Thoracic Cage Flashcards

1
Q

Bony framework of walls is called thoracic cage, which is formed of:

●___________ posteriorly
● ___________ on the sides
●________ and _______ anteriorly

A

Vertebral column

Ribs & intercostal spaces

Sternum and costal cartilages

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2
Q

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 ______

A

1st thoracic

1st

manubrium sterni

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3
Q

Suprapleural membrane

•_____ shaped dense fascial sheet that covers the ____ of each lung.
●An extension of the ________
●Extends approximately ____ superior to _____

A

Tent; apex

endothoracic fascia

an inch

superior thoracic aperture

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4
Q

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

A

1st

transverse process of C7

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5
Q

Thoracic cage

Inferiorly: communictes with abdomen through a large opening bounded:

●Posteriorly by ______ vertebra
●Laterally by ——— _______
●Anteriorly by _____ joint
•Opening is closed by ____

A

12th thoracic

curving costal margin

xiphisternal

diaphragm

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6
Q

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

A

Supraclavicular

anterior & lateral cutaneous; intercostal

Posterior

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7
Q
there are \_\_\_ ribs on each side, there are \_\_\_\_ intercostal spaces.
•Each space contains:
●Intercostal \_\_\_\_
●Intercostal \_\_\_\_\_\_ bundle
●Lymphatics
A

12

11

muscles

neurovascular

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8
Q
Each intercostal space has 3 muscles:
•\_\_\_\_\_\_
•\_\_\_\_\_\_\_ Intercostal
• \_\_\_\_\_\_\_ Intercostal
•Supplied by corresponding intercostal nerves

Action:
•Tend to ________
●Strengthen tissue of the space

A

External Intercostal

Internal

Innermost

pull ribs nearer to each other

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9
Q

EXTERNAL INTERCOASTAL MUSCLE

Most superficial; Fibers directed _____ and ____
•Origin: from _____ border of rib _____
•Insertion: ____ border of rib ____

A

downward & forward

lower; above

upper; below

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10
Q

EXTERNAL INTERCOASTAL MUSCLE

Extends from ______ behind to ______ in front

•Deficient _____riorly & replaced by _________

A

rib tubercle

costo-chondral junction

ante; external (anterior) intercostal membrane

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11
Q

INTERNAL INTERCOSTAL MUSCLE

Intermediate layer; Fibers directed ______ and ______
•Origin: from ______ of rib _____
•Insertion: ____ border of rib ____

A

downward & backward

subcostal groove; above

upper; below

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12
Q

INTERNAL INTERCOSTAL MUSCLE

Extends from _____ in front to ______ behind
•Deficient ____riorly & replaced by _________

A

sternum

angle of rib

poste

internal (posterior) intercostal membrane

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13
Q

INNERMOST INTERCOSTAL MUSCLE

Deepest layer
•(complete or Incomplete?) layer, divided into 3 portions
•Related externally to ________ & vessels, & internally to __________

A

Incomplete

intercostal nerve

endothoracic fascia

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14
Q

Fibers of innermost intercoastal muscle are limited to one intercostal space

T/F

A

F

cross more than one intercostal space

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15
Q

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.

A

muscles and bones

apex; cupola

suprapleural

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16
Q

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

A

innermost and internal

High

subcostal groove

Vein-Artery-Nerve (VAN)

17
Q

As innermost intercostal muscle is not a complete layer, bundle is generally covered on inside by _________

A

endothoracic fascia

18
Q

INTERCOSTAL NERVES

___ pairs
•Are (anterior or Posterior?) primary rami of thoracic spinal nerves.
•__-__distributed in intercostal spaces, __-__th supply ___________

A

12

Anterior

1-6; 7-11

ant abdominal wall

19
Q

Anterior ramus of 12th nerve runs forward in _____ as the ____ nerve

A

abdomen

subcostal

20
Q

ATYPICAL INTERCOSTAL NERVES

First thoracic nerve:
•Has no ____________ branch
•Is joined to _____ by a large branch that corresponds to ________ branch

A

anterior cutaneous

Brachial plexus

lateral cutaneous

21
Q

Second thoracic nerve :
•Is joined to medial cutaneous nerve of arm by brachial plexus by a branch called the _______ nerve that corresponds to ______ branch

A

intercostobrachial

lateral cutaneous

22
Q
ARTERIES
•Each intercostal space contains:
● A \_\_\_\_\_\_ intercoastal 
●2 \_\_\_\_\_ intercostal arteries
•Each artery gives off branches to the muscles, skin, parietal pleura (& breast)
A

single posterior

anterior

23
Q

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 _______

A

superior intercostal

costocervical

subclavian

thoracic aorta

24
Q

Course and branching of intercostal arteries follow the intercostal nerves

T/F

A

T

25
Q

ANTERIOR INTERCOSTAL ARTERIES

In upper 6 spaces, arise from ________ artery
•In lower 5 spaces arise from ______ artery (one of terminal branch of _____)

A

internal thoracic

musculophrenic; internal thoracic

26
Q

Anterior intercoastal arteries do not Form anastomosis with posterior intercostal arteries

T/F

A

F

They do

27
Q

INTERCOSTAL VEINS

Accompany intercostal arteries and nerves
•Each space has posterior & anterior intercostal veins
•___ posterior intercostal and __ subcostal vein

A

11

1

28
Q

______ Lies deepest in the costal grooves

Vein
Artery
Nerve
???

A

Vein

29
Q

Intercoastal veins Contain valves which direct blood (anteriorly or posteriorly?)

A

Posteriorly

30
Q

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

A

right brachiocephalic; azygos

left brachiocephalic; hemiazygos and accessory hemiazygos

31
Q

ANTERIOR INTERCOSTAL VEINS

Lower 5 spaces drain into _____ vein (1 of tributary of _____ vein)
•Upper 6 spaces drain into _______ vein

A

musculophrenic; internal thoracic

internal thoracic

32
Q

Internal thoracic vein drains into ______ vein.

A

subclavian

33
Q

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 _________

A

Deep

anterior; internal thoracic

posterior; posterior mediastinum