Thoracic O, A And M Flashcards
What is the thorax?
Region b/w the neck and abdomen
The superior portion of the trunk
What surrounds the the thoracic cavity?
Osteocartilaginous thoracic cage
What makes up the osteocartilaginous thoracic cage?
Formed by sternum, ribs, and thoracic vertebrae
What are the 3 primary divisions of the thoracic cavity?
2 pulmonary cavities
1 mediastinum
What do the pulmonary cavities contain?
lungs and pleurae
What is the mediastinum?
Heart, thoracic great vessels, trachea, thoracic esophagus, and thymus
What are the 2 thoracic apertures?
Superior and inferior thoracic apertures
What does the superior thoracic aperture allow for?
Communication b/w the neck and thorax
What are the contents of the superior thoracic aperture?
Trachea
Esophagus
Nerves and vessels supplying and draining head, neck, and UE
What are the boundaries of the Superior thoracic apertuare
T1
Paired first ribs
Superior manubrium
What does the inferior throacic aperture allow for?
IRREGULAR communication b/w thorax and abdomen
What are the contents of the Inferior THoracic Aperture?
Esophagus
Inferior vena cava
Aorta
What are the boundaries of the Inferior thoracic aperture?
T12 vertebral segment
11 and 12 ribs
7-10 costal cartilages
Xyphisternal joint
What are the 3 parts of the sternum?
Manubrium
Body of sternum
Xyphoid process
What are the features of the Manubrium? (4)
Suprasternal notch
Sternal angle of Louis
Clavicular notch
Costal notches
Where is the suprasternal notch?
Superior border of manubrium
Where is the sternal angle of Louis?
Junction of manubrium and sternum body
What does the clavicular notch articulate w/?
Sternal end of clavicle
What are the costal notches found of the manubrium?
1st
Half of 2nd
What are the features of the
Body of the Sternum?
Xyphoid-sternal joint
Costal notches
Transverse ridges
What is the xyphoid/sternal joint?
Junction of sternum body and xyphoid process
What are the costal notches found in the Boyd of the sternum?
1/2 of 2nd
3-6
1/2 of 7
Where are the transverse ridges on the Body of the Sternum?
Anterior surface b/w costal notches
What are the features of the xyphoid process?
Specifically?
Costal notch
1/2 of 7
s?
What are “true” ribs?
Vertebrocostal ribs
1-7
s?
What are “false” ribs?
Vertebreochondral
8-10
s?
What are “floating” ribs?
Vertebral ribs
What are the atypical ribs?
1-2
10-12
How are True ribs attached in body?
Attach directly from vertebral segments to sternum via their OWN COSTAL cartilages
How are False ribs attached in body?
Attach from vertebral segments to joint SUPERIOR segment’ s costal cartilage
How are Floating ribs attached in body?
Do not attach to the sternum at all
What are the typical rib’s bony landmarks?
Head - articulates w/ thoracic vertebrae
Neck- b/w head and tubercle
Tubercle - articulates w/ transverse costal facets on thoracic vertebrae and has attachment point for lateral Costotransverse l.
Body - shaft, costal groove, costal angle
What are the 2 facets found on the head of a typical rib?
Superior articular facet
Inferior articular facet
What does the superior articular facet of the Head of a typical rib articular with?
W/ inferior costal demifacet on thoracic vertebral body ONE numeric segment SUPERIOR
What does the inferior articular facet of the Head of a typical rib articular with?
Articulates w/ superior costal demifacet on thoracic vertebral body of SAME numeric segment
What are the 2 parts to the Tubercle of a Typical rib?
What do these parts articulate with?
Articular facet - articulates w/ transverse costal facets on thoracic vertebrae
Non-articular part - attachment point for Lateral Costotransverse L.
What does the Costal Groove of the BOdy of a Typical Rib house?
Intercostal nerve and vessels
What is the Costal angle of the body of a Typical rib?
It is the anterolateral turning point of the rib
What are the features unique to Rib 1?
Broad, flat, and wider
Most sharply curved
Head
Scalene tubercle
Groove for the subclavian a.
Groove for the Subclavian v.
The heads of atypical ribs have how many facets?
One
What is the role of the Scalene tubercle of Rib 1?
Insertion point for ANterior scalenes M.
Where is the groove for the subclavian a. In relation to the groove for the subclavian v.
Groove for the Subclavian A. Is POSTERIOR to the v. Groove
Is rib 1 or rib 2 longer?
Rib 2
What is the feature unique to rib 2?
Role?
Tuberosity of Serratus anterior m.
-insertion for serratus anterior m.
What are the unique features of ribs 11 and 12?
Short and do NOT attach to sternum
Does NOT have tubercle or neck
Which ribs are most commonly fractured?
Where?
Middle ribs
@ weakest locus, just anterior to costal angle
What are the consequences of a rib fracture?
Can damage internal organs and produce severe pain w/ respiration, coughing, laughing, and sneezing
What are supernumerary ribs?
Extra ribs in cervical or lumbar region
What are the consequences of supernumerary cervical ribs?
- Typically produce no sxs
* Can produce neural and circulatory problems based on their proximity to the brachial plexus and subclavian A.
What are the consequences of a supernumerary lumbar rib?
- Typically produce no sxs
* Can result in confusion when reading radiographs and other diagnostic images
What does the vertebral body of thoracic vertebrae articular w/?
What features are found on it?
- Articulates w/ 12 ribs
* Superior and Inferior costal facet
What is the role of the vertebral foramen of the thoracic vertebrae?
Transmits spinal cord
What makes up the vertebral arch of the thoracic vertebrae?
Pedicle
Lamina
What is unique about hte spinous process of thoracic vertebrae?
Big going down
The transverse processes of thoracic vertebrae have what unique feature?
Transverse costal facet
What does the superior articular process of thoracic vertebrae articulate with?
W/ inferior articular process of vertebral segment ABOVE
What does the Inferior articular process of thoracic vertebrae articulate with?
W/ superior articular process of vertebral segment BELOW
What 2 vertebrae would articulate w/ Rib 6?
Inferior costal facet of T5
Superior costal facet of T6
How are the ribs connected to the sternum?
Via costal cartilages
connect the anterior portion of ribs to sternum
How is the costal cartilages of ribs 1-7?
Individually connect ribs to sternum
How do ribs 8-10 utilize costal cartilages?
Articular w/ the costal cartilage SUPERIOR to them before articulating w/ sternum
What type of joint is the costovertebral joint?
Synovial planar
What is the costovertebral joint?
Where ribs meet up with vertebrae
What are the components of the costovertebral joint?
Radiate l.
Intraarticular l.
Articular capsule
What does the radiate L. Of the costovertebral joint do?
Connects head of rib to vertebral body
What does the Intraarticular L. Of the Costovertebral joint do?
Connects head of rib to the intervertebral disc
Where is the articular capsule strongest?
Strongest anteriorly as the Radiate L.
What does the articular facet of the costal tubercle articulate w?
W/ same numeric thoracic vertebral segment
What are the 2 forms of movement capable of the Costovertebral joint?
- Bucket handle movement
2. Pump handle movement
What is the “buckle handle movement” of the Costovertebral joint?
What will it do?
Elevation of the lateral most portion of the rib
Increase transverse diameter of the thorax
What is the “pump handle movement” of the Costovertebral joint?
What will it do?
Elevation of the sternal end of rib
Increases anterior to posterior diameter of the Thorax
What is the function of the movement performed by the costovertebral joint?
Increase thoracic volume
Thereby decreasing thoracic pressure
Producing inspiration
What is the joint classification of the Manubriosternal joint?
Cartilagenous symphysis joint
What are the unique features of the Manubriosternal joint?
Sternal angel of Louis
2nd costal notch
What is the joint classification of the Xyphisternal joint?
Why is this unique
Cartilagenous Synchondrosis joint
Usually this hyaline cartilage joint is temporary
What makes up the Xyphisternal joint?
Inferior limit of thorax
7th costal notch
What is the Sternocostal joint?
Junction of costal cartilages w/ sternum
What is the joint classification for
Rib 1’s sternocostal joint
Synchondrosis Cartilagenous joint
What is the joint classification of
Rib 2-7’s sternocostal joint?
What L.s are involved?
Synovial planar
Anterior radiate sternocostal L.
posterior radiate sternocostal L.
What is the Costotransverse joint?
Joint formed between..
the facet of the tubercle of the rib
and
the adjacent transverse process of a thoracic vertebrae
What is the classification of the Costotransverse joint?
Synovial planar
What are the ligaments involved int he Costotransverse joint?
Lateral Costotransverse l.
Superior Costotransverse L.
Where is the Lateral Costotransverse L. Found?
From tubercle of the rib to the TP
Where is the ASuperior Costotransverse L. Found?
From Neck of rib to TP one segement ABOVE
What is the costochondral joint?
Articulation b/w the ribs and costal cartilages
What is the classification of the costochondral joint?
Synchondrosis joint
Where are the interchondral joint?
Between costal cartilages of
6-7
7-8
8-9
9-10
What is the classification of the interchondral joints from costal cartilages 6-9?
Synovial planar
What is the classification of the interchondral joints from costal cartilages 9-10?
Fibrous joint
(Usually bone-fibrous CT-bone) but oh well
What is the ligament found in the interchondral joint?
Function?
Interchondral l.
Strengthens the interchondral joint
What are the joints found in the thoracic vertebrae?
Intervertebral joint
Zygapophyseal joint
What is the classification of the intervertebral joint of the THoracic vertebrae
Where is it?
Symphysis
B/w bodies where that intervertebral disc is
What is the classification of the zygapophyseal joint of the THoracic vertebrae
Where is it?
Planar synovial
What are the Ls. Found in the thoracic vertebrae joints?
Anterior longitudinal l.
Posterior longitudinal l.
Ligamentous flavum
Interspinous l.
Intertransverse l.
Supraspinous l.
Intervertebral discs w/ annulus fibrosis and nucleus pulposus
Where is the anterior longitudinal l. Of the thoracic vertebrae?
On anterior surface of vertebral bodies
Where is the posterior longitudinal l. Of the thoracic vertebrae?
On posteiror surface of the vertebral bodies inside the vertebral canal
Where is the Ligamentous Flavum Of the thoracic vertebrae?
Pale yellow fibers on back surfaces of vertebral laminae inside the vertebral canal
Where is the interspinous l. Of the thoracic vertebrae?
B/w adjacent SPs
Where is the Intertransverse l. Of the thoracic vertebrae?
Exist as fibrous cords in the Thoracic regions b/w TPs
Where is the Supraspinatus l. Of the thoracic vertebrae?
On back surface of SPs
What is the annulus fibrosis
Tough fibrous other region of the intervertebral disc
What is the nucleus pulposus?
Soft gelatinous inner portion of the intervertebral discs
What is a rib dislocation?
Dislocation at the Sternocostal joint
What is a rib separation?
Separation at costochondral joint
How many pairs of
External Intercostal M.
Are there?
11 pairs
How many pairs of
internal Intercostal M.
Are there?
11 Paris
How many pairs of
Innermost Intercostal M.
Are there?
11 pairs
What will replace the External Intercostal M. Fibers ANTERIORLY?
What will this overlie
Fibers replaced by External Intercostal Membrane
Will overlie the internal intercostal m.
What is the External Intercostal M. Continuous with INFERIORLY?
W/ the External Abdominal Oblique m.
What is the O and I and N of the External Intercostal M.?
O: inferior border of ribs posteriorly
I: superior border of ribs below anteriorly
N: intercostal n.
What is the action of the External intercostal m.?
Elevate ribs
What will replace the
INTERNAL Intercostal M. Fibers POSTERIORLY?
M. Fibers replaced by INternal Intercostal Membrane
Where is the internal intercostal membrane visible?
In posterior mediastinum immediately lateral to the vertebral column
What is the Internal Intercostal M. Continuous with inferiorly?
W/ internal abdominal oblique m.
What is the O and I and N of the internal intercostal M.?
O: inferior border of the ribs anteriorly
I: superior border of ribs posteriorly
N: intercostal n.
What is the action of the
Internal Intercostal M. ?
Depress ribs
W/ interchondral part elevating rib
How are the innermost intercostal ms. Separated from eh Internal intercostal Ms?
By the intercostal nerve and vessels
They are the deepest fibers
If you can see bundle of intercostalnerve and vessels, what will be there?
Innermost intercostal M. Will NOT be there
What is the O and I and N of the innermost intercostal ms.?
O: inferior border of ribs
I: superior border of ribs below
N: intercostal n.
What is the action of the innermost intercostal ms.?
Undetermined
Probably same as internal intercostal m.
To depress ribs
What is the O and I and N of the Transverse Thoracic M.?
O: posterior surface of lower sternal body and xyphoid process
I: internal surface of 2nd-6th costal cartilages
N: intercostal n.
What is the action of the transverse thoracic m.?
Depress ribs
Where do you typically see the subcostal ms?
Appear over the innermost intercostal m. On the internal surface of the posteiror thoracic wall
(Near the angles of the ribs)
What is the O and I and N of the Subcostal M.?
O: inferior border of rib
I: superior border of rib (1-2 segment above)
N: intercostal n.
What is the action o the subcostal m.?
Act as internal intercostal ms. To
Depress ribs
What is a thoracentesis procedure?
- Insertion of a hypodermic needle thru the intercostal musculature b/w ribs to obtain a fluid sample or drain small amts. of blood or fluids from Pleural Cavity
- Needle inserted b/w ribs inferior to the intercostal Neurovascular bundle and superior to the collateral branches
What is a Chest tube placement procedure?
Where is it typically performed?
◦ Insertion of a tube to remove large amts. of air, fluid blood or pus from the Plerual cavity
◦ Typically inserted in 5th or 6th intercostal space
What is a thoroscopy?
◦ Insertion of a Thoroscope into the Plerual cavity thru small incisions for visualizing and biopsying the space inside the Pleural cavity
What is another name for the External intercostal membrane?
Anteiror intercostal membrane
What is another name for the internal intercostal membrane?
Posterior intercostal membrane
