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anatomy of the thorax > The thoracic wall > Flashcards

The thoracic wall Flashcards

1
Q

anterior

A

front

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2
Q

posterior

A

back

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3
Q

superior

A

up

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4
Q

inferior

A

bottom

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5
Q

neuroscience terms

A

ventral
dorsal
cranial/rostral
caudal

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6
Q

mid line

A

mid sagittal line

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7
Q

what are the relative porstions to the midline

A 
medial
lateral (further away) 
proximal - limbs 
distal - limbs 
superficial
deep
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8
Q

what are the anatomical planes

A

sagittal - parallel to the midline (parasagittal if not on the midline)
frontal/coronal
horizontal - transverse/axial

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9
Q

how many thoracic vertebrae are there

A

12

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10
Q

how many pairs of ribs and costal cartilage are there

A

12

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11
Q

what is the role of costal cartilage

A

join rib to bone at the front (sternum)

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12
Q

explain the different names of ribs

A

1-7 are true - reach sternum
8-10 are false - they reach the costal cartilage above
11 and 12 - floating they lack anterior attachment

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13
Q

describe the ribs

A

different shapes and sizes

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14
Q

what is the tubercle

A

sticks out of bony structure that provide attachment for ligaments and muscles

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15
Q

what are the facets

A

join ribs to other bones

articular surfaces

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16
Q

how does the size of the ribcage change down the thorax

A

it is bigger at the bottom

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17
Q

which way do ribs slope

A

downwards

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18
Q

what is the costal margin

A

where the diaphragm attaches

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19
Q

3 parts of the sternum

A

manubrium
body
xiphoid

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20
Q

what is the manubriosternal joint a landmark for

A

the 2nd costal cartilage

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21
Q

where does the 1st costal cartilage attach

A

the manubrium

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22
Q

where are the articular facets for ribs 3-7

A

the sternum

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23
Q

where is the apex beat of the heart found

A

the 5th intercostal space

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24
Q

what is the ring of the thoracic inlet formed of

A

the 1st thoracic vertebrae
1st ribs
manubrium

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25
Q

what are the contents of the thoracic inlet

A

great vessels heading for the neck and upper limb, oesophagus (down), trachea (down), nerves and lymphatics

26
Q

what is the danger of trauma in the neck

A

it is not protected by the rib cage but contains large vessels

27
Q

where is the capacity for lung expansion

A

in the lower parts of the thorax - where there is the most lung tissue

28
Q

what are the great vessels

A

major vessels emerging from the heart

aorta, carotid artery, jugular artery, subclavian veins and arteries

29
Q

what is the thoracic inlet

A

conduit between top and bottom

30
Q

correct name for thoracic inlet

A

superior thoracic aperture

31
Q

what do nerves control in the thoracic inlet

A

diaphragm

peristalsis and sensations of fullness after eating

32
Q

describe the diaphragm

A

it has a central tendon with muscle radiating to costal mergin and vertebrae

33
Q

actions of the diaphragm

A

dome flattens when muscles contract - increase vertical diameter of the chest
then it pulls the costal margin up to increase transverse and anteroposterior diameters

34
Q

what are the crus

A

means leg

diaphragm attaches here posteriorly

35
Q

where does the heart sit on the diaphragm

A

on the tendon

36
Q

what is the role of intercostals

A

stiffen chest wall to improve efficiency of breathing movements - only allow air in through airways
if struggle to breath - muscles move more than you would expect

37
Q

describe movement of the bones in the chest to increase volume

A

bones move more horizontally
sternum moves up and out
dimensions increase anterioposterially and mediolaterally

38
Q

what are the 3 layers of the intercostal muscles

A

external intercostals
internal
innermost

39
Q

describe the external intercostals

A

downward and laterally from lower border of the rib to the rib below
replaced by intercostal membrane at costo-chondrial junction (rib cartilage)

40
Q

describe the internal intercostals

A

supromedially
attachments begin anteriorally at sternum
from lower border of rib above to rib below
fibres directed at R angles to external intercostals
replaced by membrane posteriorly

41
Q

describe the innermost intercostals

A

supromedially
relatively trivial
orientation same as internal intercostals

42
Q

describe the order of the components of the neurovascular bundle of the lungs

A

vein (superior)
artery
then nerve (more inferior than the bottom of the rib)

43
Q

how does the organisation of the neurovascular bundle affect surgery

A

don’t want to damage the nerve - lose motor function and sensation (analgia)
you would insert tube to remove air from pleural cavity eg in pneumothorax - air can escape through holes
you need to insert closer to the superior of the lower rib to avoid the nerve

44
Q

how does the structure of the rib relate to the neurovascular bundle

A

it has a groove so the bundle is mostly protected except for the nerve

45
Q

where are the intercostal nerves

A

they run along the intercostal space along the rib from the back

46
Q

describe the intercostal nerves

A

11 pairs intercostal nerve - T1-T11 plus one subcostal rib
they are mixed - afferent and efferent
branches that supply the skin and muscle on way and then have more branches
supply the intercostal spaces
made of lateral cutaneous branch - runs anteriorly and posteriorly
and anterior cutaneous branch - runs medial and laterally

47
Q

describe the branches of the spinal nerve

A

ramus = branch
spinal nerve have efferent fibres at the front and afferent fibres at the back
spinal nerve - branch to back - supply erector spinae muscles
anterior ramus larger branch

48
Q

what is the effect of damage to the pleural cavity

A

pleural cavity is a continuous lining
needs to be intact for air to go into the lungs
otherwise the outer membrane moves out but the lung wont inflate

49
Q

how does the pleural cavity work to inflate the lungs

A

it is a continuous lining
fluid provides the surface tension
as the external lining moves it pulls the internal lining with it and inflates the lungs

50
Q

what is the area for inserting a chest drain

A

the safe triangle
anterior border of latissimus dorsi - at the back
lateral border of pectoralis major muscle
line superior to the horizontal level of the nipple
apex below the axilla (5th intercostal space, anterior to the mid axillary line)

51
Q

what is an anastomosis

A

the join of an artery and vein to the same region

52
Q

describe intercostal anastomoses

A

vessel from the aorta at the back moves anteriorly (posterior intercostal arteries) and meets vessel from the front (anterior intercostal arteries) (running down sternum)
when they join tey supply the same region of tissue

53
Q

describe the flow to the abdomen

A

bv down sternum past bottom chest into muscles of abdomen
anastomoses from bv from groin o supply skin of abdomen - continuous supply to the abdomen (from internal thoracic vessels and epigastric aretries)

54
Q

what are the contents of the thoracic cavity

A

laterally filled by lungs
space between the pleural cavities is the mediastinum - it has the heart, great vessels, oesophagus, trachea, thymus, thrracic duct and major lymph trunks, lymph nodes, phrenic and vagus nerves

55
Q

what happens to thymus that means you cant see it

A

it is replaced by fat

56
Q

how does a secondry tumour occur

A

travels through the lymphatics and circulation

57
Q

what do the major lymph trunks do

A

mop fluid up around the tissue

58
Q

what is the heart in

A

the pericardial sac

59
Q

effect of removing the lymphatic system

A

lymphoedema
very painful
limit mobility

60
Q

what is the medistinum

A

tissue containing everything except lungs and pericardial tissue

61
Q

where are the top of the lungs

A

above the clavicle

anatomy of the thorax (14 decks)

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