Thoracic Wall 1 Flashcards
The thoracic cage is formed by ___ pairs of
ribs, the _____, _____ cartilages, and 12 _____ vertebrae.
12; sternum; costal; thoracic
The part of the rib that attaches to the sternum is (osseous or cartilaginous)?
Cartilaginous
What are the functions of the thoracic wall? (3)
- PROTECTION of contents in the thoracic cavity and upper abdominal cavity.
- RESPIRATION
- ATTACHMENT for skin, fascia, and overlying muscles of the neck, thorax, upper limbs, abdomen, and back.
What are the ANTERIOR boundaries of thoracic cage? (2)
Sternum and costal cartilages
What is the LATERAL boundaries of thoracic cage?
RIBS
What are the POSTERIOR boundaries of thoracic cage? (2)
Thoracic vertebrae and IV discs
Communication occurs between the thoracic cavity, the neck and the abdomen is through the _____ and _____ thoracic apertures, respectively.
superior; inferior
Superior Thoracic Aperture (thoracic inlet) is bounded by ___, the ___ ribs plus their cartilages and the _____ border of the
manubrium.
T1; 1st; superior
Trachea, esophagus, nerves and blood vessels that either supply or drain the head, neck and upper extremities ALL PASS THROUGH what structure?
Superior thoracic aperture (thoracic inlet)
Inferior Thoracic Aperture (thoracic outlet) is bounded by ___, the ___ and ___ pairs of ribs, costal cartilages of ribs _ - _ and the _____
joint.
T12; 11th; 12th; 7-10; xiphisternal
Which thoracic aperture is more spacious, superior or inferior?
Inferior
Which thoracic aperture is CLOSED BY THE DIAPHRAGM separating the thorax from the abdomen?
Inferior
Structures pass to and from the thorax to the abdomen travels through which 3 openings?
- Esophageal Hiatus
- Aortic Hiatus
- Inferior Vena Caval Hiatus
Esophageal Hiatus is located at which vertebral level?
T10 (“I Eat Asparagus”: T8, T10, T12)
Aortic Hiatus is located at which vertebral level?
T12 (“I Eat Asparagus”: T8, T10, T12)
Inferior Vena Caval Hiatus is located at which vertebral level?
T8 (“I Eat Asparagus”: T8, T10, T12)
Twigs of RIGHT PHRENIC NERVE travels through which hiatus?
Inferior Vena Caval Hiatus (T8)
Anterior and Posterior Vagal Trunk travels through which hiatus?
Esophageal Hiatus (T10)
Thoracic Duct travels through which hiatus?
Aortic Hiatus (T12)
Twigs of the Right Phrenic Nerve carries what type of information?
Somatic sensory
Twigs of the Right Phrenic Nerve provides somatic sensory to _____ _____ abdominal wall under the diaphragm.
Superior posterior
Pain within the superior posterior abdominal wall will be referred to which body part?
Shoulder
Typical THORACIC vertebrae have vertebral arches and __ processes for muscular and articular attachments.
7
Special features of THORACIC VERTEBRAE:
-Long, _____ angled spinous processes.
-Costal facets on the _____ transverse processes (except the last 2 or 3 thoracic vertebrae).
-2 _____ located laterally on the bodies of T2-T9
vertebrae.
- Inferiorly
- Anterior
- Demifacets
THORACIC VERTEBRAE: The _____ demifacet articulates with the head the rib of the same number.
Superior
The inferior demifacet articulates with the head of the rib _____ to it (higher number).
Inferior
Spinous process of T6 is at which vertebral (body) level?
T7 (Projects inferiorly)
- Which thoracic vertebrae are TYPICAL?
- Which ribs are TYPICAL?
T2-T9 (Has uniform structures)
Ribs 3-9
Which ribs are considered as “True Rib”?
Ribs 1-7 (Each rib will articulate the sternum individually)
Which ribs are considered as “False Ribs”?
Ribs 8-10 (These ribs share ONE costochondral joint)
Which ribs are considered as “Floating Ribs”?
Ribs 11-12 (Does NOT attach to the sternum)
__ vertebrae has only a single costal facet for the 1st rib and a
demifacet for the superior part of the head of the _____ rib on each side of the body.
T1; second
T10 has a costal facet that is partly on its _____ and partly on its _____, plus a demifacet on each side of the body.
body; pedicle
Does T10 have Inferior demifacet?
NO
T11 and T12 only have one _____ facet on each side, on the pedicles.
Costal
Which part of the rib is prone to fracture?
Angle of rib
What are the typical VERTEBRAS?
T2-T9
What are the typical RIBS?
Ribs 3-9
_____ articular facet of the rib head articulates with the vertebra of the same number as rib.
Inferior
The superior articular facet of the rib head articulates with the vertebra _____ (lower number).
above
Crest of the rib HEAD attaches to the _____ ligament at most of the costovertebral joints.
Intra-articular ligament
Crest of the rib NECK is the point of attachment for the _____ _____ ligament.
superior costotransverse ligament
The Tubercle of the rib articulates with which part of the vertebra?
Transverse costal facet
The Tubercle of the rib has an attachment site for _____ _____ ligaments.
Lateral costotransverse ligaments
The Tubercle of the rib articulates with the _____ vertebra.
same numbered
What is the DEPRESSION of the costal margin of the rib shaft called?
Costal groove
Costal groove shelters what structures? (3)
Intercostal vein, artery and nerve
What structure begins at the cup for the costal cartilage (anterior end of rib) and end at their sternal attachment?
Costal cartilages
The costal cartilages _____ in length through the first seven ribs and then gradually _____ after the first seven.
Increase; decrease
ATYPICAL RIBS- 1st rib:
Has an insertion for which 2 muscles?
Anterior scalene and middle scalene muscles
ATYPICAL RIBS- 1st rib:
Has a single facet for articulation with only the __ vertebra.
T1
ATYPICAL RIBS- 2nd rib:
Possesses tubercle for origin of which muscle?
Serratus anterior muscle
ATYPICAL RIBS- 2nd rib:
Which muscle will insert here just medial to serratus anterior muscle?
Posterior scalene muscle
The typical rib takes a _____ slope and then the cartilage takes an _____ slope.
downward; upward
Which rib slopes downward throughout its entire course?
1st rib
The sternal end of each arch lies at a _____ level than the vertebral end.
lower
Both ribs and cartilages _____ in length progressively from the 1st to the 7th.
Increase
Sternum is made up by 3 bones and 2 joints, what are they?
- Bones: Manubrium, Body of sternum, and xiphoid process.
- Joints: Manubriosternal joint, and xiphisternal joint
Manubrium is at the level of of the bodies
of ___ and ___ vertebrae.
T3 and T4
Jugular notch (suprasternal notch) Clavicular notches are part of which structure?
Manubrium
What is the joint classification of the 1st rib articulating with the manubrium? (Odd ball)
Sternocostal SYNCONDROSIS joint
How many sternebra (gap between each rib attachment) does the sternum body have?
4
Sternum body is located at what vertebrae levels?
T5-T9 (9-5=4 sternebra)
The body of sternum is usually _____ and _____ in females than in males.
shorter; thinner
What is the classification of Manubriosternal joint?
Secondary Cartilaginous joint
What is the classification of Xiphisternal joint?
Primary cartilaginous joint
What is Comminuted fracture?
When the sternum is broken into pieces.
Most common site of sternal fracture is at the _____ _____.
Sternal angle (Angle of Luis)
Mammary buds develop during the ___ week.
6th
Only the _____ _____ ducts are formed at birth and the mammary glands remain underdeveloped until puberty.
main lactiferous
The fibrous connective tissue and fat of the mammary gland develop from the surrounding _____. (Embryologically)
Mesenchyme
Excessive development of the male mammary tissue is known as?
Gynecomastia
An extra breast (polymastia) or nipple (polythelia) occurs in
about 1% of the female population. This is known as?
Supernumerary breasts and nipples
Mammary glands are a modified and highly specialized type of _____ glands.
sweat
Female breast: 2/3 rests on _____ _____fascia; 1/3 on fascia
covering the _____ _____.
deep pectoral; serratus anterior
Between the breast and deep pectoral fascia is a loose connective tissue plane. What is this space known as?
Retromammary space
The areola contains numerous _____ glands known as areolar glands or glands of Montgomery.
sebaceous (oil producing)
Nipple (papilla mammae):
- Lactiferous ducts open into the tips.
- Mostly composed of circularly arranged _____ _____ fibers.
smooth muscle
A LOBULE is a functional unit of the breast tissue which is drained by a single _____ duct and is separated from other lobules by suspensory ligaments.
lactiferous
The ENLARGEMENT of the lactiferous duct proximal to its exit onto the papilla mammae. This structure is known as?
Lactiferous sinus
FIBROUS BANDS which connect the skin overlying the breast with the superficial fascia, thus separating the glandular tissue into 15- 20 lobules. This structure is known as?
Suspensory ligaments (of Cooper)
What is the innervation to the breast tissue?
4th to 6th intercostal nerves
Most lymph from the breast drains to the _____ lymph nodes, initially to the PECTORAL (anterior) nodes.
AXILLARY
The remaining lymph, particularly from the
medial quadrants, drains to the _____ nodes or to the OPPOSITE breast.
PARASTERNAL
Lymph from the lower quadrants pass deeply to the _____ _____(abdominal) nodes.
INFERIOR PHRENIC