Structure of the Thoracic wall and Diaphragm Flashcards
What forms the thoracic skeleton
12 pairs of ribs
12 thoracic vertebra
sternum
The Superior thoracic aperture communicates which structures with each other
thoracic cavity to upper limb and neck.
What are the boundaries of the superior thoracic aperture
behind: T1 vertebra
infront: 1st rib
sides: manubrium of sternum
The inferior thoracic aperture communicates which structures with each other
thoracic cavity with the abdomen
Which structure closes the inferior thoracic aperture
diaphragm
What are the boundaries of the inferior thoracic aperture
behind: T12
sides: 11th & 12th ribs
front: xiphisternum
What are the 2 joints in the sternum
Manubriosternal joint (sternal angle)
Xiphisternal joint
The Xiphisternal joint corresponds with which rib and which vertebra
7th rib
T9 vertebra
What are the 3 types of ribs
True
False
Floating
Which ribs are true ribs
1st -7th ribs
Which ribs are false ribs
8th – 10th ribs
Which ribs are floating ribs
11th & 12th ribs
What makes a false rib what it is
cartilages of these ribs are joined to the cartilages of the ribs above
What makes a floating rib what it is
no cartilages in front, articulates with vertebrae behind
The sternal angle corresponds with which rib and which vertebra
2nd rib
T4/T5
Which surgical procedure can be used to gain access to thoracic cavity for surgical procedures on heart and great vessels
Median sternotomy
Which surgical procedure can be used to enter pleural cavity
Thoracotomy
What are the three types of intercostal muscles
External intercostal, Internal intercostal and Innermost intercostal muscle
What is the arrangement of structures of the neurovascular bundle from superior to inferior
Vein, Artery and Nerve
Nerves of the thoracic wall are located between which 2 layers of muscle
internal intercostal muscle and innermost intercostal muscle (between 2nd and 3rd layer of muscle)
Which nerves supply the intercostal space
Intercostal nerves, anterior rami of T1- T11 spinal nerves including T12 (subcostal nerve) supply the intercostal spaces
Each intercostal space is supplied by which arteries
a posterior intercostal artery and a pair of anterior intercostal arteries
posterior intercostal and subcostal arteries arise from which vessel
thoracic aorta
internal thoracic and supreme intercostal arteries arise from which vessel
subclavian artery
superior and lateral thoracic arteries arise from which vessel
axillary artery
Which veins drain the thoracic wall
Anterior and Posterior intercostal veins
The posterior intercostal veins drain into which veins
azygos/ hemiazygos veins
The anterior intercostal veins drain into which veins
internal thoracic veins
Which part of the ribs move like a “pump handle” during breathing
upper ribs
Which part of the ribs move like a “bucket-handle” during breathing
middle parts of the lower ribs
The primary movement of inspiration is contraction of which structure
The diaphragm
Contraction of the diaphragm increased which dimension (vertical, horizontal) of the thoracic cavity
Vertical
Intercostal nerve blocks require how many adjacent intercostal spaces to be completely anesthetized
2 or more
Which dome of the diaphragm is higher
right
What is another name for the trifoliate tendinous part of the diaphragm
central tendon
The diaphragm is attached to which sternal part
posterior part of xiphoid process
The diaphragm is attached to which costal part
inner surface of lower six ribs and their costal cartilages
The diaphragm is attached to which lumbar part
Upper 3 lumbar vertebrae, medial and lateral arcuate ligaments
What passes through the caval opening of the diaphragm
IVC, right phrenic nerve and some lymphatics from liver
What passes through the esophageal opening of the diaphragm
esophagus, anterior & posterior vagal trunks, esophageal branches of left gastric vessels and lymphatics
What passes through the aorta opening of the diaphragm
descending aorta, azygos vein and thoracic duct
The caval opening in the diaphragm is at which vertebral level
T8
The esophageal opening in the diaphragm is at which vertebral level
T10
The aortic opening in the diaphragm is at which vertebral level
T12
The lymphatic vessels from liver and superior epigastric vessels are transmitted through which opening in the diaphragm
sternocostal foramen
The greater and lesser splanchnic nerves travel through which opening of the diaphragm
Crura of the diaphragam
What is the motor supply of the diaphragm
Right and left phrenic nerves
What is the sensory supply of the disphragm
Phrenic nerve (most part)
Lower six intercostal nerves (periphery)
