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Anatomy RS > Thoracic cage and muscles of thoracic wall > Flashcards

Thoracic cage and muscles of thoracic wall Flashcards

1
Q

order of thoracic wall:

(from the lungs)

A

Lungs—-visceral pleura—-pleural cavity—-Thoracic wall—-parietal pleura

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2
Q

Thoracic wall boundaries:

A

Posteriorly-thoracic vertebra
Anteriorly-sternum and coastal cartialages
Laterally-intercostal muscles and ribs
Superiorly-suprapleural membrane
Inferiorly-diaphragm

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3
Q

Manubrium:

articulates with 3, location, notes

A

Articulates with:
* coastal cartialages of first and second rib
* Clavicle
* body of sternum at manubriosternal joint

Location: T3 and T4

notes: sternal angle connects manubrium to sternal body at T4-T5

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4
Q

Body of sternum:

Articulates with 3, location

A

Articulates:
Above- with manubriosternal joint
Below- xiphoid process at xiphosternal joint at T9
On each side, 2nd to 7th coastal cartialages

Location: T5-T8

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5
Q

Xiphoid process

location and notes

A

no articulations
-lies opposite of T10
-thin plate becomes ossifeid during adult life

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6
Q

Angle of Louis

clinical

A

-Surface anatomy to count ribs
-Starts at the 2nd costal cartialage (sternal angle) T4-T5
-can locate the heart on the 5th costal cartialage

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7
Q

typical Rib structure:

A

-head: has 2 facets, one for the corresponding vertebra level and one for the vertebra above

-Neck:

-Tubercle: It has a facet for articulation for the corresponding vertebra number

Angle: where the rib bends sharply near head

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7
Q

True ribs

A

1st to 7th ribs

8-12 are false fibs

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8
Q

Atypical ribs:

1st 2nd 10th 11th 12th

A

1st rib: Broader wider and shorter, facet only articulates with one vertebra T1, scalene tubercle

2nd rib: tuberosity for serratus anterioir muscle

10th:one facet on the head

11th and 12th:shorter, one facet on head, no neck no tubercle

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9
Q

Extra rib rising from 7th cervical vertebra:

clinical importance

A

-articulates with first rib

-can apply pressure on the subclavian vein or artery or brachial plexus

-causing pain down medial side of forearm and hand

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9
Q

Joints of the sternum:

A

1)manubriosternal joint: allows small angular movement for respiration
2)Xiphisternal joint: fuses with body during middle age

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10
Q

FIRST RIB:

anterior and posterior to the tubercle:

A

**Anterior to the tubercle: **subclavian vein crosses the rib

Posterior to the tubercle: subclavian groove for subclavian artery and lower trunk of brachial plexus.

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11
Q

Joints of costal cartialages with sternum: 2nd-7th

A

Articulate with sternum and are synovial mobile joints

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11
Q

Joints of costal cartialages with sternum: 1st costal cartialage

A

articulate with manubrium, permit no movement

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12
Q

Joints of costal cartialages with sternum:6th 7th 8th 9th 10th

A

articualte with one another by small synovial joints.

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13
Q

Joint of the tubercles of ribs:

A

synovial joint articulates with coressponding transverse process of vertebra, 11th and 12th dont have this.

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14
Q

Joints of the heads of the ribs:

A

-1st and 10th 11th 12th ribs have synovial joint that articualtes with corresponsding vertebra

-2nd to 9th have synovial joints that articulate with corresponding vertebra and one above it.

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14
Q

Joints of costal cartialages with sternum:11th and 12th

A

embedded in abdominal muscle

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15
Q

Inferior thoracic opening:

A

Anteriorly:Xiphisternal joint
Laterally:curving costal margin
Posteriorly T12

closed by diaphragm

16
Q

Superior thoracic opening Boundaries:

A

Anteriorly: manubrium
Laterally: first rib and costal cartialge
posteriorly: T1

17
Q

Thoracic outlet syndrome:

A

Compression to subclavian artery and vein and brachial plexus

Symptoms:
1)numbness in fingers
2)pain in neck or shoulder or hand
3)weakening grip
4)paleness of upper limb

18
Q

External intercostal muscle:

A

-Starts from tubercle of rib, ends before the cartialages, after them is the external aponeurosis. anterior intercostal membrane

-Origin:inferior part of rib above
-Insertion: superior part of rib below

Fibres run down and forward (hands in pockets)

19
Q

Internal intercostal muscles:

A

-Origin: subcostal groove of rib above
-Insertion: superior border or rib below

-Extends from the sternum to the angle of the rib, the back is replaced by posterior internal intercostal memebrane.

Fibres run down and backward

20
Q

Innermost intercostal:

A

Divided into:
1)innermost intercostal: deepest part of internal intercostal muscle
2)sternocostralis: Lower 1/3 of sternal body and posterior xiphoid process
3)subcostalis: from inner surface of rib to its angle or 2nd or 3rd rib from below.

21
Q

External intercostal muscle action:

A

raise the ribs during inspiration

22
Q

Internal intercostal muscle action:

A

Lower the ribs during expiration

23
Q

posterior Intercostal arteries:

A

first 2 spaces: branches of costocervical trunk of the 2nd part of the subclavian artery

lower 9 spaces:branches of descending thoracic aorta

24
Q

Anterior intercostal arteries:

A

First 6 spaces: branches of the internal thoracic artery, branch of the first part of subclavian artery

lower spaces: branches of musculopherinic artery. one of terminal branches of internal thoracic artery.

25
Q

Posterior Venous drainage of thoracic wall:

A

Into azygous and hemi azygous veins.

right —- left

26
Q

Anterior venous drainage of thoracic wall:

A

-internal thoracic and musculopherinic vein.

26
Q

Typical nerves:

A

3rd-6th nerve: as they only supply the chest wall

27
Q

Atypical nerves:

A

1st and 2nd nerve: supply chest wall and upper limb

7th to 11th nerves: supply chest wall and anterior abdominal wall

28
Q

1) Rami communicantes

A

connect intercostal nerve to a ganglion of sympathetic trunk

29
Q

2)Lateral cutaneous branch
3)Anterior cutaneous branch

A

2) reaches midaxillary line then separates into postrerior and anterior branches

3)terminal part of the nerve, divides into medial and lateral branches

30
Q

2nd intercostal nerve;;;;

Clinical importance

joined to what

A

joined to medial cutaneous nerve of the arm by the intercostobrachial nerve.

people with CVS feel pain in upper limb from this nerve.

31
Q

7th and 11th intercostal nerve supply:

A

Abdominal muscles:

external oblique
internal oblique
transversus abdominis
rectus abdominis

32
Q

Diaphragm Origins:

A

Sternal part: arise from posterior surface of xiphoid process
Costal part:arise from deep surfaces of the lower 6 ribs and their costal cartialages.
Lumbar part: upper 3 lumbars

33
Q

Crura and Arcuate ligaments:

A

Right crus:From L1-L3
Left Crus:L1-L2

Medial Arcuate ligament: Passes from lateral part of second lumbar to the tip of transverse process of first lumbar

Lateral arcuate ligament: continuation from tip of transverse process of L1 to lower border of 12th rib.

34
Q

Insertion of Diaphragm:

A

inserted into a central tendon

35
Q

one of the functions of the diaphragm:

A

Thoracoabdominal pump: descent of the diaphragm decreases intrathoracic pressure, and increases intra abdominal pressure

35
Q

IMPORTANT

3 main openings of the diaphragm:

A

Caval: T8, transmits inferior vena cava and right phrenic nerve branches

Esophageal: T10, in right crus, esophagus and left+right vagus nerves pass thru

Aortic:T12, lies between the crura anterior to median ligament,
transmits aorta, thoracic duct, and azygous vein.

36
Q

Nerve supply of diaphragm:

A

Motor nerve: right an dleft phrenic nerves

Sensory:phrenic nerve, and lower 6 intercostal nerves.

37
Q

Paralysis of the diaphragm:

A

from phrenic nerve in the neck being cut, AND nerve to subclavius muscle cut.

Accessory phrenic nerve acts as a replacement for phrenic nerve function.

38
Q

Penetrating damage of the diaphragm:

A

Any damage done below the nipple

39
Q

supra pleural membrane attached to:

A

attached laterally to first rib border, and transverse process of C7

Anatomy RS (8 decks)

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