The Thoracic Wall Flashcards

1
Q

thorax

A

part of body b/n neck & diaphragm

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2
Q

mid-clavicular line

A

imaginary line running vertically downward from the midpoint of the clavicle

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3
Q

mid-axillary line

A

imaginary line running vertically downward from mid-axilla

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4
Q

manubrium:

part of the ___

lies at the level of ___

jugular (suprasternal) notch: ___

articulates with the ___

lower border articulates with the ___

rib 2 lies at the ___

A

sternum

T3 - T4

concave center of the upper border

clavicles & the 1st & upper part of the 2nd rib

body (manubriosternal joint, sternal angle of Louis)

manubriosternal joint

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5
Q

body (part of the sternum):

lies at the level of ___

articulates with ___

rib 7 lies at the ___

A

T5 - T9

ribs 2-7

xiphosternal joint

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6
Q

xiphoid process:

part of the ___

lies at the level of ___

A

sternum

T10

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7
Q

true ribs

A

vertebrosternal

upper 7 pairs

attached anteriorly to the sternum by costal cartilages

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8
Q

false ribs

A

lower 5 pairs

vertebrochondral ribs (8, 9, 10) - attached to each other & to 7th rib by their costal cartilages (connection to sternum is indirect)

free/floating ribs (11 & 12) - have no anterior attachment

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9
Q

typical ribs

A

ribs 3-9

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10
Q

typical ribs:

head

A

two facets for articulation w/ the corresponding vertebral bodies & the body above

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11
Q

typical ribs:

tubercle

A

facet for the transverse process of the corresponding vertebra

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12
Q

typical ribs:

neck

A

constriction b/n head & tubercle

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13
Q

typical ribs:

shaft/body

A

thin, twisted, contains a costal groove along the inferior border

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14
Q

typical ribs:

costal groove

A

contains (superior to inferior): VAN

  • intercostal vein
  • intercostal artery
  • intercostal nerve
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15
Q

typical ribs:

costal angle

A

where the shaft bends sharply forward

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16
Q

atypical ribs:
first rib

important b/c ___

___ than other ribs

almost ___

___ for first vertebral body

scalene tubercle: ___

  • subclavian vein crosses rib ___ to scalene tubercle
  • subclavian artery & inferior trunk of brachial plexus cross rib ___ to scalene tubercle
A

of its relationship to the brachial plexus & large vessels of the arm

shorter & wider

horizontal

head single facet

insertion of the scalenus anterior muscle (near inner border)

  • anterior
  • posterior
17
Q

atypical ribs:

second rib

A

main atypical feature is a rough area on its upper surface, the tuberosity for the serratus anterior muscle

18
Q

atypical ribs:

10, 11, & 12

A

single facet of head for bodies of corresponding vertebrae

19
Q

atypical ribs:

11 & 12

A

no tubercles or facets for transverse processes

20
Q

intercostal muscle nerve supply

A

intercostal nerves

21
Q

external intercostal muscles:

pass ___ from the rib above to the rib below

conform to the ___ muscles of the ___

extend from the ___ posteriorly to the ___ anteriorly

replaced anteriorly by the ___

A

downward & forward

external oblique, abdomen

rib tubercle, costochondral junction

external intercostal membrane

22
Q

internal intercostal muscles:

pass ___ from rib above to rib below

conform to the ___ muscles of the ___

extend from ___ anteriorly to ___ posteriorly

replaced posteriorly by the ___

A

downard & backward

internal oblique, abdomen

sternum, angles of ribs

internal intercostal membrane

23
Q

innermost intercostal layer:

___ than the other two intercostal muscles

best distinguished by the fact that they ___

the ___ of both the thoracic & abdominal walls lies b/n the middle & deepest layer of muscles

A

less well developed

are separated form the internal intercostal muscles by the neurovascular bundles

neurovascular plane

24
Q

innermost intercostal layer:

innermost intercostal muscles (intercostalis intimi)

A

similar to internal intercostal muscles

25
innermost intercostal layer: subcostal muscles: pass from ___ usually span ___ parallels direction of the ___
inside angle of one rib to rib two levels inferior two intercostal spaces internal intercostal muscles
26
innermost intercostal layer: transversus thoracis: ___ fan out from the ___ continuous inferiorly w/ the ___
4-5 slips of muscle, inferior part of sternum to costal cartilages 2-6 transversus abdominus muscle
27
intercostal nerves: ___ of the first ___ nerves subcostal nerve: ___ after giving off the ___, the ___ continues in the direction of the original spinal nerve each intercostal nerve enters the space b/n the ___ & the ___, then continues forward between the ___ & the ___
ventral rami, 11 thoracic ventral ramus of T12 lies below 12th rib dorsal ramus, ventral ramus parietal pleura, internal intercostal membrane, internal intercostal muscles, innermost layer
28
atypical nerves: first intercostal nerve: represents ___ major part of the ___ joins the ___
only a small portion of the ventral ramus of T1 ramus, brachial plexus
29
atypical nerves: second intercostal nerve (sometimes also third intercostal nerve): lateral cutaneous branch (intercostobrachial nerve): ___ in coronary artery disease, ___ is referred along this nerve to the medial side of the arm
joins the medial cutaneous nerve of the arm & helps supply the skin of the axilla (armpit) & upper medial arm pain
30
atypical nerves: 7th - 11th intercostal nerves: leave the ___ & continue into the ___ continue in the ___
intercostal spaces, abdominal wall same plane (b/n the internal oblique & transversus abdominus muscles)
31
``` atypical nerves: subcostal nerve (T12) ```
follows course of 7th-11th intercostal nerves
32
intercostal arteries
each space contains one large posterior intercostal artery & two small anterior intercostal arteries
33
posterior intercostal arteries: first two spaces: ___ lower nine spaces: ___ continue into the ___
branches of the supreme intercostal artery (which itself is a branch of the costocervical trunk of the subclavian artery) direct branches from the thoracic aorta abdominal wall w/ the corresponding nerves
34
anterior intercostal arteries: upper six spaces: ___ lower anterior intercostals & subcostal artery: ___
branches of the internal thoracic artery, anastomose laterally w/ the posterior intercostal arteries branches of the musculophrenic artery (one of the terminal branches of the internal thoracic artery), continue into abdominal wall w/ corresponding nerves
35
internal thoracic artery (internal mammary artery): branch of the ___ descends in the ___ divides behind the ___ into two terminal branches: ___ & ___
subclavian artery in the root of the neck thorax just lateral to the sternum, anterior to the transversus thoracis muscle 6th costal cartilage, superior epigastric artery, musculophrenic artery
36
branches of the internal thoracic artery
upper six anterior intercostal arteries pericardiophrenic artery perforating branches
37
internal thoracic artery (internal mammary artery): | pericardiophrenic artery
runs w/ phrenic nerve supplies the pericardium, diaphragm, & part of the pleura
38
internal thoracic artery (internal mammary artery): | perforating branches
pass to the skin w/ the anterior cutaneous branches of the intercostal nerves contribute to the blood supply of the breast & enlarged in women during lactation
39
veins: all ___ are accompanied by corresponding veins the posterior intercostal veins empty into the ___ veins anterior intercostal veins: ___ internal thoracic vein: ___
arteries azygous & hemiazygous drain into the musculophrenic vein or the internal thoracic vein drains into the brachiocephalic vein