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DPT Anatomy > Thoracic Skeleton, Ventilation & Thoracic Wall > Flashcards

Thoracic Skeleton, Ventilation & Thoracic Wall Flashcards

1
Q

What is the function of the thoracic skeleton?

A
  • attachment for upper limb muscles (bony landmarks)
  • protection and landmarks to the underlying viscera of the thorax (heart & lungs) and superior abdominal cavity
  • openings for communication with superior and inferior region (aperatures)
  • movement for respiration (ribs)
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2
Q

What 3 bones make up the sternum?

A

Manubrium
Body
Xiphoid process

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3
Q

What internal structures make up the sternal angle?

A

superior and inferior mediastinum

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4
Q

Where is the sternal angle found in the transverse thoracic plane?

A

between T4 & T5

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5
Q

Where is the sternocostal joint?

A

Between the sternum and the costal cartilage

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6
Q

where is the costochondral joint?

A

between the costal cartilage and the ribs

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7
Q

what is the function of costal cartilage?

A

increases elasticity of the structure

better for movement

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8
Q

What are the true ribs?

A

Ribs 1-7

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9
Q

What are the false ribs?

A

ribs 8-10 (attaches to the superior costal cartilage)

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10
Q

what are the floating ribs?

A

ribs 11 & 12 (attaches to T11 and T12 vertebral bodies)

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11
Q

Where is the costal margin located?

A

inferior boundary anterior thoracic wall

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12
Q

what does the costal margin do?

A

attachment for diaphragm and abdominal wall muscles

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13
Q

Where is the costovertebral joints located?

A

between the vertebral body and rib (costal facet)

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14
Q

where is the costotransverse joint located?

A

between the tubercle of rib with the transverse process

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15
Q

What does the tubercle of rib 5 articulate with?

A
  • transverse process of T5
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16
Q

What is the relationship between the rib and vertebral body?

A

number rib attaches to same number vertebral body

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17
Q

What does the head of rib 5 articulate with?

A

superior costal facet of T4
interior costal facet of T5
T4/T5 intervertebral disc

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18
Q

what is unique about the 1st rib?

A

only has one articulation - T1 vertebrae

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19
Q

where is the costal groove located and why is it significant?

A

located on inferior border of rib and the intercostal neurovascular bundle can be found here

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20
Q

what is the weakest part of the rib?

A

anterior to the angle - many trauma related fractures occur here

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21
Q

why are rib fractures painful?

A
  • can puncture the lining resulting in pneumothorax

- neurovascular bundle is located within the costal groove

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22
Q

what is the order of the neurovascular bundle?

A

rib –> thoracic wall
Vein
Artery
Nerve

[muscle]

Nerve
Artery
Vein
(rib)

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23
Q

describe the location of the superior thoracic aperature

A

1st rib, T1 vertebra, jugular notch of sternum

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24
Q

describe the passageway for vital structures in and out of the thoracic cavity to the superior thoracic aperature

A

thoracic cavity neck

thoracic cavity upper limb

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25
Q

describe the passageway for vital structures in and out of the thoracic cavity to the inferior thoracic aperture

A

thoracic cavity abdominal cavity

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26
Q

describe the location of the inferior thoracic aperature

A

enclosed by the diaphragm

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27
Q

during inhalation and exhalation, how do the structures move?

A

everything moves up and down together

28
Q

What happens to the thoracic skeleton during inhalation?

A

volume increases
pressure decreases
ribs move up and out
diaphragm flattens

29
Q

what happens to the thoracic cavity during exhalation?

A

volume decreases
pressure increases
ribs fall
diaphragm moves up

30
Q

what nerve innervates the diaphragm?

A

phrenic nerve (C3, C4, C5)

31
Q

where does the diaphragm sit at the right dome?

A

liver inferior

level of the 5th rib at rest

32
Q

where does the diaphragm sit at the left dome?

A

stomach and spleen inferior

level of the 5th intercostal space at rest

33
Q

what is the superior attachment of the diaphragm?

A

central tendon

34
Q

what are the functions of the diaphragm?

A
  • separates thoracic cavity and abdominal cavity
  • encloses inferior thoracic aperture
  • primary muscle for ventilation
35
Q

what are the inferior attachments to the diaphragm?

A
  • xiphoid process of sternum
  • costal margin
  • ends of ribs 11 and 12
  • arcuate ligaments across posterior wall
  • lumbar vertebrae
36
Q

What major structure passes through the caval opening/vena caval hiatus and at what level?

A

Inferior vena cava

Level T8

37
Q

what major structure passes through the esophageal hiatus and at what level?

A

Esophagus

Level T10

38
Q

what major structure passes through the aortic hiatus and at what level?

A

thoracic aorta

level T12

39
Q

what other structures pass through the caval opening?

A

right phrenic nerve

40
Q

what other structures pass through the esophageal hiatus?

A

vagal trunks

41
Q

what other structures pass through the aortic hiatus?

A

azygos vein
thoracic duct
sympathetic trunks

42
Q

what are the accessory muscles used in forced inspiration?

A 
external intercostals
neck muscles (sternocleidomastoid and scalene group)
43
Q

what are the accessory muscles of expiration?

A 
internal intercostals
abdominal muscles (external oblique and rectus abdominus)
44
Q

name the thoracic wall muscles

A 
pec major
pec minor
serratus anterior
sternocleidomastoid
anterior, middle, posterior scalenes
external oblique
rectus abdominus
45
Q

name the true muscles of thoracic wall (muscles directly on the ribs)

A

transversus thoracis
subcostal (found in between each rib)
serratus posterior superior and inferior
levatores costarum longus and brevis

46
Q

what are the functions of the intercostal muscles?

A
  • maintain structure of thoracic wall
  • rib movement during respiration
  • inner layers enclose neurovascular bundle
47
Q

what does the external intercostal layer do and what way does the fibers run?

A
  • elevates ribs during inspiration

- fibers run hands in pockets

48
Q

where is the external intercostal membrane located?

A

sternum anteriorly

49
Q

what does the internal intercostal muscles do and which way does the fibers run?

A
  • depress ribs during exhalation

- “oh my” muscle fiber direction

50
Q

where is the internal intercostal membrane located?

A

vertebral bodies posteriorly

51
Q

which intercostal muscle layer is the most deep and has same fiber direction as the internal layer?

A

innermost intercostal muscles

52
Q

between which layers are the intercostal vein, artery and nerve found?

A

between internal and innermost layers - innermost does not have intercostal membrane

53
Q

describe the posterior intercostal vein system

A

posterior intercostal veins drain into azygos vein
accessory hemi-azygos vein and hemi-azygos vein drain into azygos vein
azygos vein drains into the superior vena cava
superior vena cava branches to the right and left brachiocephalic veins

54
Q

at superior levels where does the posterior intercostal veins sometimes drain into?

A

straight into the brachiocephalic vein

55
Q

describe the anterior vein drainage

A

anterior intercostal veins drain into internal thoracic veins
internal thoracic veins drain into brachiocephalic veins

56
Q

which two main sources does the intercostal arteries originate from?

A

subclavian artery

thoracic aorta

57
Q

describe the anterior drainage from the subclavian artery

A

suclavian artery supplies blood to the internal thoracic artery
internal thoracic artery supplies blood to anterior intercostal arteries

58
Q

describe the posterior blood supply of the subclavian artery

A

subclavian artery supplies blood to costocervical trunk

costocervical trunk supplies blood to 1st and 2nd posterior intercostal arteries

59
Q

describe the blood supply from the thoracic aorta

A

thoracic aorta supplies blood to posterior intercostal arteries (T3-T11) AND subcostal artery (T12)

60
Q

where do the intercostal and subcostal nerves arise from?

A

anterior rami of thoracic spinal nerves

61
Q

describe the pathway of the intercostal nerve

A

intercostal nerve –> lateral cutaneous branch –> anterior cutaneous branch

62
Q

what is the motor innervation of the intercostal nerve?

A

intercostal mm
transversus thoracis mm
subcostal mm
rectus abdominus and external oblique (abdominal wall muscles)

63
Q

what is the sensory innervation for the intercostal nerves?

A

skin at each thoracic nerve level (dermatomes)
- can overlap 1-2 dermatome levels
lower thoracic nerves (T6-T11) and subcostal nerve cross the costal margin

64
Q

what does sympathetic innervation in the periphery do?

A
  • activate sweat glands
  • cause hair follicles to stand on end
  • vasoconstricts blood vessels in the skin
65
Q

what is involved in the sympathetic pathway?

A

sympathetic chain - will see its location in the posterior mediastinum

DPT Anatomy (8 decks)

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