Thoracic Cage Flashcards
Bony framework of walls is called thoracic cage, which is formed of:
●___________ posteriorly
● ___________ on the sides
●________ and _______ anteriorly
Vertebral column
Ribs & intercostal spaces
Sternum and costal cartilages
Superiorly: communicates with neck through an opening bounded:
●Posteriorly by ______ vertebra
●Laterally by medial border of ___ ribs and their costal cartilages
●Anteriorly by superior border of ______
1st thoracic
1st
manubrium sterni
Suprapleural membrane
•_____ shaped dense fascial sheet that covers the ____ of each lung.
●An extension of the ________
●Extends approximately ____ superior to _____
Tent; apex
endothoracic fascia
an inch
superior thoracic aperture
Suprapleural membrane
●It is attached:
•Laterally to internal border of ___ rib & costal cartilage
•At its apex to _____ of ____ vertebra.
•Medially to fascia covering structures passing through superior thoracic aperture
1st
transverse process of C7
Thoracic cage
Inferiorly: communictes with abdomen through a large opening bounded:
●Posteriorly by ______ vertebra
●Laterally by ——— _______
●Anteriorly by _____ joint
•Opening is closed by ____
12th thoracic
curving costal margin
xiphisternal
diaphragm
INNERVATION of thoracic cage
Anterior wall:
●Above level of sternal angle: _____ nerves
●Below level of sternal angle: Segmental innervation by _____ and _____ branches of the ____ nerves
•Posterior wall:
●Segmental innervation by (anterior or posterior?) rami of the thoracic spinal nerves nerves
Supraclavicular
anterior & lateral cutaneous; intercostal
Posterior
there are \_\_\_ ribs on each side, there are \_\_\_\_ intercostal spaces. •Each space contains: ●Intercostal \_\_\_\_ ●Intercostal \_\_\_\_\_\_ bundle ●Lymphatics
12
11
muscles
neurovascular
Each intercostal space has 3 muscles: •\_\_\_\_\_\_ •\_\_\_\_\_\_\_ Intercostal • \_\_\_\_\_\_\_ Intercostal •Supplied by corresponding intercostal nerves
Action:
•Tend to ________
●Strengthen tissue of the space
External Intercostal
Internal
Innermost
pull ribs nearer to each other
EXTERNAL INTERCOASTAL MUSCLE
Most superficial; Fibers directed _____ and ____
•Origin: from _____ border of rib _____
•Insertion: ____ border of rib ____
downward & forward
lower; above
upper; below
EXTERNAL INTERCOASTAL MUSCLE
Extends from ______ behind to ______ in front
•Deficient _____riorly & replaced by _________
rib tubercle
costo-chondral junction
ante; external (anterior) intercostal membrane
INTERNAL INTERCOSTAL MUSCLE
Intermediate layer; Fibers directed ______ and ______
•Origin: from ______ of rib _____
•Insertion: ____ border of rib ____
downward & backward
subcostal groove; above
upper; below
INTERNAL INTERCOSTAL MUSCLE
Extends from _____ in front to ______ behind
•Deficient ____riorly & replaced by _________
sternum
angle of rib
poste
internal (posterior) intercostal membrane
INNERMOST INTERCOSTAL MUSCLE
Deepest layer
•(complete or Incomplete?) layer, divided into 3 portions
•Related externally to ________ & vessels, & internally to __________
Incomplete
intercostal nerve
endothoracic fascia
Fibers of innermost intercoastal muscle are limited to one intercostal space
T/F
F
cross more than one intercostal space
ENDOTHORACIC FASCIA
The extrapleural fascia that lines wall of the chest
•Located between ______ and _____ of thoracic wall and parietal pleura, extends over ___ (_____) of pleura as ______ membrane, and forms a thin layer between diaphragm and pleura.
muscles and bones
apex; cupola
suprapleural
INTERCOSTAL NEUROVASCULAR BUNDLE
Lies between ____ and _____ intercostal muscles
•Runs (low or high?) in intercostal space, related to ______ of rib above
•Has a strict order in arrangement: ____-___-____, from top to bottom
innermost and internal
High
subcostal groove
Vein-Artery-Nerve (VAN)
As innermost intercostal muscle is not a complete layer, bundle is generally covered on inside by _________
endothoracic fascia
INTERCOSTAL NERVES
___ pairs
•Are (anterior or Posterior?) primary rami of thoracic spinal nerves.
•__-__distributed in intercostal spaces, __-__th supply ___________
12
Anterior
1-6; 7-11
ant abdominal wall
Anterior ramus of 12th nerve runs forward in _____ as the ____ nerve
abdomen
subcostal
ATYPICAL INTERCOSTAL NERVES
First thoracic nerve:
•Has no ____________ branch
•Is joined to _____ by a large branch that corresponds to ________ branch
anterior cutaneous
Brachial plexus
lateral cutaneous
Second thoracic nerve :
•Is joined to medial cutaneous nerve of arm by brachial plexus by a branch called the _______ nerve that corresponds to ______ branch
intercostobrachial
lateral cutaneous
ARTERIES •Each intercostal space contains: ● A \_\_\_\_\_\_ intercoastal ●2 \_\_\_\_\_ intercostal arteries •Each artery gives off branches to the muscles, skin, parietal pleura (& breast)
single posterior
anterior
POSTERIOR INTERCOSTAL ARTERIES
In upper 2 spaces, arise from _________ artery (a branch of _____ trunk of ____ artery)
In lower 9 spaces, arise from the branches of _______
superior intercostal
costocervical
subclavian
thoracic aorta
Course and branching of intercostal arteries follow the intercostal nerves
T/F
T
ANTERIOR INTERCOSTAL ARTERIES
In upper 6 spaces, arise from ________ artery
•In lower 5 spaces arise from ______ artery (one of terminal branch of _____)
internal thoracic
musculophrenic; internal thoracic
Anterior intercoastal arteries do not Form anastomosis with posterior intercostal arteries
T/F
F
They do
INTERCOSTAL VEINS
Accompany intercostal arteries and nerves
•Each space has posterior & anterior intercostal veins
•___ posterior intercostal and __ subcostal vein
11
1
______ Lies deepest in the costal grooves
Vein
Artery
Nerve
???
Vein
Intercoastal veins Contain valves which direct blood (anteriorly or posteriorly?)
Posteriorly
POSTERIOR INTERCOSTAL VEINS
On right side:
1st space drains into _____ vein
•Rest of intercostal spaces drain into ___ vein
On left side:
Upper 3 spaces drain into the _____ vein.
•Rest of intercostal spaces drain into __________ veins, which drain into azygos vein
right brachiocephalic; azygos
left brachiocephalic; hemiazygos and accessory hemiazygos
ANTERIOR INTERCOSTAL VEINS
Lower 5 spaces drain into _____ vein (1 of tributary of _____ vein)
•Upper 6 spaces drain into _______ vein
musculophrenic; internal thoracic
internal thoracic
Internal thoracic vein drains into ______ vein.
subclavian
LYMPHATICS
•Lymph vessels of intercostal space conform to general rule, that (superficial or deep?) lymphatics follow arteries
•Anteriorly drain into _____ intercostal nodes that lie along ______ artery
•Posterioly drain into _____ intercostal nodes that lie in _________
Deep
anterior; internal thoracic
posterior; posterior mediastinum