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anatomyyyy y2s1 > thoracic > Flashcards

thoracic Flashcards

1
Q

what are the components of thoracic cage?

A

1- Sternum

2- 12 pairs of rib ( so 24 )

3- Costal cartilage ( 10 for the first 10 rib )

4- 12 thoracic vertebrae and the disks

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2
Q

what are the true ribs count em

A

1-7

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3
Q

why are they called true ribs?

A

because their costal cartilage attach to the sternum directly

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4
Q

what are the false ribs, count em up

A

8-10

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5
Q

why are they called false ribs?

A

because their costal cartilage is attached to the costal cartilage of the rib above ( 8 will attach to 7th , 9 will attach to 8 , 10 will attach to 9 )

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6
Q

what are the floating ribs count em up

A

11-12

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7
Q

why are they called floating ribs

A

because they dont attach to the costal cartilage –> floatinggg not connected anteriorly

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8
Q

what other classification of ribs?

A

typical

atypical

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9
Q

what are the typical ribs

A

3-9

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10
Q

what are the characteristics of typical ribs ( what makes them typical) on the posterior END.

A

1- 2 faucets on the head

2- tubercle on the neck with a faucet

3- Twisted shaft ( twisted shaft means eno the anterior and posterior end should not be on the same level )

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11
Q

whats the neck of a rib?

A

extension between the tubercle , the head.

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12
Q

what ligament attaches to the neck

A

costotransverse ligament , smooth articular faucet

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13
Q

whats the ligament that attaches to the transverse process

A

lateral costotransverse ligament, rough for non articular surface

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14
Q

what does the head of a TYPICAL rib articulate with? ( typical 2 faucets )

A

the corresponding vertebral body

the body of the vertebrae above.

Example :- 7th rib head will articulate with the 7th vertebrae and 6th vertebrae w hakaza

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15
Q

what does the head of the ATYPICAL rib articulate with? one faucet only on the head

A

the corresponding vertebrae only

10th rib will articulate 10th vertebrae only

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16
Q

what does the tubercle of the rib articulate with?

A

the transverse process of corresponding vertebrae

  • 4th rib tubercle articulate with the transverse process of the 4th vertebrae
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17
Q

the tubercle of rib has 2 surfaces , define them and what they attach to ?

A

1- smooth surface this one articulates with the vertebrae transverse process

2- rough surface attaches to the ligament , lateral costo transverse

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18
Q

whats name of the joint between rib head and vertebrae body

A

Costovertebral joint

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19
Q

whats the name of the joint between rib tubercle and transverse process

A

costotransverse joint

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20
Q

whats the type of joint in the posterior end of the rib?

A

ALL are synovial plane

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21
Q

whats angle of the rib?

A

the point of maximum convexity in the body ,and its the most liable to fractures

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22
Q

whats costal groove?

A

an area below the inferior border and it protects intercostal vessels

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23
Q

whats are the surfaces and borders of normal rib?

A

normal rib has :

Upper and lower border

Inner and outer surface

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24
Q

what are the Atypical ribs?

A

1,2
10-12

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25
Q

what are the borders and surfaces first rib?

A

upper w lower surface

inner and outer border , THE INNER BORDER IS WITH THE SUPRAPLEURAL MEMBERANE ( dEEP FASCIA )

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26
Q

whats the broadest and most curved rib?

A

1st rib

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27
Q

what makes the first rib ATYPICAL?

A

head : one complete faucet which articulate with the T1 only

shaft is not twisted

the shaft is horizental not vertical and its not prone to fractures cuz its protected

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28
Q

what about the tubercle of the first rib?

A

its regular with the faucet on it articulating with T1 transverse process BUT IT COINCIDES WITH THE NECK.

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29
Q

what tubercle does the first rib has in inner border?

A

scalene tubercle

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30
Q

what ridge is present on the first rib upper surface?

A

scalene ridge

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31
Q

what grooves are present on the first rib?

A

subclavian vessels

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32
Q

what makes the 2nd rib atypical?

A

it has normal head with 2 faucets –> articulates with the T1 and T2

  • normal tubercle faucet

-THE SHAFT IS NOT TWISTED .

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33
Q

what tuberosity does the 2nd rib has?

A

serratus anterior tuberosity

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34
Q

what makes 10th rib atypical?

A

it has everything normal EXCEPT :

1 faucet on the head not 2. so it will only articulate with T10

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35
Q

what makes 11th rib Atypical?

A

it has no tubercle – > no articulation with T11 transverse process

one single faucet on the head –> articulate with t11

  • slight angle and groove
  • it has NO neck because it has no tubercle
  • pointed anterior end cuz no costal cartilage
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36
Q

what makes 12th rib atypical?

A
  • No tubercle –> articulation with T12
  • ONE SINGLE FAUCET ON THE HEAD –> ARTICULATE WITH T12
  • NO ANGLE AND NO GROOVE

-no neck due to absence of tubercle
- pointed anterior end cuz no costal cartilage

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37
Q

what are the 2 abnormal ribs?

A

1- Cervical rib –> attach to C7

2 - Lumbar rib –>attach to L1 and its raree

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38
Q

what issue could abnormal rib do?

A

compress vessels

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39
Q

what are the 3 parts of sternum?

A
  • Manubrium
  • Sternal body
  • Xiphoid process
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40
Q

whats present on the manubrium?

A

jugular notch/suprastenral notch

clavicle notch –> sternoclavicular joint –> synovial saddle

1ST COSTAL FACUET –>for the costal cartilage of the first rib -

half faucet 2nd costal –> for the costal cartilage of the 2nd rib

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41
Q

what the vertebral lvl of jugular notch

A

Jugular notch is on the level of T2

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42
Q

what forms the body of the sternum?

A

its formed by 4 segments ( sternbrae )

it has faucets for half rib 2 costal cartilage

  • FAUCET FOR 3RD RIB COSTAL CARTILAGE
    -FAUCET FOR 4TH COSTAL CARTILAGE
    -FAUCET FOR 5TH COSTAL CARTILAGE
    -FAUCET FOR 6TH COSTAL CARTILAGE
  • HALF FAUCET FOR 7TH COSTAL CARTILAGE
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43
Q

what do the ridges on the sternum indicate?

A

fusion of the sternbrae

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44
Q

whats sternal foreman?

A

incomplete ossification of sternrae resulting in holes in the sternum

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45
Q

wheres the xiphoid process located?

A

infrasternal subcostal angle

it has HALF FAUCET FOR 7TH COSTAL CARTILAGE

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46
Q

whats the level of xiphoid process in respect to vertebrae ?

A

xiphoid process is at the T10

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47
Q

what happens to the xiphoid process later on the life?

A

calcifies and causes a hard lump in epigastrium –> at the age of 40 synostosis

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48
Q

what are the other relations of xiphoid process?

A

1- central tendon of the diaphragm

2- inferior border of the heart

3- superior limit of the liver

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49
Q

what are the joints in the sternum?

A

1st joint -> manubriosternal joint AKA STERNAL ANGLE
2nd joint – > xiphisternal joint

3rd type –> sternocostal joints

4th type - costochondral joints

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50
Q

whats the type of manubrium stenral joint

A

symphesis –> 2nd cartilage

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51
Q

whats the level of manubrium stenral joint

A

is on the level of 2nd rib and T4 from behind

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52
Q

whats the type of xiphsternal joint?

A

at first its symphesis –> 2nd cartilage but later it becomes PRIMARY CARTILAGE –> SYNCHONDROSIS/SYNTOSIS

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53
Q

whats the type of sternocostal joint?

A

between sternum and costal cartilage:
1st one –> primary cartilage

the other 6 –> synovial plane

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54
Q

whats the type of costochondral joint?

A

all of them are primary cartilage

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55
Q

whats ossification date for the sternum pats?

A

5 month —> manubrium
6 motn –> 1st sternabrae
7 motnh —> 2nd sternabrae
8 month —> 3rd sternbrae
9 month — > 4th sternbrae
4 year –> xiphoid

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56
Q

what are the costal cartilagE?

A

cartilage that attach the ribs to the sternum via sternocostal joint and costochondral

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57
Q

whats costal marginal?

A

space below 7th-10th ribs

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58
Q

what type of cartilage is costal cartilage?

A

hyaline cartilage

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59
Q

what happens to costal cartilage in old age?

A

calcify and reduce mobility and appear shadow in xray

60
Q

whats the relation between scapula and vertebra and ribs?

A

upper border of scapula = T2 2nd rib
spine of scapula = T3 , 3rd rib
Inferior border of scapular = T7, 7th rib

61
Q

whats the special use of sternum ?

A

can be used for bone marrow aspiration because its superficial and it used for diagnosis of LEUKEMIA .

62
Q

what are the typical T vertebrae?

A

2-8 vertebrae

63
Q

whats makes a vertebrae typical?

A

BODY heart shaped with 2 demi faucets ( articulate with the corresponding rib and the one below , for example T5 articulates with 5 and 6), WHY 2 DEMI FAUCETS? cuz typical rib has 2 heads one for corresponding vertebrae and the one above

-Transverse process –> faucet on transverse process for the corresponding rib tubercle

  • Spinous process —> long and pointing inferiorly
64
Q

whats the shape of the vertebral canal?

A

circular in shape

65
Q

what are the atypical vertebrae

A

1, 9, 10,11,12

66
Q

why T1 is atypical?

A

because it HAS ONE FULL FAUCET AND A HALF ( ONE FULL FROM THE FIRST RIB, AND HALF FROM 2ND RIB )

  • has normal transverse process with faucet for 1st rib tubercle
67
Q

why T9 is Atypical?

A

because it only has 1 DEMI FAUCET from 9th rib ( no other demi faucet because 10th rib doesnt have 2 heads to attach with 9 too )

everything else is normal

68
Q

why is T10 atypical?

A

because it only has 1 full faucet from 10th rib
Everything else is normal

69
Q

why T11 is atypical?

A
  • ONE FULL FAUCET ON from 11th rib
  • NO FAUCET ON TRANSVERSE PROCESS CUZ 11 RIB HAS NO TUBERCLE
70
Q

why is T12 atypical?

A

like T11 :

one full faucet on body from 12th rib

no faucet on transverse process because 12th rib has no tubercle

71
Q

whats an intercostal space?

A

space between 2 ribs and its the space below a rib

72
Q

how many intercostal spaces do we have anteriorly?

A

we have 9

73
Q

how many intercostal spaces do we have posteriorly

A

we have 11

74
Q

whats the content of the intercostal space?

A
  • intercostal vessels
  • intercostal muscles
  • intercostal nerve
  • lymphatic
75
Q

what are the 3 muscles in the thoracic cage?

A

1- EXTERNAL INTERCOSTAL MUSCLE

2- INTERNAL INTERCOSTAL MUSCLE

3- TRANSVERSE THORACIC MUSCLE

76
Q

what does the transverse thoracic muscle divide to?

A

1- Sternocostalis

2- Intercostalis intimi

3- Subcostalis

77
Q

whats the origin of external intercostal muscle?

A

lower border of the rib above

78
Q

whats the insertion of external intercostal muscle?

A

upper border of the rib below

79
Q

where are the fibers directed?

A

downward and forward

80
Q

whats the extension of external intercostal muscle?

A

from the tubercle of the rib from behind TO costochondral junction in front ( FROM BEHIND TO FRONT )

81
Q

what does external intercostal muscle continue as?

A

anterior/external intercostal membrane

82
Q

whats the nerve supply for external intercostal muscle?

A

intercostal nerves

83
Q

whats the action of external intercostal muscle

A

elevation of rib during inspiration

84
Q

Whats the origin of internal intercostal muscle?

A

costal groove of the rib above

85
Q

whats the insertion of internal intercostal muscle?

A

upper border of the rib below

86
Q

whats the direction of fibers?

A

downward and backward

87
Q

whats the extension of internal intercostal muscle?

A

from lateral margin of the sternum anteriorly to the angle of the rib posteriorly ( FROM ANTERIOR TO POSTER , opposite to external )

88
Q

whats the continuation of internal intercostal muscle?

A

posterior/internal intercostal membrane

89
Q

whats the nerve supply?

A

intercostal nerves

90
Q

whats the action of internal intercostal muscle?

A

-forced exhalation

  • depress the ribs and decrease space in chest cavity
91
Q

whats the origin of sternocostalis muscle?

A

the lower 1/3 of the sternum and xiphoid process posteriorly

92
Q

whats the insertion of sternocostalis muscle?

A

costal cartilage of 2nd to 6th

93
Q

direction of fibers?

A

upward and laterally

94
Q

whats the nerve supply?

A

intercostal nerves

95
Q

whats the action of sternocostalis

A

support the sternocostal joint

96
Q

whats the origin of intercostalis intimi muscle?

A

lower border of rib above

97
Q

whats the insertion of intercostalis intimi

A

upper border of the rib below

98
Q

direction of fibers ?

A

downward and backward but also along middle two forth intercostal space

99
Q

nerve supply?

A

intercostal nerves

100
Q

whats the action of it?

A

depression of the ribs during forced expiration

101
Q

origin of subcostalis muscle?

A

inner sufrace of the rib at its angle

102
Q

insertion of subcostalis muscle?

A

2 or 3 ribs below

103
Q

direction of fibers?

A

downward and medially

104
Q

nerve supply?

A

intercostal nerve

105
Q

whats the function of subcostalis muscle?

A

depressses the LOWER ribs during forced expiration

106
Q

whats the origin of the diaphragm?

A

multiple origins :

1- costal origin –> lower 6 ribs

2- sternal origin –> xiphoid process

3- vertebral origin –> L1 - L3

4- medial and lateral arcuate ligaments

107
Q

whats the insertion of diaphragm?

A

central tendon

108
Q

whats the nerve supply?

A

phrenic nerve ( C3,4,5)

109
Q

whats the function of diaphragm?

A

-primary muscle of inspiration

-closes the thoracic outlet (below )

  • peripheraly - striated muscle
  • inspiration
  • abdominal straining
  • weight lifting
  • VENOUS PUMP CUZ VENA CAVA PASSES THROUGH IT
110
Q

what happens in phrenic nerve palasy?

A

elevated hemidiaphragm and paradoxical movement

  • when its contracted it will be down so when paral it will be upward.

-will be elevated by stomach in exray.

111
Q

what are the structures passing through it

A

I ATE 2 EGGS AT 12

I- inferior vena cava –> ate /8 –> T8

EGGS - ESOPHAGUS –> 2 -> T2

AT –> AORTIA -> 12 —> T12

112
Q

whats the origin of the internal thoracic artery?

A

first part of the subclavian artery

113
Q

whats the course of it?

A

descends downard and medially behind the clavicle and 1st costal cartilage

  • descends and terminates at the 6th intercostal space ( below 6th rib )
114
Q

what does the intenral mammary artery terminate by dividing into what?

A

terminates at 6th intercostal space by dividing into

1- superior epigastric

2- musculophrenic

115
Q

what are the branches of internal mammary artery?

A

1- preicardiophrenic artery —> runs with the phrenic nerve

2- anterior intercostal arteries –> 2 anterior in each except the last 2

3- perforating arteries

4- musclophrenic

5- superior epigastric

116
Q

what venae comitantes form the internal mamary artery venae comitantes?

A

the superior epigastric venae comitantes

musculophrenic venae comitantes

117
Q

where do the venae comitantes of mamary artery unite to form the internal thoracic vein?

A

3RD COSTAL CARTILAGE

118
Q

where does the internal thoracic vein empty/terminate?

A

brachiocephalic vein

119
Q

what 2 veins join to form brachiocephalic vein?

A

jugular vein and subclavian vein

120
Q

what tributaries?

A

there are tributaries for each internal thoracic artery branch ( the 5 )

121
Q

what are intercostal arteries?

A

we have 11 intercostal spaces ( 9 anterior and 11 posterior )

each space has 2 anterior intercostal arteries and 1 posterior intercostal artery

122
Q

describe the anterior intercostal arteries?

A

two small in each space except the last 2 they dont have anterior

anastomose with the posterior

123
Q

where do the first 6 anterior intercostal come from

A

internal mamary artery

124
Q

what about the lower 3?

A

musculophrenic

125
Q

what about 10-11?

A

they dont have anterior intercostal arteries only posterior

126
Q

describe the poster intercostal arteries?

A

one in each space

anastomosis with the anterior

127
Q

where do the first 2 posterior intercostal arteries come from?

A

superior intercostal artery

128
Q

what about the lower 9?

A

descending thoracic aorta

129
Q

whats special about the LOWER RIGHT 9 posterior intercostal arteries?

A

they longer than the left ones because the descending aorta is more located to the left.

130
Q

what forms the posterior intercostal vein?

A

azygos and hemiazygos veins

131
Q

what forms the anterior intercostal veins?

A

internal thoracic vein

132
Q

whats an intercostal nerve?

A

ventral rami of spinal nerve of the 12th thoracic nerve

11 intercostal nerves for each intercostal spaces

133
Q

describe the basic anatomy of the spinal nerve?

A

you posterior root ( dorsal root ganglion ) and anterior root fuse together to form the spinal nerve and then it divides into ventral (anterior ) rami and dorsal ( posterior ) rami

134
Q

what are 2 classification of intercostal nerves?

A

typical

atypical

135
Q

what are the typical intercostal nerves? and why they are considered typical?

A

3-6

they are typical becase they are distributed in the chest wall only. and they dont go out

136
Q

what are the atypical intercostal nerve and why they are not typica?

A

1
2
lower 5

they are atypical because they are outside the chest wall too not only inside

137
Q

what are the branches of typical intercostal nerve?

A

1- ganglionic ( sympathetic trunk )

2- muscular to the intercostal muscles

3- collateral branch –> upper border of the rib below

4- lateral cutaneous –> skin of the side of the chest

5- anterior cutaneous –> skin of the front of the chest

138
Q

what are the branches of atypical nerve?

A

same as the normal branches in addition to :

1st intercostal nerve T1 will go and form brachial plexus

2nd intercostal nerve will go the arm

lower 5 they go the abdomen

139
Q

what does the 2nd intercostal nerve enter the arm as ?

A

intercostobrachial nerve

140
Q

whats the a dermatome?

A

area of skin supplied by a single nerve

141
Q

sternal angle is diving 2 dermatomes what are they?

A

C4 FROM ABOVE

T2 FROM BELOW ( t1 is in the arm)

142
Q

whats herpes zoster?

A

reactivation of varcille zoster virus and it will cause rash in a single dermatome حزام ناري

143
Q

what are the possible movements of thorax?

A

vertical, lateral , anteroposteior direction

144
Q

what movement is formed by diaphragm?

A

elevation and depression in vertical dimension

145
Q

what does elevation and depression of the ribs change?

A

change the antero posterior and lateral dimensions

146
Q

water pump is which movement?

A

antero posterior ( sternum upward and forward ) and its mainly the upper ribs which are attached to the sternum

147
Q

whats the water bucket handle movement?

A

lateral dimension, MAINLY INS LOWER RIBS COSTAL CARTILAGE

anatomyyyy y2s1 (12 decks)

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