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Anatomy 1 > Thoracic and Abdominal Walls > Flashcards

Thoracic and Abdominal Walls Flashcards

1
Q

3 Parts of the Sternum

A
  1. Manubrium
  2. Body
  3. Xiphoid Process (CPR)
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2
Q

Sternal Angle/Angle of Louis

A
  1. Trachea bifrucates into right and left bronchi in the thoracic cavity
  2. Arch of the aorta begins and ends
  3. SVC penetrates the pericardium to enter the heart
  4. It marks the second rib and the division between the manubrium and the body
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3
Q

Clavicle Connections

A
  1. Lateral: acromion process of scapula
  2. Medial: manubrium (thorax)
    Most broken bone in body because it transmits force from the upper limbs to the thorax
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4
Q

Winged Scapula-surgical error

A

After a radical mastectomy, if a person comes in with a winged scapula, it means that the long thoracic nerve which innervates the serratic anterior (one muscle that keeps scapula from winging) was knicked

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5
Q

Coronoid Process

A

small hook/node-like structure on lateral edge of superior anterior portion of the scapula

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6
Q

Rib Types

A
  1. True (1-7)
  2. False (8-10)-they’re cartilage does not directly connect to the body of the sternum. Instead, it joins the costal cartilage to connect to the sternal body
  3. Floating (11, 12)-embedded in the musculature of the abdominal wall
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7
Q

What are the 6 posterior components of the rib?

A

Head, neck, tubercle, angle body, costal groove (N:179)

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8
Q

Costal Margin

A

The medial margin formed by the costal cartilage of the false ribs and the 7th rib

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9
Q

Costal Cartilage

A

Cartilage that attaches true ribs 1-7 to the sternal body and false ribs 8-10 to the costal cartilage of the 7th rib

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10
Q

Costo-chondral Junctions

A

Where the bony portion of the ribs meets the cartilaginous portion

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11
Q

Intercostal Spaces

A

Spaces between ribs, named for the rib above it

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12
Q

Where do you puncture when you have a collapsed lung?

A

The second intercostal space, just superior to the third rib because the nerve bundle goes inferior to each rib and you don’t want to hit

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13
Q

Name the anterior thoracic muscles

A
  1. pectoralis major
  2. pectoralis minor
  3. external intercostals
  4. internal intercostals
  5. serratus anterior
  6. latissimus dorsi
    (N:182, 183)
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14
Q

Name the thoracic layers starting from the skin

A
  1. Skin
  2. Superficial fascia
  3. external intercostal muscle
  4. internal intercostal muscle
  5. innermost intercostal muscle
  6. deep facia
  7. pleura
    - ->there are also the pectoralis muscles and the serratus muscles, make sure you know them too!
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15
Q

Function of external vs internal intercostal muscle

A

External=elevate ribs and sternum

Internal=depress them

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16
Q

What innervates the serratus anterior?

A

The long thoracic nerve

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17
Q

Lateral pectoral nerve

A

innervates pectoralis major

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18
Q

Medial pectoral nerve

A

Passes through the pectoralis minor and penetrates the deep surface of the pectoralis major

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19
Q

Pectoral branches of the thoracoacrominal artery

A

Branches of the thoracoacromonial artery, which is part of the axilary artery that supplies the anterior axilla, including the pectoral muscles, deltoid, clavicle, and acromioclavicular joint
–>in BREAST, it is the lateral source of blood supply

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20
Q

Axillary artery

A

Lateral source of blood for the breast

-very large artery with lots of branches coming from it

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21
Q

Mammary Gland

A

Secrete ze milk

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22
Q

Structure of the breast (posterior to anterior)

A
  1. The Pectoralis major
  2. Pectoral fascia
  3. Membrane of fat and suspensory ligaments/ligaments of cooper, which anchor the mammary gland to the skin
  4. Mammary glands are drained by a lactiferous duct into the lactiferous sinus
  5. This empties into the nipple
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23
Q

If a woman contracts her pectoral muscles, what should happen normally, and what happens in abnormal conditions

A

Normally: nothing, sags
Tumor of the retromammary space attaches to the pectoral fascia and the pec major so the breast moves up when pecs contract

24
Q

What does dimpling of the breast imply?

A

Cancer has invaded the suspensory ligaments of cooper that anchor the glands to skin

25
Q

What is peau d’orange

A

Dimpling and orange peel-like appearance of the skin. Retraction and elevation of the nipple. Signs of cancer spread to suspensory ligaments. Obstruction of cutaneous lymphatics. Involvement of lactiferous ducts. When all of this isn’t working, get this orange look and lots of inflammation

26
Q

What two types of lymph nodes are involved in lymphatic draining of the breast?

A

75% axillary nodes

Rest=parasternal nodes deep to anterior thoracic wall

27
Q

Radical mastectomy

A

Removal of skin over the tumor and of the dome of the breast, breast tissue, pectoralis major/minor, upper part of anterior sheath of rectus abdominus, nerves to pectoral muscles, intercosto-brachial nerve, thoracoacromial vessels, all tributaries to the axillary vein from the breast and axilla, *axillary lymph nodes and vessels and the fat in which they are embedded

28
Q

Iliac crest

A

Form the superior margin of pelvic bones, anterior to anterior superior iliac spine. Highest point is a useful landmark for L4

29
Q

Anterior superior iliac spine (ASIS)

A

Most anterior superior part of pelvic bone. Provides attachment for the inguinal ligament

30
Q

Pubic tubercle

A

Portion of the pubic bone that the inguinal ligament attaches to. It is the forward projecting round nodule/small emenence (tubercle) on the upper boarder of the medial portion of the pubis
(N:241)

31
Q

Pubic crest

A

Boarder between the pubic tubercle and the pubic symphesis. The pubic crest and the inguinal ligament form the base of the anterior abdominal wall

32
Q

Pubic symphysis

A

Marks the inferior extent of the abdominal wall (pg 16 of the iBook)

33
Q

Name the layers of the abdominal wall

A
  1. Skin
  2. Superficial fascia
  3. External abdominal oblique
  4. Internal abdominal oblique
  5. Transversus abdominus
  6. Transversalis fascia
  7. Extraperitoneal fascia/fat
  8. Peritoneum
34
Q

Rectus abdominus

A

Muscle that extends from the xiphoid to the pubic symphysis

35
Q

Aperneurosis

A

Flat tendons of the 3 anterolateral abdominal muscles

36
Q

What is the rectus sheath? What does it cover?

A

The aponeruosis of the external oblique, internal oblique and transverse abdominus. It envelopes the rectus abdominus. The superior 3/4 of the rectus muscle in the abdomen wall is covered by the sheath front and back. The inferior 1/4 of the rectus muscle is covered by the sheath in the front only.

37
Q

What is the arcuate line?

A

Arcuate line is the line that demarcates the upper 3/4 of the rectus abdominus from the lower 1/4. It also serves as the point where the inferior epigastric vessels enter the rectus sheath

38
Q

Linea alba

A

A raphe, not a ligament that indicates the midline of the abdomen. Common site of incisions for abdominal surgery

39
Q

Conjoint tendon

A

Along with the rectus abdominal muscle, it reinforces the posterior wall of the superficial inguinal ring to prevent hernias.

Formed by the aponeurosis of the transversis abdominus and internal oblique muscles

Conjoined tendon attaches to the pubic bone posterior to the superficial inguinal ring

40
Q

Layers of the superficial fascia

A
  1. Camper’s: contains fat, continuous with superficial fascia everywhere. Is the outer layer
  2. Scarpa’s: lacks fat, is the inner layer
41
Q

Triangle of Hesselbach

A

Lateral: inferior epigastric artery
Inferior: inguinal ligament
Medial: lateral part of the rectus abdominus

42
Q

Inferior epigastric artery/vein

A

Artery: branch of the external iliac artery, it forms the lateral part of the triangle of Hesslebach

Medial to the deep inguinal ring

43
Q

Superior epigastric artery

A

Branch of the internal thoracic artery that supplies the rectus abdominus muscle

44
Q

Inguinal ligament

A

Divides the lower anterior abdominal wall from the proximal thigh. The three muscle layers of the abdominal wall are anchored to the inguinal ligament and the pubic crest

45
Q

Inguinal canal and its walls

A

Allows the passage of testis and in females it transmits the round ligament

4 of the 8 layers of the abdominal wall form the inguinal canal. Each layer has a breach through it, but is organized in such a way to prevent herniation

There are 4 walls of the inguinal canal

  1. Posterior wall: transversalus fascia (contains deep ring)
  2. Anterior wall: aponeurosis of the external oblique muscle
  3. Floor: inguinal ligament
  4. Roof: Transversus abdominus and internal oblique muscles
46
Q

Superficial/external inguinal ring

A

A fault in the external oblique aponeurosis that forms the anterior opening of the inguinal canal

Just above the pubus, medial to pubic tubercle

Breach in the inguinal ligament that fits tightly to the spermatic cord or round ligament which pass through it

Very rigid, does not dilate even when tensed by contraction of the external oblique

Give rise to external spermatic fascia

47
Q

Deep inguinal ring

A

It is a fault in the transversalis facia which forms the posterior opening of the inguinal canal

An indirect hernia goes through it

48
Q

Ilioinguinal nerve

A

Transmitted by the superficial ring. Supplies the abdominal musculature

If it is damaged, it can result in weakening of muscles in the inguinal region creating a predisposition to development of direct inguinal hernia

49
Q

Cremaster muscle

A

It consists of fibers of the internal oblique that extend along the spermatic cord. Contraction of this elevates the testis and helps regulate thermal environment of the testis

50
Q

Layers of the spermatic fascia and where they came from ????? We must ask????

A
  1. External spermatic fascia
    - from the external oblique aponerosis
  2. Cremasteric muscle and fascia
    - the fascia is derived from the fascia of the internal oblique
  3. Internal spermatic fascia

The transversus abdominus does not contribute to the spermatic fascia, but transversalis fascia does

51
Q

Round ligament of the uterus

A

It is the remnant of the gubernaculum which passes through the inguinal canal and ends in the labia majus

52
Q

Ductus deferens

A

In males, pass through the inguinal canal. Structure of the spermatic cord that conveys sperm from the epididymis to the ejaculatory duct

53
Q

Processes vaginalis

A

An invagination of the parietal canal that descends through the inguinal canal during fetal life

54
Q

Tunica vaginalis

A

Remnant of the processes vaginalis in the spermatic cord that covers the anterior and lateral parts of the testis

Out-pocketing/sac of the peritoneal layer that provides a double layer of friction reducing membrane that the testis can use to slide higher or lower

55
Q

Epididymis

A

Site of spermatogenesis

56
Q

Indirect inguinal hernia

A

Bowel can go through the deep ring and the superficial ring to form a hernia outside of hasslebachs triangle

More common in children and most common in adult men

57
Q

Direct inguinal hernia

A

The peritoneal sac/bowel protrudes through the posterior wall of the inguinal canal due to weakening in the anterior abdominal wall. The protrusion is medial to the inferior epigastric artery and vein.

If the lump is inside hasselbach triangle, it is a direct hernia. It can or cannot go into superficial inguinal ring, but does not go through the deep ring

More common in older people and females

Anatomy 1 (11 decks)

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