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Anatomy Exam 2 > Thoracic Wall > Flashcards

Thoracic Wall Flashcards

1
Q

What is the thorax

A

The part of the body between the neck and the abdomen

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2
Q

what does the thorax include?

A

includes the cavity enclosed by the ribs, sternum, and dorsal vertebrae & contains the chief organs of circulation and respiration; the chest.

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3
Q

Mediastinum

A

central compartment

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4
Q

Shape of the thoracic skeleton

A
  • shape of a dome, birdcage or a truncated cone
  • narrowest superiorly with circumference increasing inferiorly
  • relatively thin-walled
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5
Q

what is convex superiorly?

A

floor in the respiratory diaphragm

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6
Q

Normal adult chest

A

no structural deformities or visible retraction

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7
Q

barrel chest

A

increased anteroposterior diameter

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8
Q

functions of the thorax (4)

A
  1. Protect vital thoracic/abdominal organs from external forces.
  2. Resist the negative internal pressure created by the elastic recoil of the lungs.
  3. Provide attachments for and support the weight of the upper limbs.
  4. Provide the origin for some upper limb muscles and attachments for muscles of the abdomen, neck, back & respiration.
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9
Q

3 types of ribs

A
  1. True
  2. False
  3. Floating
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10
Q

True ribs

A

1-7 attach vertebrae to sternum

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11
Q

False ribs

A

8-10 have cartilages attached to the cartilages of ribs superior (not attached to sternum)

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12
Q

Floating ribs

A

11-12 have cartilages ending in the posterior abdominal wall musculature

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13
Q

what do cartilages 7-10 form?

A

infrasternal angle

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14
Q

how are ribs and costal cartilage separated?

A

intercostal space

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15
Q

Superior thoracic aperture

A

(= thoracic outlet or inlet)

bounded by 1st thoracic vertebra, 1st pair of ribs, and superior border of manubrium

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16
Q

Inferior thoracic aperture

A

closed by diaphragm, structures must pass through the diaphragm or behind it

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17
Q

Rib osteology

A
  • head
  • neck
  • tubercle
  • angle
  • costal groove (intercostal vessels)
  • body or shaft
  • sternal end
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18
Q

What does articular facets of head articulate with?

A

with inferior and superior costal facets of adjacent thoracic vertebrae

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19
Q

what does articular facet of tubercle articulate with?

A

with costal facets of transverse process of vertebrae of same #

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20
Q

Costal groove is known as what?

A

intercostal vessels; runs along the inferior line of the rib

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21
Q

supernumerary ribs

A

of ribs is increased by the presnece of cervical and/ or lumbar ribs, or decreased by the failure of the 12th to form

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22
Q

cervical ribs

A

relatively common and may interfere with neurovascular structures exiting the superior thoracic aperture

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23
Q

thoracic outlet syndrome

A

group of disorders that occur when there is a compression, injury, or irritation of the brachial plexus and/ or subclavian vessels in the lower neck and upper chest

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24
Q

What are the 3 parts that make up the sternum?

A
  1. manubrium
  2. body
  3. xiphoid process
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25
Q

what are the 3 areas of the manubrium?

A
  1. Jugular notch
  2. Clavicular notch
  3. notch for 1st costal cartilage
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26
Q

body

A

notches for costal cartilages

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27
Q

what 2 things can become a synostosis

A

fusion of manubriosternal and xiphisternal joints

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28
Q

sternal cleft =(sternal foramen)

A

failure of fusion between halves of the sternal bars

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29
Q

cardiac tamponade

A

=pericardial tamponade

  • type of pericardial effusion where fluid, pus, blood, clots, or gas accumulates in the pericardium
  • results: slow or rapid compression of heart
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30
Q

Chest wall deformities

A
  1. Pectus carinatum
  2. pectus excavatum
  3. sternal cleft
  4. cleft sternum
  5. poland syndrome
  6. rare lesions (ectopia cordis)
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31
Q

pectus carinatum

A
  • abnormal development causing sternum to protrude
  • seen at birth or adolescent males
  • may occurs as a solitary congenital abnormality or in association with other genetic disorders or syndromes
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32
Q

pectus excavatum

A
  • ” funnel chest”
  • abnormal development of rib cage in which the sternum grows inward
  • cause is unknown
33
Q

sternal cleft

A
  • sternum come together but do NOT fuse

- treatment: magnet correction where a magnet is placed on the sternum and on a shift to help reposition the sternum

34
Q

poland syndrome

A

deformability of chest wall pectoralis muscle

35
Q

Ectopia cordis

A

= rare lesions

- heart is out of the thorax

36
Q

Congenital scoliosis

A

Caused by a bone abnormality present at birth.

37
Q

Neuromuscular scoliosis

A

A result of abnormal muscles or nerves. Frequently seen in people with spina bifida or cerebral palsy or in those with various conditions that are accompanied by, or result in, paralysis.

38
Q

Degenerative scoliosis

A

may result from traumatic bone collapse, previous major back surgery, or osteoporosis.

39
Q

Idiopathic scoliosis

A

most common type of scoliosis, idiopathic scoliosis, has no specific identifiable cause. There are many theories, but none have been found to be conclusive. There is, however, strong evidence that idiopathic scoliosis is inherited.

40
Q

types of joints

A
  1. costotransverse
  2. costochondral
  3. interchondral
  4. sternocostal
41
Q

costotransverse joints

A

▪Upper ribs (1-7) rotate
▪Lower ribs (8-10) glide
▪Ribs 11 and 12 do not articulate with transverse processes.

42
Q

costochondral joints

A

▪Primary cartilaginous joints and no movement.

43
Q

interchondral joints

A

▪Some plane synovial joints (b/t costal cartilages 6-9).

▪Some fibrous (b/t cartilages 9& 10).

44
Q

sternocostal joints

A
  • 1st joint is cartilaginous

- joints 2-7 are synovial plant joint

45
Q

intercostal muscles

A
  • function during respiration

- occupy intercostal spaces

46
Q

what do intercostal muscles include?

A
  • external
  • internal
  • innermost
  • subcostal
  • transversus thoracis
47
Q

external intercostal

A
  • attach superiorly to the inferior border of the rib above and inferiorly to the superior border of the rib below.
  • Fibers run infero-anteriorly.
  • Function to elevate ribs during forced inspiration.
48
Q

Internal & Innermost intercostals

A

▪Attach superiorly to the inferior border of the rib above and inferiorly to the superior rib below. Fibers run inferoposteriorly.
▪functions to depress the ribs during forced respiration.

49
Q

what separates Internal & Innermost intercostals

A

intercostal neurovascular bundle

50
Q

subcostalis

A

▪Attach superiorly to internal surfaces of lower ribs near their angles and inferiorly to superior borders of ribs 2 or 3 levels below.
▪Fibers run in same orientation and blending with internal and innermost intercostals.
▪ same function as internal intercostals.

51
Q

Transversus thoracis

A

▪Attaches superiorly on the posterior sternum and inferiorly on costal cartilages 2-6.
▪Functions to depress ribs

52
Q

levator costae

A

▪O: Transverse processes
▪I: Rib below between tubercle and angle.
▪A: Elevate ribs

53
Q

Serratus posterior superior

A

▪O: Spines of C7-T3
▪I: Ribs 2-4
▪A: Elevate ribs

54
Q

Serratus posterior inferior

A

▪O: Spines of T11-L2
▪I: Ribs 8-12
▪A: Depress ribs

55
Q

What forms the intercostal nerves

A

ventral rami

56
Q

roots function

A

carry sensory (dorsal) OR motor (ventral)

57
Q

rami function

A

mixed nerves and carry both sensory and motor

58
Q

dermatome

A

area of skin supplied by nerve from a single spinal root

59
Q

sensory impairment effect dermatome?

A

sensory impairment for a specific dermatome is related to level of spinal cord injury

60
Q

T1

A

medial arm

61
Q

T4

A

Nipple line

62
Q

T10

A

Navel

63
Q

Thoracotmy

A

surgical opening through the thoracic wall to access the lungs, heart, esophagus, diaphragm, and the thoracic aorta.

64
Q

Thoracentesis

A

a procedure to remove fluid from the space b/t the lining of the outside of the lungs (pleura) and the wall of the chest.

65
Q

Nerve root block

A

used to diagnose the specific source of nerve root pain and for therapeutic relief of low back pain and/or leg pain.

66
Q

Thoracic epidural steroid injections

A

most commonly used to reduce the pain associated with herpes zoster (shingles).

67
Q

Bucket handle movement

A

lateral-most parts of the ribs are elevated and the transverse diameter of the thorax increases

68
Q

thorax pump handle movement

A

The ribs are also elevated at the neck (especially ribs 2-6) resulting in an increase in the antero-posterior diameter

69
Q

inhalation

A
  • active, muscles contract
  • chest wall & lungs expand
  • expansion of ribs move sternum upward and outward
70
Q

exhalation

A
  • passive, muscles relax
  • chest cavity & lungs contract
  • ribs and sternum depress
71
Q

vasculature of the thoracic wall

A
  • parietal (somatic) branches of the thoracic aorta

- visceral branches of thoracic aorta

72
Q

what are the primary blood supplies to the thoracic wall derived from?

A

branches of the aorta and subclavian arteries

73
Q

internal thoracic artery

A

descends into thorax 1.2cm lateral to edge of sternum, and ends at 6th costal cartilage by dividing musculophrenic and superior epigastric arteries

74
Q

internal thoracic vessels

A

Give off anterior intercostal arteries to the first six intercostal spaces

75
Q

anterior intercostal arteries ____ with posterior intercostal arteries in the intercostal space

A

anastomose

76
Q

Posterior Intercostal Arteries

A

▪Two of these arteries branch off the superior intercostal artery in the first two intercostal spaces
▪The remaining posterior intercostal arteries are branches of the descending thoracic aorta

77
Q

Posterior Intercostal Vveins

A

▪Most of these veins return blood to the azygos and hemiazygosveins.
▪Left superior intercostal is the exception

78
Q

Spatial relationships in intercostal space

A

innermost intercostal muscle consist of vein, artery, nerve.. it lines in between the external and internal layers reflected

Anatomy Exam 2 (6 decks)

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