Thoracic Wall 1 Flashcards
Give 5 functions of the thorax
Protection of organs, rigidity and elasticity, attachment for muscles (which allow locomotion), haematopoiesis and respiration
Describe the shape of the thorax
Truncated cone
Name the components of the thoracic cage
Sternum, 12 pairs of ribs + CCs, 12 thoracic vertebrae and intervertebral discs
Name the components of the thoracic wall
Thoracic cage, skin, subcutaneous tissue, thoracic muscles, fascia, muscles between ribs (3 layers) (+ mammary gland/breast tissue in females)
How do posterior and anterior ribs appear on an X-ray?
Posterior = transverse Anterior = oblique
How does the sagittal and transverse diameter of the thorax differ?
Transverse > sagittal
What is the function of thoracic vertebrae?
Rotation but no flexion
What are true ribs?
Ribs 1-7 that articulate directly to the sternum
What are false ribs?
Ribs 8-10 that articulate indirectly with the sternum through the CC of rib 7
What are floating ribs?
Ribs 11-12 that don’t articulate with the sternum
Give the function of this aspect of the rib: Head
Articulates with body of vertebrae
Give the function of this aspect of the rib: Neck
Neck region between head and tubercle
Give the function of this aspect of the rib: Costal angle
Attachment for deep back muscles
Give the function of this aspect of the rib: costal groove
Protects neurovascular bundle
Give the function of this aspect of the rib: Tubercle
Articulates with transverse process of thoracic vertebrae
Give the function of this aspect of the rib: body
Shaft of the rib (protective)
Where is the costal groove located?
On the inner surface of the body close to the inferior border
Give the main features of #1 rib (atypical)
- scalene tubercle
- groove for subclavian vein, artery and inferior trunk of brachial plexus
- single fact = only articulates with T1
- No costal groove
Give the main features of floating ribs – #11-12
Heads articulate only with corresponding vertebra and don’t articulate with transverse processes
What muscle attaches to the tuberosity on #2 rib
serrates anterior
What 3 bones form the sternum
Manubrium, body and xiphoid process
What 5 landmarks are located in the sternal angle?
- 2nd CC
- intervertebral disc between T4 and T5
- proximal and distal boundaries of aortic arch
- bifurcation of trachea
- superior limit of the pulmonary trunk
What dermatome is the solar plexus region located?
T6 dermatome
What bone in the thoracic cage is a site for bone marrow aspiration?
sternum
What joint articulates with the rib’s costal facets and vertebrae? And what ribs are exempt to this?
Costovertebral joint; 1, 11 and 12
What type of joint is the costovertebral joint?
Synovial
What is the costotransverse joint?
Joint between tubercle of rib (except 11 and 12) and the transverse process of the corresponding vertebra
What ribs have curved facets?
1-7
What movement does curved facets allow?
rotatory movement
What ribs have flat facets?
8-10
What movement does flat facets allow?
gliding movement
What is the costochondral joint?
Articulation between rib and costal cartilage
What is the direction of CC 1-4?
horizontal
What is the direction of CC 5-10?
oblique
What binds the thoracic inlet (superior aperture)?
T1, 1st rib, CC and manubrium
Describe the orientation of the thoracic inlet
Slopes antero-inferiorly from the transverse plane
Where are the lungs situated in the thoracic inlet?
Apex of the lung extends 2-3cm above the anterior part of the 1st rib and clavicle
Name the 5 structures that pass between the thorax and neck
- Vessels that supply and drain the head and neck
- trachea
- oesophagus
- vagus and recurrent laryngeal nerves
- phrenic nerves
What binds the thoracic outlet?
Bound by T12, 11th + 12th ribs, costal cartilages of ribs 7-10 (costal margin, costal arch) and xiphoid process
What is a breast?
An accessory gland consisting of mammary glands, skin and connective tissue **Modified sweat gland
Nipple
Small projection in which the mammary ducts of females terminate, and milk can be secreted
Areola
Ring of pigmented skin surrounding the nipple
Montgomery tubercle
Visible portions of areolar glands on the skin
Where is the breast located in adult females?
2nd-6th/7th rib, lateral border of sternum to mid-axillary line, upper lateral portion may extend towards axilla
Between what layers is the breast found?
Between superficial and deep layers of fascia
What muscles does the breast sit on?
Pectoralis major, serratus anterior, external oblique muscles
What name is given to the suspensory ligaments of the breast and what is their function?
Cooper’s ligaments; connect deep fascia to the dermis of the skin and support the breast
What is the retromammary space?
Layer of loose CT between the deep layer of superficial fascia and deep fascia
What branches from the internal thoracic artery?
Mammary branches and anterior intercostal arteries
What branches from the axillary artery?
Lateral thoracic and thoraco-acromial branches
Where does each of these regions of the breast drain to: Areola and lateral quadrants
Axillary lymph nodes
Where does each of these regions of the breast drain to: medial quadrants
Parasternal lymph nodes and opposite side of the breast
Where does each of these regions of the breast drain to: inferior quadrants
Inferior phrenic lymph nodes
What does NAC stand for?
Nipple areola complex
