Session 1.1e - TeachMeAnatomy - Bones of the Thorax - Ribs Flashcards
What are the ribs?
A set of twelve bones which form the protective ‘cage’ of the THORAX.
What do the ribs articulate with?
The vertebral column posteriorly
How do the ribs terminate?
They terminate anteriorly as cartilage (costal cartilage)
What is the function of the ribs?
- Protection
- Breathing
What do the ribs protect?
As part of the bony thorax, they protect the internal thoracic organs.
When does the ribcage move?
During CHEST EXPANSION in breathing
Why does the ribcage move?
To permit lung inflation during breathing
What are the two classifications of ribs?
Atypical
Typical
What is different between the two classifications of ribs?
The typical ribs have a generalised structure, while the atypical ribs have variations on this structure.
What do the typical ribs consist of?
A head, neck and body.
What shape is the head of a typical rib?
Wedge-shaped
Describe the structure of the head of a typical rib.
It has two articular facets separated by a wedge of bone.
What do the facets on the head of a typical rib articulate with?
One facet articulates with the numerically corresponding vertebrae, and the other articulates with the vertebrae above.
Describe the structure of the neck of a typical rib.
It contains no bony prominences.
What is the function of the neck of a typical rib?
It connects the head with the body.
What do you find when the neck meets the body (head?) of a typical rib?
A roughed tubercle
What do you find on the roughed tubercle of the neck of a typical rib?
A facet for articulation with the transverse process of the corresponding vertebrae.
What does the transverse process of the corresponding vertebrae articulate with?
The roughed tubercle on the neck, near the head, of a typical rib.
What is the body of a typical rib sometimes known as?
The SHAFT.
Describe the structure of the body/shaft of a typical rib.
It is flat and curved.
What does the body/shaft of a typical rib have?
The internal surface of the shaft has a groove.
What is the groove on the body/shaft of a typical rib for?
The neurovascular supply of the thorax
Why does the neurovascular supply run in the costal groove of the body of a typical rib?
To protect the vessels and nerves from damage.
Which ribs are atypical?
Ribs 1, 2, 10, 11 and 12.
Why are atypical ribs so named?
They have features that are not common to all ribs.
Describe rib 1 in comparison to other ribs.
It is shorter and wider than the other ribs.
Describe the head of rib 1.
It only has one facet on its head for articulation with its corresponding vertebrae.
Why is the structure of the head of rib 1 slightly different to other ribs?
It only has one facet, rather than two, for articulation with its corresponding vertebrae, because there isn’t a thoracic vertebrae above it.
What is significant about the superior surface of rib 1?
It is marked by two grooves, which make way for the subclavian vessels.
Where and what function are the two grooves on rib 1 found/for?
On the superior surface, to make way for the subclavian vessels.
Describe rib 2 in comparison to rib 1.
Rib 2 is thinner and longer than rib 1.
Describe the head of rib 2.
it has two articular facets on the head as normal.
What is significant about the upper surface of rib 2?
It has a roughened area
Why does rib 2 have a roughened area on its upper surface?
It is where the serratus anterior muscle attaches.
What is atypical about rib 10?
It only has one facet - for articulation with its numerically corresponding vertebrae?
Which ribs contain no neck?
Ribs 11 and 12
Describe the structure of ribs 11 and 12.
They have no neck, and only contain one facet, which is for articulation with their corresponding vertebrae.
Which ribs only contain one facet?
Ribs 1, 10, 11 and 12.
This is for articulation with their corresponding vertebrae.
Describe the atypical ribs.
Ribs 1, 10, 11 and 12 only have one facet for articulation with their corresponding vertebrae.
Ribs 1, 2 have grooves/areas on their superior surface, for subclavian vessels/serratus anterior respectively.
Ribs 11, 12 have no neck.
The majority of the ribs have an ________ and _________ articulation.
Anterior and posterior
What do the ribs articulate with posteriorly?
With the VERTEBRAE of the spine
Which ribs articulate posteriorly with the vertebrae of the spine?
All twelve
Each ribs forms ___ joints.
Name them.
two
COSTOTRANSVERSE JOINT
COSTOVERTEBRAL JOINT
Where is the costotransverse joint?
Between the tubercle of the rib and the transverse costal facet of the corresponding vertebrae.
Where is the costovertebral joint?
Between the head of the rib, superior costal facet of the corresponding vertebrae, and the inferior costal facet of the vertebrae above.
What are the anterior attachments of ribs 1-7?
These attach independently to the sternum
What are the anterior attachments of ribs 8-10?
These attach to the costal cartilages superior to them
What are the anterior attachments of ribs 11-12?
These do not have an anterior attachment and end in the abdominal musculature. because of this, they are sometimes called ‘floating ribs’.
Which ribs are the ‘floating ribs’ and why are they so-named?
Ribs 11 and 12, because they do not have an anterior attachment and instead end in abdominal musculature.
(Clinical Relevance: Rib Fractures)
Where do rib fractures most commonly occur?
In the middle ribs
(Clinical Relevance: Rib Fractures)
How did rib fractures normally occur?
As a consequence of CRUSHING injuries or direct trauma.
(Clinical Relevance: Rib Fractures)
What is a common complication of a rib fracture?
Further SOFT TISSUE INJURY.
(Clinical Relevance: Rib Fractures)
How can further soft tissue injury occur in rib fractures?
From the broken fragments.
(Clinical Relevance: Rib Fractures)
What structures are most at risk of damage in a rib fracture?
Lungs
Spleen
Diaphragm
(Clinical Relevance: Rib Fractures)
What happens to the muscles if two or more fractures occur in two or more adjacent ribs?
The affected area is no longer under control of the thoracic muscles.
(Clinical Relevance: Rib Fractures)
Under what situation is the lung not under control of the thoracic muscles?
If two or more fractures occur in two or more adjacent ribs.
(Clinical Relevance: Rib Fractures)
What movement occurs when 2+ fractures occur in 2+ adjacent ribs?
A paradoxical movement during lung inflation and deflation.
(Clinical Relevance: Rib Fractures)
What is it called when an injured area is no longer under control of the thoracic muscles, due to 2+ fractures in 2+ adjacent ribs (multiple fractures in multiple ribs), so the area moves independently (paradoxically during lung inflation and deflation)?
Flail chest
(Clinical Relevance: Rib Fractures)
What is flail chest?
When a patient suffers multiple fractures in multiple ribs, so the injured area is no longer under thoracic control, and thus moves independently and paradoxically during breathing.
(Clinical Relevance: Rib Fractures)
What problems occur physiologically in a patient with flail chest?
It impairs full expansion of the ribcage, thus affecting the oxygen content of the blood.
(Clinical Relevance: Rib Fractures)
How is flail chest treated?
By fixing the affected ribs, preventing their paradoxical movement.
Fig. 1
Label the key and caption
- Ribs
- Costal cartilage
- Sternum
Overview of the ribs and costal cartilage.
Fig. 2
Label the image and caption
- ARTICULAR FACET: Articulates with the vertebrae above
- ARTICULAR FACET: Articulates with numerically corresponding vertebrae (correctly labelled)
- TUBERCLE: Articulates with numerically corresponding vertebrae
- COSTAL GROOVE: For intercostal vein, artery and nerve
The bony landmarks of a typical rib.
Fig. 3
Label the image and caption
- Costovertebral joint
- Costotransverse joint
(Correctly labelled)
Articulations between a rib and its numerically corresponding vertebrae.
Fig. 4
Explain what this x-ray is showing.
Radiograph of multiple fractured ribs, producing ‘flail chest’
Which option correctly describe the contents of the costal groove?
A. Intercostal artery
B. Intercostal vein
C. Intercostal nerve
D. All of the above
D. All of the above
The intercostal artery, vein and nerve all run in the costal groove.
Which part of the vertebrae does the tubercle of each rib articulate with?
A. Spinous process
B. Superior costal facet
C. Inferior costal facet
D. Transverse process
D. Transverse process
The tubercle is located at the neck of each rib, and articulates with the transverse process of the numerically corresponding vertebrae
Which statement below correctly describes a feature of the second rib?
A. It only has one articular facet
B. It has no neck
C. It has a roughened area for attachment of the serratus anterior
D. It is marked by the subclavian vessels
C. It has a roughened area for attachment of the serratus anterior
Rib 2 is marked by a roughened area on its upper surface for the attachment of the serratus anterior