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Anatomy > Thoracic Wall > Flashcards

Thoracic Wall Flashcards

1
Q

what is the thorax and what is its location

A

the chest cavity
-between neck and abdomen, enclosed by the ribs, sternum, and dorsal vertebrae

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2
Q

what are the 3 parts of the thorax

A

mediastinum and left and right pleural compartments

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3
Q

describe the shape of the thoracic cavity

A

shaped like a dome, birdcage or truncated cone

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4
Q

what is the floor of the thoracic cavity

A

diaphragm, convex in shape

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5
Q

describe the walls of the thoracic cavity

A

thin

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6
Q

what is a barrel chest characteristic of

A

emphysema

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7
Q

what are the functions of the thorax

A

-protect vital thoracic/abdominal organs
-resist the negative internal pressure created by the elastic recoil of the lungs
-provide attachments for and support the weight of the upper limbs
- provide the origin for some upper limb muscles and attachments for muscles of the abdomen, neck, back and respiration

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8
Q

what are the 3 types of ribs

A

true ribs, false ribs, and floating ribs

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9
Q

describe the true ribs

A

1-7 attach vertebrae to sternum. have cartilage at the ends

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10
Q

describe the false ribs

A

8-10 have cartilages attached to the cartilages of ribs superior, costal cartilage

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11
Q

describe floating ribs

A

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

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12
Q

what is the infrasternal angle

A

cartilages of ribs 7-10 join to form this

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13
Q

what is the intercostal space

A

separation between ribs and between cartilage

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14
Q

what is the superior thoracic aperture bound by

A

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

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15
Q

what seals the inferior thoracic aperature

A

the diaphragm

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16
Q

what do the articular facets of the head of the rib articulate with

A

the superior facet articulates with the vertebrae above the rib, the inferior facet articulates with the corresponding vertebra to that rib

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17
Q

where is the neck of the rib

A

in between the head and the tubercle

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18
Q

what does the tubercle of the rib articulate with

A

the articular facet of the tubercle articulates with costal facet of the transverse process of the vertebrae of same number

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19
Q

what does the sternal end of the rib do

A

connects to sternum to the cartilage of the rib

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20
Q

what runs in the costal groove

A

intercostal vessesl

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21
Q

where can supernumerary ribs occur

A

cervical ribs or lumbar ribs

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22
Q

what is thoracic outlet syndrome

A

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

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23
Q

what is the manubrium

A

the top part of the sternum

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24
Q

what are the notches in the manubrium

A

jugular notch, clavicular notch and notch for 1st costal cartilage

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25
Q

what does the body of the sternum do

A

has notches for costal cartilage

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26
Q

what is the xiphoid process of the sternum

A

the inferior portion of the sternum

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27
Q

what is a sternal foramen

A

failure of fusion between halves of the sternal bars during development

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28
Q

what are some chest wall deformities as a result of an abnormal sternum

A

pectus carinatum, pectus excavatum, cleft sternum, poland syndrome, ectopia cordis

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29
Q

what is pectus carinatum and when does it occur

A

abnormal development causing the sternum to protrude. can be at birth or adolescent males during growth spurts, can be congenital or genetic

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30
Q

what is pectus excavatum

A

abnormal development of the rib cage in which the sternum grows inward, cause is unknown, more common in males

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31
Q

what is congenital scoliosis

A

caused by a bone abnormality present at birth

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32
Q

what is neuromuscular scoliosis

A

a result of abnormal muscles or nerves, seen in spina bifida or cerebral palsy

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33
Q

what is degenerative scoliosis

A

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

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34
Q

what is idiopathic scoliosis

A

most common, no identifiable cause, may be inherited

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35
Q

what do upper ribs do at costotransverse joints

A

rotate

36
Q

what do lower ribs do at costotransverse joint

A

glide

37
Q

which ribs do not articulate with transverse processes

A

11 and 12

38
Q

what are costochondral joints

A

primary cartilaginous joints and they usually do not move

39
Q

what are intercondral joints

A

between costal cartilages 6-9 synovial joints
between cartilages 9 and 10, fibrous joint

40
Q

explain sternocostal joints

A

1st joint is cartilaginous
- joints 2-7 are synovial joints

41
Q

which rib joints have the most movement involed

A

costotransverse joints

42
Q

where are the intercostal muscles located and what is their function

A

occupy intercostal spaces and function during respiration by moving the ribs and keeping the intercostal spaces rigid

43
Q

what are the 3 layers of intercostal musclrs

A

external intercostal, internal intercostal, and innermost intercostal

44
Q

describe the attachments of the external intercostal muscles

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

45
Q

what is the function of the external intercostal muscles

A

elevate the ribs during forced inspiration, pull up on ribs

46
Q

describe the attachments of the internal and innermost intercostal muscles

A

they attach superiorly to the inferior border of the rib above and inferiorly to the superior rib below. fibers run inferoposteriorly

47
Q

what is the function of internal and innermost intercostals

A

functions to depress the ribs during forced respiration

48
Q

what separates the internal intercostal muscle from the innermost intercostal muscle

A

the intercostal neurovascular bundle

49
Q

describe the actions of the intercostal muscles during inspiration (breathing in)

A

external intercostals contract
internal intercostals relax

50
Q

describe the actions of the intercostal muscles during expiration

A

external intercostals relax and internal intercostals contract

51
Q

what direction internal and innermost intercostal muscles run

A

downward and outward

52
Q

where does the subcostalis attach

A

superiorly to internal surfaces of lower ribs near their angles and inferiorly to superior borders of ribs 2 or 3 levels below

53
Q

what direction do subcostalis muscles run

A

same orientation and blending with internal and innermost intercostals

54
Q

what is the function of subcostalis muscles

A

help breathe out and pull down on ribs

55
Q

where does the transversus thoracis attach

A

inferiorly on the posterior sternum and superiorly on costal cartilages 2-6

56
Q

what is the function of the transversus thoracis

A

depress ribs, involved in expiration

57
Q

what is the origin, insertion, and action of the levator costae

A

origin: transverse processes
insertion: rib below between tubercle and angle
action: elevate ribs

58
Q

what is the origin, insertion, and action of the serratus posterior superior

A

origin: spines of C7-T3
insertion: ribs 2-4
action: elevate ribs

59
Q

what is the origin, insertion, and action of the serratus posterior inferior

A

origin: spines of T11-L2
insertion: ribs 8-12
actions: depress ribs

60
Q

what is a dermatome

A

an area of the skin supplied by nerves from a single spinal root

61
Q

what are some important markers of the dermatome

A

nipples are at T4 and umbilicus is at T10

62
Q

what is a thoracotomy

A

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

63
Q

what is a thoracentesis

A

a procedure to remove fluid from the space between the lining of the outside of the lungs and the wall of the chest

64
Q

where is the needle inserted in a thoracentesis and why

A

above the ribs to avoid nerves and vessels

65
Q

what is an intercostal nerve block

A

injection to block sensory pain

66
Q

what is a nerve root block

A

selective nerve root block primarily used to diagnose the specific source of nerve root pain and secondarily for therapeutic relief of low back pain and/or leg pain

67
Q

what type of injections are used for shingles

A

thoracic epidural steroid injections

68
Q

what is the order of the vessels and nerves from superior to inferior

A

vein, artery, nerve

69
Q

describe what happens in the thorax during inspiration

A

-ribs raise
- increased volume leads to decreased pressure

70
Q

what is the result of the pump handle movement in inspiration

A

elevation of ribs, increase in antero-posterior diameter of thoracic cavity

71
Q

what is the result of the bucket handle movement in inspiration

A

elevation of ribs, increase in lateral diameter of thoracic cavity

72
Q

what muscle is responsible for passive breathing

A

the diaphragm

73
Q

what are the principle muscles of inspiration

A

-external intercostals
-diaphragm

74
Q

what are the principle muscles of forced expiration

A

internal intercostals and abdominals

75
Q

what is the primary blood supply of the thoracic wall derived from

A

aorta and subclavian arteries

76
Q

what branches from the aorta

A

posterior intercostals

77
Q

what branches from the subclavian

A

internal thoracic (left and right)

78
Q

where is the internal thoracic artery located

A

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

79
Q

what comes off of the internal thoracic artery

A

anterior intercostal 1-6

80
Q

what arteries do anterior intercostals 7-10 come off of

A

musculophrenic arteries

81
Q

what do intercostal veins drain back into

A

musculophrenic or internal thoracic veins

82
Q

what do anterior intercostal arteries anastomose with

A

posterior intercostal arteries in the intercostal space

83
Q

what do the posterior intercostal arteries branch off of

A

two of the arteries branch off of the supreme intercostal artery in the first two intercostal spaces. the remaining arteries branch off the descending thoracic aorta

84
Q

where do the posterior intercostal veins drain into

A

the azygous and hemiazygous/accessory veins

85
Q

which side are the azygous veins on

A

right side

86
Q

which side are the hemiazygous veins on

A

left side

87
Q

what is the exception to posterior intercostal veins

A

left superior intercostal

Anatomy (27 decks)

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