symptoms and how they are caused Caused by the virus invading the spinal ganglia which causes a sharp burning pain in the dermatome supplied by the involved nerve.
Visual symptoms: The affected skin area becomes red,
and vesicular eruptions appear.
