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Unit 5 > The Thoracic Wall > Flashcards

The Thoracic Wall Flashcards

List the borders of the thorax. Recognize the anatomy of the thoracic skeleton. Define the joint types located in the thoracic skeleton. Describe the musculature of the thoracic wall. Label the nerves and vessels of the thoracic wall. Describe the anatomy of the breast. Paraphrase the bony, muscular, and neurovascular components of the thoracic wall.

1
Q

An axial slice at the level of the xiphoid process anteriorly and the body of T9 posteriorly indicates the level of:

A

1- superior border of the liver

2- inferior border of the heart

3- the central diaphragmic tendon

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2
Q

marks the superior level of the pericardium and the superior limit of the pulmonary trunk

A

Sternal angle

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3
Q

Shows the level of the beginning and end of the arch of aorta

A

Sternal angle

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4
Q

is the level at which the trachea bifurcates into R and L main bronchi

A

Sternal angle

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5
Q

Sternal angle

A

An axial slice through the sternal angle:

ant: sternal angle
pst: T4-T5 intervertebral discs

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6
Q

List 4 of the structures marked/shown by an axial slice through the sternal angle anteriorly and the T4/T5 intervertebral disc posteriorly:

A

1- sup level of pericardium

2- sup limit of the pul. trunk

3- arch of aorta begins and ends

4- trachea divides into R/L main bronchi

5- rib II articl8 w/ sternum

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7
Q

Protection of intercostal vasculatures

A

The intercostal vein and artery lie in costal groove and are protected by bone. The intercostal nerve is not typically protected by bone.

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8
Q

Costal groove

A

The ribs shaft has a groove on the inf. margin of its internal surface. Intercostal aa and vv lie in this groove.

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9
Q

Crest of the head

A

the head of a typical rib is wedge-shaped and is divided into two facets by the crest of the head.

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10
Q

The tubercle for serratus anterior is located on its superior surface.

A

Rib II

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11
Q

It has a singular articular facet on its head for articulation with T1

A

Rib 1

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12
Q

Ant. scalene muscle inserts into this rib

A

Rib I (Scalene tubercle)

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13
Q

Short ribs without a neck or tubercle

A

11 and 12

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14
Q

Ribs with one facets on their heads ( articulation with single vertebrae)

A

1 and 10-12

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15
Q

Demifacets on each side of the vertebral body articulate with —— while transverse costal facets articulate with the —– of the ribs.

A

head, tubercles

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16
Q

Has a complete superior costal facet instead of a demifacet.

A

T1

Vertebra T1 has a complete superior costal facet instead of a demifacet. The head of rib 1 does not articulate with vertebra C7.

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17
Q

a single complete costal facet for articulation with the same-numbered rib.

A

vertebrae T10-12

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18
Q

lack transverse costal facets on their transverse processes.

A

Vertebrae T11 & T12

Vertebrae T11 and T12 lack transverse costal facets on their transverse processes. Ribs 11 and 12 do not articulate with the transverse processes.

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19
Q

Joints of costal articulation

A

1- Costochondral joints
2- Sternocostal joints
3- Costotransverse joints
4- Costovertebral joints (joint of head of rib)

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20
Q

Costovertebral and costotransverse joints are

A

synovial joint

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21
Q

Costovertebral joint

A

The head of a typical rib articulates with the superior demifacet of the same-numbered vertebra and the inferior demifacet of the vertebra above it to form a joint of head of rib (synovial joint).

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22
Q

Costotransverse joint

A

The tubercle of the rib articulates with the transverse process of the same-numbered vertebra to form a costotransverse joint (synovial joint).

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23
Q

The types of the sternocostal joints

A

Rib I- Synchondrosis (fibrocartilaginous)

Ribs II- VII- Synovial

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24
Q

Costochondral joints

A

The bodies of ribs articulate with their costal cartilages at fibrocartilaginous joints known as costochondral joints.

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25
Q

Sternocostal joints

A

The costal cartilages of the 7 true ribs articulate with the sternum at sternocostal joints.

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26
Q

Interchondral joints

A

The costal cartilages of ribs 7-10 articulate with the cartilage above at synovial joints known as interchondral joints.

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27
Q

The contents of intercostal space (general)

A 
intercostal muscles (3 layers)
intercostal nn and bv
28
Q

From the costochondral junctions to the sternum, the muscles are replaced by

A

external intercostal membrane

29
Q

External intercostal membrane

A

orientation: forward and down

replaced by external intercostal membrane starting from costochondral junctions

30
Q

Internal intercostal membrane

A

“backward & down”

Posterior and medial to the angles of the ribs, the muscles are replaced by the internal intercostal membrane

31
Q

innermost intercostal muscle

A

similar to the internal intercostal muscle

32
Q

innervation of the intercostal muscles

A

intercostal nn.

T12 n is subcostal n

33
Q

subcostal n.

A

T12 n. is subcostal

34
Q

Transversus thoracis m.
Subcostal m.
Also innervated by

A

intercostal nn.

35
Q

Contents of intercostal space (specific)

A

Posterior intercostal Vein

Posterior intercostal Artery
From thoracic aorta

Intercostal Nerve

Anterior intercostal artery
From internal thoracic artery

Form the VAN

36
Q

Orientation of intercostal a and v

A

intercostal v is sup to a.

Both V and A are protected by the costal groove.

37
Q

Orientation of the intercostal n

A

Inf. to the intercostal a.

38
Q

The location of intercostal VAN

A

lies b/w the internal and innermost intercostal muscles.

39
Q

Intercostal nn

A

Ant ramus of a thoracic spinal nerve.

Gives off lateral and anterior cutaneous branches

40
Q

The arterial supply to the thoracic wall comes from the:

A

Thoracic aorta
Subclavian a
Axillary a

41
Q

Thoracic aorta supplies the thoracic wall via

A

the pst. intercostal and subcostal aa.

42
Q

Subclavian a. supply the thoracic wall via

A

internal thoracic and supreme intercostal aa.

43
Q

Axillary a. supply the thoracic wall via

A

sup. and lat. thoracic aa.

44
Q

The posterior intercostal arteries give rise to —–.

A

The posterior intercostal arteries give rise to branches that accompany the posterior rami of the spinal nerves and the lateral cutaneous branches of the intercostal nerves.

45
Q

The posterior intercostal arteries of intercostal spaces 3-11 (and the subcostal arteries) arise —–.

A

The posterior intercostal arteries of intercostal spaces 3-11 (and the subcostal arteries) arise posteriorly from the thoracic aorta.

46
Q

The posterior intercostal arteries of intercostal spaces 1 and 2 arise from —–.

A

The posterior intercostal arteries of intercostal spaces 1 and 2 arise from the supreme (superior) intercostal artery, a branch of the costocervical trunk.

47
Q

The internal thoracic arteries terminate in the sixth intercostal space by dividing into the —– and —–arteries.

A

Superior epigastric and musculophrenic arteries.

48
Q

The internal thoracic arteries arise in the root of the neck from the —–surfaces of the —– arteries.

A

From the inferior surfaces of the subclavian arteries.

49
Q

The internal thoracic arteries descend on the —– surface of the thorax —– to the sternum and —– to the clavicle and upper six costal cartilages.

A

internal surface
lateral to the sternum
posterior to the clavicle

50
Q

Spaces without anterior intercostal aa.

A

Intercostal spaces 10-11

51
Q

The anterior intercostal arteries of intercostal spaces 1-6 arise from the —–.

A

internal thoracic aa.

52
Q

The anterior intercostal arteries of spaces 7-9 arise from —–.

A

musculophrenic aa.

53
Q

The anterior and posterior intercostal arteries have —–and —– branches that anastomose with each other.

A

terminal and collateral

54
Q

The intercostal veins accompany the intercostal arteries and nerves and lie most superior in the —–.

A

costal grooves

55
Q

The posterior intercostal veins anastomose with the —– veins.

A

anterior intercostal

56
Q

Most posterior intercostal veins drain into the —– , while the anterior intercostal veins drain into the —–.

A

pst- azygos system of veins

ant- internal thoracic veins

57
Q

The internal thoracic veins accompany the —–.

A

internal thoracic arteries

58
Q

The breast

A

Breast tissue is typically found overlying the pectoralis major m.

Overlies ribs 2-6 from sternum to midaxillary line

location of the nipple will vary according to the size and shape of the breast

The nipple contains the openings of the 15-20 lactiferous ducts

59
Q

The mammary glands are enclosed in

A

superficial fascia/ subcutaneous connective tissue.

60
Q

suspensory ligament

A

variable amt of fat and bands of fibrous CT

61
Q

retromammary space

A

separates the breast from deep fascia over pectoralis major by loose CT.
It also allows some movement over the chest wall.

62
Q

Allows minor movement of the breast over chest wall

A

retromammary space

63
Q

The axillary tail

A

breast tissue extend into axilla.

Significant during breast examination

64
Q

Blood supply of the breast

A

Mainly from mammary branches of:

internal thoracic artery
lateral thoracic artery
posterior intercostal arteries

65
Q

Venous drainage of the breast

A

Has a venous drainage roughly mirroring its arterial supply:

tributaries of the posterior intercostal veins may carry cancer cells to the vertebral venous plexus.

66
Q

lymphatic drainage of the breast

A

60-75% of lymph from the breast drains into the axillary nodes

Very important in understanding the mechanisms of metastasis of breast cancer

Unit 5 (7 decks)

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