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Anatomy Exam III > Thoracic Cage I > Flashcards

Thoracic Cage I Flashcards

1
Q
  • If damaged, can result in winged scapula due to lack of innervation of serratus anterior
  • May be a complication of mastectomy
A

Long thoracic nerve

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2
Q

Rib categorization

A
  • True Ribs 1st to 7th pairs
  • False Ribs 8th to 12th pairs
  • Floating Ribs 11th and 12th pairs only
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3
Q

Structure of Costovertebral joints

A

A single rib will articulate with 2 vertebra but only with one transverse process

  • Costovertebral Joint- Between head of rib and 2 vertebral bodies, at and above rib level.
  • Costotransverse Joint- Between tubercle of rib and transverse costal facet of vertebra, at rib level
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4
Q

When structures from the inlet are compressed….

Results in upper limb issues

A

Thoracic inlet syndrome occurs

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5
Q

Sternal angle of Louis is a landmark for…

A

Level at Intervertebral disc between T4-T5
Manubriosternal Joint
Costal Cartilage of 2nd Rib

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6
Q

Xyphoid process is a landmark for …

A

Xiphoid Process- Level at Intervertebral disc between T9-T10

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7
Q

The root/spine of the scapula and the inferior angle of the scapula are landmarks for…

A

Root of the spine of scapula-Vertebral level T4 & Spine of T3
Inferior angle of scapula-Vertebral Level T8 & Spine T7; Also Overlies Rib 7, “points” to Rib 8

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8
Q

Breast anatomy

A
  • Mammary gland lobules (15-20) –> Lactiferous ducts –> Lacterifous sinus.
  • suspensory ligatments- Cooper’s ligaments.
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9
Q

Retromammilary space

A
  • between glands and deep fascia. Allows for breast movement
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10
Q

Breast Blood Supply

A

Lateral Thoracic A.

internal thoracic A. and branching pectoral from thoraco acromial trunk A.

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11
Q

Breast Lymphatic drainage

A

75% into axillary nodes

25% via parasternal and clavicular lymphnodes

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12
Q

Pectoralis Major

A

N: Medial and lateral pectoral nerves
Blood: Pectoral branches of thoraco acromial trunk

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13
Q

Pectoralis Minor

A

N: Medial pectoral nerve (dives through pec minor)
Blood: Pectoral branches of thoraco acromial trunk

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14
Q

Serratus Anterior

A

N: long thoracic Nerve (superficial to the muscle)
Blood: Lateral Thoracic A

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15
Q

Rib Elevators of the back…

A

Serratus posterior inferior
Levator Costarum- (also lengthens spine;rotates and flexes spine) 12 pairs of fan shaped muscle,Transverse Processes C7-T11 to Costal Tubercle and Costal Angle

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16
Q

Rib depressors in the back…

A

Serratus Posterior inferior

17
Q

3 Layers of intercostal muscles

A

External intercostal muscles are most superficial
internal intercostal muscles are in the middle
Innermost intercostal Muscles are the deepest layer

18
Q

External Intercostal muscles

A

-1 st layer
- rib elevators
- Fibers run Anterioinferiorly (hands in pockets), from upper to lower ribs
Starts from costal tubercle to costochondral junction
Continues as external (anterior) intercostal membrane to sternum
- Anterior or external membrane

19
Q

Internal intercostal Muscles

A
  • 2nd layer
  • rib depressors in the Costal Region, elevates ribs in the chondral region
  • Fibers run Posteroinferiorly (hands in gloves), from upper rib to rib below
  • Starts at lateral border of sternum, runs to costal angle
  • Continues to vertebrae as internal (posterior) intercostal membrane
  • has internal or posterior membrane
20
Q

Innermost intercostal Muscles:

A
  • 3rd layer, most deep
  • Action similar to internal intercostal mm, depressing ribs
  • Located internally on posterolateral thoracic walls
  • formed by 3 different muscles types
21
Q

(Thoracic) Diaphragm

A
  • lumbar, costal and sternal attachments
  • central tendon
  • main muscle of inspiration
  • ## Phrenic nerve C3-C5
22
Q

Muscles of Inspiration

A
  • diaphragm
  • external intercostals
  • chondral portion of internal intercostals
23
Q

Muscles of FORCED inspiration

A
  • diaphragm
  • external intercostals
  • chondral portion of internal intercostals
  • SCM
  • Scalenes
24
Q

Muscles of Expiration

A
  • Most of expiration is passive
  • Costal portion of internal intercostal muscles
  • innermost intercostal muscles
25
Q

Muscles of FORCED expiration

A
  • Most of expiration is passive
  • Costal portion of internal intercostal muscles
  • innermost intercostal muscles
  • Abdominal muscles
26
Q

Fascial and plueral layers of the thoracic cavity

A
  • Endothoracic fascia (lines muscles)
  • Costal Parietal Plueral (lines the thoracic wall, cervical, costal, diaphragmatic, medialstinal near the heart)
    intimately connected with endothoracic fascia
  • Visceral Plueral (lines the lungs themselves)
27
Q

VAN

A
  • first 11: Intercostal arteries nerves and veins,
  • 12- subcostal VAN
  • found in between 2nd and 3rd layers of muscles, and rest along each rib’s costal groove, inferior border of the rib.
  • Superior border of the bottom rib is the safest place for chest tubes/needles, etc.
28
Q

Nerve Supply

A
  • traditional “perfect spinal nerve”, ventral primary rami, both sensory and motor, and line up with dermatomes.
  • T10 is the level of the navel
  • Intercostal Nerves- comes of thoracic T1- T11
  • thoraco-abdominal T7-T11
  • T12 is subcostal nerve
29
Q

Anterior Arterial Supply

A
  • notes: blood supply is split between anterior posterior supply
  • internal Thoracic A (branch of the subclavian)
    - gives off Anterior intercostal ateries to supply ribs 1-6.
    Eventually biphricates into:
  • Superior epigastric Artery- supplies upper abdomen.
  • Musculorphrenic A which supplies spaces 7-9
  • floating ribs 10-11- no anterior intercostal spaces- no ateries
30
Q

Posterior Arterial supply

A
  • Primary from Descending Aorta
  • ## Supreme intercostal/superior intercostal from costal cervical trunk from IC space 1 and 2
31
Q

Anterior venous drainage

A
  • The anterior intercostal veins follow the anterior arteries and drain into the internal thoracic vein
32
Q

Posterior Venous Drainage

A
  • right side is different from left.
  • Azygous system
  • right side- drains into Azygous
  • Left side: superior side drains into Accessory Hemiazygous, inferior drains into Hemiazygous
  • ## both then drain into the azygos
33
Q

Posterior Venous Drainage

A
  • right side is different from left.
  • Azygous system
  • right side- drains into Azygous to get to the SVC
  • Left side: superior side drains into Accessory Hemiazygous, inferior drains into Hemiazygous
  • ## both then drain into the azygos
34
Q

Costocervical trunk gives rise to…

A

The Supreme intercostal artery, which is the posterior arterial supply for intercostal spaces 1 and 2

Anatomy Exam III (5 decks)

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